How does valgus extension overload differ from ulnar collateral ligament injury in terms of symptom location?

Valgus extension overload (VEO) and ulnar collateral ligament (UCL) injuries are both common conditions affecting the elbow, particularly in throwing athletes, but they manifest distinctly in terms of symptomatology and the activities that exacerbate or alleviate the pain.

In the case of valgus extension overload, the pain is typically associated with the deceleration phase of throwing. This phase occurs when the arm transitions from the acceleration phase to follow-through, resulting in significant stress across the elbow joint, particularly at the anterior aspect where structures experience compression. Consequently, athletes often report pain located at the anterior aspect of the elbow due to this overload, especially when attempting to throw or during rapid deceleration of the arm.

On the other hand, an ulnar collateral ligament injury tends to present pain during the acceleration phase of throwing. This is when the medial side of the elbow is under significant stress from the high torque and stress applied while the arm accelerates through the delivery of the pitch. The pain associated with a UCL injury typically manifests on the inner (medial) aspect of the elbow, reflecting the site of the ligament's attachment and the stress it incurs during this phase of throwing.

Thus, understanding the timing of the pain relative to the phases