A flexor pronator strain of the elbow is a common source of pain in the elbows of pitchers. The pain is located on the medial side of the elbow (the inside of the elbow closest to the body). There are many causes of pain on the medial side of the elbow in pitchers and other throwing and overhead athletes, such as medial epicondylitis (“golfer’s elbow), ulnar neuritis or ulnar nerve compression, and ulnar collateral ligament injury. Therefore diagnosis of this injury can be difficult.

Signs and symptoms of a flexor pronator strain

A flexor pronator strain can either result from an acute event or can develop as a result of overuse. A pitcher who has an acute flexor pronator strain will remember a specific throw where he felt sharp pain on the medial side of the elbow. His pain will usually be located just past the bony prominence on the inside of the elbow. He often will have pain flexing the wrist or pronating the forearm.

Location of flexor pronator injury
The flexor pronator muscle are a source of medial elbow pain in throwing athletes. Note the location of the flexor pronator origin (orange arrow).

Diagnosis and treatment of a flexor pronator injury

Evaluation by a sports medicine physician is important soon after the injury to try to determine the correct diagnosis quickly. X-rays are usually normal with this injury. In high-level athletes an MRI is often ordered to ensure that the pain is not coming from an underlying injury to the ulnar collateral ligament, also known as the Tommy John injury. Most of the time, a flexor pronator strain is treated with rest from pitching for several weeks to give the tendons time to heal. Ice and physical therapy can also be helpful to decrease the athlete’s symptoms. As the pain improves, the pitcher will be started on a long toss program prior to returning to full pitching.

I want to help you! Please take a few seconds to share the biggest challenge or struggle you’re facing with your injury! Click here!

Recommended Products and Resources
Click here to go to Dr. David Geier’s Amazon Influencer store!
Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. While this information and these products are not intended to treat any specific injury or illness you have, they are products I use personally, have used or have tried, or I have recommended to others. THE SITE MAY OFFER HEALTH, FITNESS, NUTRITIONAL AND OTHER SUCH INFORMATION, BUT SUCH INFORMATION IS DESIGNED FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY. THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. YOU SHOULD NOT RELY ON THIS INFORMATION AS A SUBSTITUTE FOR, NOR DOES IT REPLACE, PROFESSIONAL MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT. THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USER’S PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. Please note that as an Amazon Associate I earn from qualifying purchases.