See More. Know Earlier.
We got better at building velocity. Nobody was tracking the tissue and the workload behind it — together.
The pitcher who blows out at 22 likely had years of overuse leading up to it.
Sources: rise in UCL injuries — Zaremski et al., 2017; Tommy John rate — J. Roegele Tommy John Surgery List; velocity — MLB Statcast.
Built to watch a career.
The significant increase in throwing injuries is likely due to many factors, such as year-round pitching from an early age, early sport specialization, and extra emphasis on max effort and velocity. This leads to significant mileage on arms, and ultrasound can be a helpful tool to monitor how the tissue is handling the workload.
MRI needs symptoms and could be weeks or months to get scheduled. Ultrasound is fast, accessible, and safe. Scans throughout the year, compared against your own baseline, show whether the tissue is holding up under this year's workload, or starting to break down before it ever hurts. These imaging trends can help guide sports-medicine decision making on your load management to preserve the length of your career.
What we're looking at.
Every baseball player's elbow shows normal, adaptive changes on imaging. What matters is the abnormal — changes that line up with a physical-exam finding or an excessive workload. That's what guides the decisions we make together.
UCL integrity at rest and under dynamic valgus stress
Growth plate gap measurement at rest and under valgus stress
Bone contour and early stress signs at the growth plate
Joint swelling or fluid buildup
Flexor tendon stress signs or injury
Three scans. One season. Complete picture.
Establish your baseline.
Before the first pitch of the season, we image the UCL, growth plate, and surrounding structures at rest and under load. This baseline is the reference point for everything that follows — a true picture of your elbow before stress accumulates.
Monitor as the season builds.
Mid-season imaging catches changes before they become symptoms. We compare directly to your baseline, tracking tissue response as pitch counts and intensity climb. If something is developing, we can adjust your workload to reduce the likelihood of a major injury.
Understand what the season cost.
End-of-season imaging documents how your elbow responded to a full year of throwing. We assess recovery needs, guide your off-season arm care, and set up next year's baseline with a full season of context already in hand.
Imaging is always followed by a physical exam.
A scan shows the tissue. The exam shows the athlete.
How the athlete moves — their strength, their range of motion, their movement-pattern efficiency. We do a baseball-specific, full-body PT exam on every player.
Built by a pitcher's PT. Powered by physician-level imaging.
Josh Ostrom
PT, DPT, SCS, CSCS · Protocol Designer & Clinical InterpreterJosh developed PitchSight after a decade-plus working with throwing athletes, from Little League up to the MLB. Tired of watching the alarming rise in throwing injuries, he set out to get in front of them. He leads the interpretation of the full exam — translating findings into language that makes sense for players, parents, and coaches.
Peter Aguero
PT, DPT, RMSK · Imaging SpecialistPeter holds the RMSK — Registered in Musculoskeletal Sonography, a physician-level certification — and is an internationally recognized educator, keynote speaker, and published author in medical imaging. He reads and provides a diagnosis for every scan.
Built for players who want to last.
Youth pitchers aged 10–14
The growth plate is the most vulnerable structure in a developing arm. This is the age group where early intervention matters most.
High school and travel ball athletes
Year-round throwing and multi-position play create cumulative load that adds up fast. Seasonal imaging keeps you informed before it becomes an injury.
Post-injury or post-surgical return
Returning from a UCL injury or Tommy John — reconstruction, repair with an internal brace, or a hybrid. Monitor your tissue's response throughout your Interval Throwing Program.
Anyone who throws hard for their age
Velocity is the single biggest risk factor for arm injury. If you're throwing hard relative to your age, your tissue is carrying load that deserves to be watched.
College and professional arms
When it's your career on the line, the stakes are highest. Arm yourself with objective information and protect your investment in every outing.
Catchers & two-way players
Catching, or playing a position and pitching, stacks throws on top of throws. That extra volume is exactly what workload monitoring is built to catch.
Throwing hard for your age is itself a flag.
Velocity is a strong, well-documented risk factor for arm injury. When a pitcher clears these marks for their age, the arm is carrying load worth watching — even if nothing hurts yet. Our goal is to keep you on the field and make sure you get through the developmental stages healthy so that when you're older, you can have longevity at the highest level.
Source: Axe, Hurd & Snyder-Mackler. "Data-Based Interval Throwing Programs for Baseball Players." Sports Health, 2009.
Individual and team options.
A one-time diagnostic scan with dynamic stress testing, a baseball-specific PT exam, and a written findings report. A clear snapshot of where the arm is right now.
Book a scan →Pre-season baseline, in-season check, and post-season review — dynamic stress testing, PT exam, and a written report at every visit. The full picture, tracked across the year.
Book the season →Roster-wide scanning for travel, high school, and club programs. Priced by team size and how often you scan.
Call for team pricing →Questions, answered.
How is this different from an MRI?
MRI provides excellent static imaging but misses the dynamic component — how the UCL and growth plate behave under actual throwing stress. Ultrasound lets us apply valgus load in real time and measure how the tissue responds.
Is this appropriate for youth players?
Yes — and it is where it matters most. In youth athletes, the growth plate is the primary structure at risk, not the UCL itself. We assess both, using age-appropriate stress testing throughout.
What if something shows up?
All baseball players have normal adaptive findings on imaging for their throwing elbow. We establish a baseline, then look for excessive signs of stress in later scans. Some findings may mean temporarily reducing pitch count or innings, avoiding higher-risk positions, or adjusting the arm-care plan. More serious findings may lead us to recommend a temporary shutdown from throwing and/or a referral to a sports-medicine physician.
Do you need symptoms to benefit?
No — whether you're a parent asking about your player or an athlete checking your own arm, this is built for throwers who feel fine. By the time pain appears, the tissue has usually been under stress for weeks or months, so earlier information means more options.
Can we do just one scan instead of the full protocol?
Yes. A standalone scan provides value as a snapshot. The full seasonal protocol adds longitudinal context — the ability to compare across time — which is where the real clinical picture emerges.
What does team pricing include?
Team packages are customized based on roster size and desired assessment frequency. Contact us to discuss options for your organization.
Track the workload. Not just the scans.
The Pitch Count Portal is free and open to any athlete. Log pitches and high-intent throws after each outing and it applies MLB Pitch Smart guidance, tracks your workload, and flags when rest is warranted.
At its core is your Acute:Chronic Workload Ratio — how much you've thrown recently versus what your arm is conditioned for over the longer haul. Stay in the 0.7–1.3 sweet spot and you're building capacity safely; spike above it and injury risk can significantly increase. The portal calculates it for you after every outing.
(Mehta et al., 2022)
Open the Pitch Count Portal →