Educating the Athlete

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You Are Not Your MRI: Why Structural "Abnormalities" in Asymptomatic Pitchers Might Be Normal

A 2011 study found that nearly 70 percent of pain-free high school pitchers showed “abnormal” elbow findings on MRI, including UCL thickening, bone remodeling, and osteophytes, changes that are often normal adaptations to throwing. Follow-up research in high school, college, and professional players shows the same pattern: structural abnormalities on imaging frequently don’t match symptoms, performance, or injury risk. The takeaway is simple—MRIs are a tool, not a diagnosis, and decisions about treatment should be based on symptoms, function, and clinical context, not imaging alone.

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