Causes / typical injury mechanism: Valgus extension overload, also known as pitcher's elbow, is repetitive microtrauma to the posteromedial elbow caused by throwing motions. This injury is not typically acute but rather progresses over months to years from overuse.

Classic history and presentation: Valgus extension overload is often an overuse injury seen in athletes. A typical patient is a semiprofessional baseball player presenting to an outpatient office relating pain in their posteromedial elbow. A typical history includes the patient noticing pain increasing over the past few months that gets worse after practice or games. The patient may relate that the pain gets worse with any arm extension. Patients usually find that their symptoms are relieved with rest from throwing activities.

Prevalence:

• Age – This is typically seen in young athletes.
• Sex / gender – There is no significant difference.

Risk factors:

• Throwing athletes, such as in baseball and softball.
• Athletes in nonthrowing sports, including swimming, volleyball, gymnastics, racquet sports, and golf.

Pathophysiology: The tip of the olecranon is repeatedly pressed into the fossa with forcible extension at the elbow. Along with excessive valgus force at the elbow, this may cause posteromedial impingement of the ulnar collateral ligament (UCL), leading to osteophyte formation and irritation.