Pitchers breathe a sigh of relief when elbow trouble turns out to be loose bodies instead of ligament damage. Nobody wants to hear “Tommy John surgery” – that’s at least a year on the shelf.
But loose bodies aren’t exactly a walk in the park either. They can still require surgery, and any elbow procedure is serious business for a pitcher in today’s game.
Several top arms have dealt with loose-body issues recently, so here’s what you need to know about this elbow injury and how it’s different from the kind that leads to Tommy John surgery.
What Are Loose Bodies?
According to the Colorado University School of Medicine, loose bodies are “small pieces of bone or cartilage that have broken off and are lying or floating free within the joint.”
They’re not exclusive to the elbow, but that’s where they matter most for pitchers when they start causing problems.
Think of it this way – muscles, ligaments, tendons and cartilage all work together to let bones move freely at joints. Sometimes small pieces break off and limit range of motion.
For most people, it’s a minor inconvenience. For pitchers whose arms are their livelihood? That’s a different story. Even a slight drop in velocity can throw off a pitcher’s entire game.
What Causes Loose Bodies in Pitchers?
Loose bodies can stem from traumatic injury or inflammatory diseases like osteoarthritis. But for pitchers, it’s often just the repeated throwing motion itself.
Yankees team physician Dr. Christopher Ahmad explained it well in 2019: “Hard throwers, including pitchers and position players, not only impose great force on their UCL, but they also put great force on the bone at the back of the elbow, called the olecranon. This additional stress can create bone spurs, also called osteophytes.”
That’s where loose bodies come in. When pieces of those bone spurs chip off, you’ve got loose bodies floating around in there. Bone chips and loose bodies are basically the same thing – loose bodies is just the formal medical term.
What Does It Feel Like?
Stiffness and pain are the main symptoms, but there’s more to it than that.
“Patients may experience a ‘catching’ sensation or be aware of something moving around inside the joint,” according to Colorado University’s medical school. “A loose body can create a feeling of the elbow being stuck, then it will suddenly ‘click-free.'”
Now that sounds uncomfortable. Pain and stiffness can also signal ligament damage, which is why a loose bodies diagnosis actually comes as a relief – it’s much less serious.
Treatment and Recovery Timeline
For regular people, doctors typically focus on reducing pain and swelling rather than removing the chips unless they’re causing serious problems. Pitchers are different – they need full range of motion to perform at their best, so surgery is more common.
The good news? It’s arthroscopic and minimally invasive. The timeline is usually 2-3 months for a return to the mound.
That’s what Dodgers closer Edwin Díaz was looking at after his procedure in 2024. Spencer Schwellenbach, Hunter Greene and Tarik Skubal all had the surgery that year too, with Greene’s recovery expected to take 3-4 months while Díaz’s was 2-3 months.
Carlos Rodón had surgery to remove bone chips after the 2023 season, but his procedure also included shaving down a bone spur, which cost him more than six months.
Veterans like Stephen Strasburg, Carlos Carrasco and Yu Darvish have all had the procedure in the past. Most waited until season’s end and were ready for spring training.
While the surgery itself is minimally invasive, pitchers put so much force on their elbows that everything needs to be fully healed before they can start throwing again. It’s not the worst injury a pitcher can face, but it’s still significant enough to derail a season if the timing’s wrong.
