PTCase SeriesInternational journal of sports physical therapy2025

A Multimodal Chiropractic Approach to the Treatment and Management of Medial Elbow Injuries in Elite Javelin Throwers: A Case Series.

Angus S McEntyre, Natalie C Clohesy, David J Steven

PMID 40041535

WHAT IT FOUND

Five elite and amateur javelin throwers with medial elbow injuries, including ulnar collateral ligament tears and fractures, returned to competition within 12 to 26 weeks.

All achieved 'Excellent' status on the Conway scale after a multimodal chiropractic approach involving manual therapy, dry needling, laser, and progressive rehabilitation.

Key findings

01All five athletes returned to training and competition within 12 to 26 weeks of initial injury presentation, scoring 'Excellent' on the Conway scale.

02Athlete A, with a high-grade UCL tear and avulsion fracture, returned to high-level competition at week 24 and threw 3% greater than previous personal best by week 27.

03Athlete B, with Valgus Extension Overload Syndrome and a UCL rupture, was symptom-free at 11 weeks and returned to competition at week 20 with a 1.8% improvement on personal best.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

This is a case series with no control group, so a causal relationship between the chiropractic treatment and the outcomes cannot be established. The treatment was multimodal, making it impossible to determine which specific component (e.g., dry needling vs. manipulation vs. rehab) contributed to the improvement. There were no standardized patient-reported outcome measures (PROMs) used to objectively quantify functional change beyond the Conway scale and throw distance. The athletes were elite or state-level competitors, so results may not generalize to recreational throwers or those with less access to specialized coaching and rehabilitation. Improvements could be due to the natural passage of time or concurrent training modifications rather than the chiropractic interventions.

Declared interests

No conflicts of interest or funding sources are declared in the provided text.

The easy way to misread this

Do not assume that chiropractic manipulation or dry needling was the primary driver of recovery. The athletes also underwent significant training modifications, rest, and a structured strength and conditioning program, and without a control group, the specific contribution of the manual therapies cannot be separated from natural healing or the other concurrent interventions.

Read it on PubMed →