“Do just once what others say you can't do, and you will never pay attention to their limitations again.”
― James Cook

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Everything You Need To Know About Medial Elbow Pain

This week I have received 4 calls from moderately distressed parents of high school and college pitchers out on the summer ball/ travel ball circus.

Their sons are complaining of medial elbow pain.

Whenever I get these calls, the first thing I do is try to calm their fears.

I assure them that they have a great team of experts in their corner, and that whether the problem is just some minor inflammation or a major issue, the staff of The ARMory and Sullivan Rehab Services is well equipped to deal with it.

I always convey our sincere commitment to be there for them every step of the way as we walk through the recovery process.

I then take a brief history of the injury, and I have them send me a picture with one finger pointing to exactly where it hurts.


They usually point to the UCL area (that’s the now infamous “TommyJohn ligament). But the anatomy alone doesn’t tell the entire story. Diagnosing a medial elbow injury is difficult because the muscles that pronate the forearm and flex the wrist and fingers all insert very near the UCL.




Check it out:

If the pitcher is an active client of The ARMory, or if they have ever attended one of our 3 hour head-to-toe assessments, I pull their chart and look for any red flags that could indicate a predisposition to elbow problems.

The first step in managing medial elbow pain is to understand all the possible mechanical and physical contributors.

I describe them all in my dual video package called

Mechanical and Physical Contributors to Arm Pain. 









Mechanically, the most common contributors to medial elbow pain are:

1) Crossing the acromial line

2) Inverted W

3) Elevated distal humerus

4) Forearm flyout

5) Early torso rotation

6) Failure to engage the glutes

7) Disconnected lead leg

8) Front knee leaking forward after foot plant

9) Glove side disconnect

10) Failure to pronate the forearm and internally rotate the shoulder at launch

11) Failure to continue to rotate around the front hip

12) Elbow crossing the midline of the body after ball release

Physically, the constraints that often spawn the aforementioned mechanical inefficiencies are:

1) Scapular dyskinesia


3) Limitations in thoracic rotation (arm side and glove side)

4) Quad Tightness

5) Lead hip internal rotation deficit

6) Trail hip external rotator tightness

6) Hip Flexor tightness (on either side)

7) Lead hip lateral tightness

8) Tight hamstrings (mostly on the lead leg)

9) Poor ankle mobility (dorisflexion and eversion on both sides)

10) grossly insufficient lumbar flexion.

11) imbalance between accelerators and decelerators.

If you’d like an easy, stepwise,guide to assessing for these and every other known mechanical and physical inefficiency, check out my book and video called Engineering the Superhuman Pitching Machine vol 2: Conducting a World Class Pitcher Assessment. 

About a year and a half ago, Ron Wolforth of the Texas Baseball Ranch said to me, “Randy, you need to become known as the guy who does the best pitcher assessments in the world.”

I took heed, and got to work.

You’d be hard pressed to find any one who does a more thorough job of assessing physical, functional, and mechanical constraints in pitchers.

The evolution and development of our assessment process has been THEmost significant factor in the incredible results our students are getting.

The assessment serves as the template for every player’s individualized training plan.

We conduct our pitcher assessments every Wednesday night at 6:00 pm.

Click here to register for your evaluation.

I’ll be in Houston this weekend….and for many more weekends throughout the summer.

I have been invited by Ron and Jill Wolforth, to perform our physical and functional assessments as part of their unparalleled Elite Pitcher’s Boot Camps.

Here are the dates:

I am truly humbled and honored I am to be a part of the Texas Baseball Ranch Team. I hope to see many of you there.

The weekends I’m not in Texas, I will be right here in Tampa running our own amazing Rocket Launchers Training Camps.

Here are the dates for our camps:

Click anywhere on the image above and watch the short video to find out more about these exciting weekend events

Right now it’s after midnight.

I still have a ton of work to do, and I have a 7:25 am plane to catch, so I’d  better go.

Until next time,

When people begin to ask you, ‘When do sleep?’, your effort is beginning to approach the level necessary for success.

Randy Sullivan, MPT

CEO, The ARMory Power Pitching Academy

Owner, President

Sullivan Rehab Services

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