FIGURE 121.11 Elbow MRI with abnormal marrow edema within the medial epicondylar apophysis and hyperintensity of ulnar collateral ligament at the attachment to the medial epicondyle Treatment emphasizes rest for a period of at least month, application of ice, and return to activity only after all pain is gone Once activity is resumed, the athlete must concentrate on limiting the total amount of pitching, as well as minimizing stress on the medial epicondyle by employing an overhand rather than sidearm pitching motion Routine stretching and range-of-motion exercises