See More. Know Earlier.
Velocity gets all the attention. The tissue and workload behind it need to be tracked.
The pitcher who needs surgery 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, 2025 season, share of pitchers who appeared in MLB or spent the season on the MLB injured list; velocity — MLB Statcast.
So — what is an elbow ultrasound?
It's a quick, painless scan that uses sound waves — the same safe technology as a pregnancy ultrasound — to see the ligaments, growth plates, and tendons inside the elbow in real time. No needles, no radiation, nothing to feel but a dab of gel. We can even apply gentle stress to watch how the UCL — the ligament rebuilt in Tommy John surgery — is holding up under load.
Diagnostic ultrasound of a throwing elbow — the UCL and joint space in view.
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.
From booking to a plan, in four steps.
Book a visit
Tell us about your athlete's season. We schedule a scan at your home or the field — no clinic, no waiting room.
We come to you
A quick, painless ultrasound scan, plus a baseball-specific physical exam by a physical therapist.
Get your report
You receive a written findings report — and we walk you through it: what we saw, what it means, and what to do next.
Stay ahead
Track workload free in the Pitch Count Portal, and rescan through the season to catch changes early.
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 advanced imaging certification.
PitchSight pairs Josh Ostrom — a physical therapist who's spent a decade-plus with throwing athletes, from Little League to MLB — with Peter Aguero, one of the small number of physical therapists holding the RMSK — a musculoskeletal sonography credential built for physicians, where fewer than one in ten holders is a PT.
Meet the team →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 play, particularly pitching creates cumulative load that adds up. Make sure your workload is managed properly.
Anyone who throws hard for their age
High velocity is a significant risk factor for injury. If you're throwing hard relative to your age, monitoring your tissue response could prolong your career.
College and professional arms
When it's your career on the line, the stakes are highest. Arm yourself with objective information and protect the arm you have spent years building.
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.
Three season packages.
The clinical core. Three visits — pre-season, mid-season, and post-season — each with a dynamic-stress ultrasound, a baseball-specific PT exam, RMSK interpretation, and a written findings report. Includes Pitch Count Portal access with workload tracking.
Get in touch →Everything in Protect, plus an individualized arm-care program built from your athlete's own exam findings and reissued at each visit. Includes the PitchSight Arm Care Kit, a mid-season video check-in, priority scheduling, and an off-season throwing plan.
Get in touch →Everything in Prepare, plus six sessions with a contracted pitching coach working from a clinical directive, a direct line through the season, an upgraded kit, and an end-of-season report that's yours to keep to help guide your future throwing.
Join the waitlist →PitchSight is a screening and decision-support service. It is not a diagnosis and does not replace evaluation by a physician. Screening cannot predict injury — a normal result does not mean an arm cannot be hurt, and a flagged result does not mean an injury is coming. What it produces is information about the tissue three times a season, where families otherwise have pitch counts and the athlete's own account of how the arm feels. Where a finding warrants it, we refer you to a sports-medicine physician or physical therapist. PitchSight is an out-of-pocket service and does not bill insurance.
Questions, answered.
How is this different from an MRI?
MRI provides excellent static imaging. Ultrasound is well suited to assessing the UCL, and unlike MRI it lets us apply valgus load in real time and measure how the ligament and growth plate respond under stress.
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?
Not through PitchSight. If your athlete has a specific complaint, a single scan is useful — that's exactly what The Collective PT & Performance is for, and we'll refer you there. But a single screening scan on an athlete who feels fine is a different question: structural findings are common in healthy throwers, so without a baseline there's no way to tell what's normal for that athlete versus an early warning sign. What carries information is how your athlete's own tissue changes across a season, measured against their own baseline — which is why we sell a season rather than a one-off screen.
How long is a visit?
The ultrasound scan and physical exam are typically completed in about 30 minutes. Your written findings report is delivered within 24 hours through Carepatron, our HIPAA-secure clinical records system — separate from the Pitch Count Portal, which holds workload data only.
Is this covered by insurance or HSA/FSA?
PitchSight is an out-of-pocket service and does not bill insurance. We can provide an itemized receipt on request. Whether it qualifies for HSA or FSA reimbursement depends on your plan — confirm with your plan administrator.
Track the workload between visits.
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 — your 7-day workload compared to your previous 28-day average. Stay in the 0.7–1.3 range and you're building capacity safely; spikes above it have been associated with higher injury risk. ACWR is one signal among several, not a prediction — which is why we pair it with a physical exam and imaging. The portal calculates it for you after every outing.
(Mehta et al., 2022)
Open the Pitch Count Portal →