Anterior Elbow Pain

[miketace]

My son, a 17 yo baseball pitcher felt tightness in his anterior forearm about a week ago that progressed to pain while pitching a couple days ago.  We've shut him down from throwing.  Right after the last time he pitched he had considerable pain when attempting resisted supination and his hand was shaking.  A couple days later he is still getting twinges when he flexes his elbow.  The pain due to resisted supination is much less.  The pain seems to be about 4cm distal to the elbow crease and deep to the brachioradialis muscle.  He has had pronator syndrome in the past but that pain was 2 to 3 cm medial to where he is feeling the pain now.  Any ideas what might be causing this?

[miketace]

This pain is located just lateral to the cubital fossa and deep so it doesn't seem to be the lacertus fibrosis compression that he had previously, although the pain on resisted supination would fit that.  I'm concerned about OCD as he has a bit more of a flexion contracture than I remember previously although once again the location of the pain doesn't really seem to fit OCD.  It could be a compression of the lateral cutaneous nerve I guess.  Just have to wait for his appt. with a specialist.

[dr_simran]

Hello miketace,

Pronator Teres Syndrome also known as pronator syndrome is uncommon and involves entrapment (compression or pinching ) of the median nerve at or about the level of the elbow. Compression of the median nerve at or just above the elbow leads to weakness of the pronator teres muscle. Median nerve entrapment at the elbow is a rare occurrence and is more commonly seen in children. Chiropractic care should be considered as the conservative approach to PTS. Your Chiropractor can aid you by helping to modify your daily activities, providing physical medicine modalities to relax and stretch the pronator muscles to reduce swelling and to aid in the return of movement of the median nerve between the two heads of the pronator teres muscle. Your Chiropractor may massage and mobilize the area as well as use ultrasound to break up adhesions which may be causing entrapment. Also your Chiropractor can manipulate your wrist, elbow, shoulder and neck to help keep the median nerve free in movement along its course.
Refer: http://www.geocities.com/HotSprings/2759/pts.htm
Best