Throwing places extremely high stresses on the elbow and thus overuse can damage the articular (cartilage) surfaces. Two characteristic areas are affected in throwing athletes: the olecranon process of the ulna and the distal humerus where it articulates with the radius, namely, the capitellum. In the olecranon, valgus forces erode the surface cartilage, and stimulate the production of bone spurs. In the distal humerus, more often the inciting pathology is ischemia of the subchondral bone causing osteonecrosis, a condition known as osteochondritis dissecans. Most patients with chondral injuries to the elbow recover with rest, but surgery may be needed if there are loose bodies or unstable cartilage flaps.
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