While ‘pitcher’s elbow’ is a popular term to reference arm soreness in baseball players, it isn’t a formal condition. 

There are a number of structures that can cause pain on the inside of the elbow. We see and treat a lot of throwers in the clinic that have medial elbow pain simply from muscle tightness. This is less concerning and relatively straightforward to treat. 

There are symptoms however that can indicate something more significant is going on, such as significant reduction in throwing power and velocity, pins and needles down the forearm or into the hand and tenderness directly over the bone.

Why does my elbow hurt after pitching?

We've seen hundreds of high-level throwers over the years, many at the professional level – pitchers with a high workload who are throwing bullpens and live outings week after week. One of the main areas that tightens up is the forearm flexor muscle group  (the ones attached to the bony bump on the inside of your elbow).

These are highly experienced baseball players who are strong, they have many years of throwing behind them, and they understand more than most, how to maximise and optimise areas of their body throughout the season. Still, they develop tightness in this area. 

Can massage help pitcher's elbow?

One of the quickest and easiest things we can do is relieve tightness in the flexor-pronators. Massage helps to stimulate blood flow, which can help with reducing sensitivity of the muscles and also allow greater ranges to be achieved with stretching and strengthening.

So, if you’re experiencing discomfort through the forearm flexors after pitching, massage can be a useful part of managing that.

Is soreness after pitching normal?

Some muscular soreness or tightness around the inside of the elbow doesn’t automatically mean that you’ve injured yourself. Provided it’s coming from structures like the flexor pronator group, in our experience, it’s more likely to be general soreness/tightness than an injury.

What changes the picture is when that discomfort is accompanied by a loss of function.

When is elbow pain a sign of a pitching injury?

In the clinic, it’s the combination of symptoms that we’re interested in. We look for recurring soreness or sharp pain over the elbow that’s accompanied by a loss of muscle strength, particularly if the player’s grip strength has reduced significantly when we test it. Another sign is a pitcher who is having trouble locating the ball or is unable to throw with the full force they normally would. 

As these things might indicate that some type of injury has occurred, if you are experiencing any of the above, we recommend you seek an assessment from a qualified health professional.

With a high-intensity throwing sport like baseball, some soreness and tightness is a normal part of putting your arm through that workload. The important thing is knowing what’s normal for you and what you need to watch out for.

Rest won’t always be enough to sort out an elbow problem, and continuing to throw through pain or a loss of function can turn a manageable issue into something that keeps you on the sidelines for much longer.

Hear from pro players we've treated and who have used our arm care programs here.

Keep working.

Jason & Josh