Three visits over one season.
PitchSight uses diagnostic musculoskeletal ultrasound to see the structures inside a thrower's elbow in real time. It's painless, there's no radiation, and we come to you. We work in full seasons rather than one-off scans, because a single image is hard to interpret on its own. What matters is how an athlete's tissue changes from pre-season to mid-season to post-season, compared against their own baseline. Every visit pairs the scan with a baseball-specific physical therapy exam, and every athlete gets the Pitch Count Portal to track workload in between.
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.
Pick your level of coverage.
The clinical core is identical in all three. Same visits, same exam, same ultrasound, same RMSK interpretation, same findings report — at every price. The packages differ only on coaching, access, and convenience.
Inaugural season pricing, 50% off, runs through the end of the 2027 season.
Three visits, each with an ultrasound interpreted by a RMSK-credentialed clinician, a baseball-specific PT exam, and a written summary. Includes free Pitch Count Portal access.
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.
Get in touch →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. Without a baseline it's harder to tell what's normal for that athlete — so if you'd like a single scan, you can schedule one at The Collective PT & Performance.
What every scan looks at.
Every structure the throwing elbow puts at risk.
Ulnar collateral ligament (UCL)
The ligament on the inside of the elbow — the one reconstructed in Tommy John surgery.
What we check: UCL integrity at rest and under dynamic valgus stress
Medial epicondyle growth plate
In young throwers, the growth plate is the structure most vulnerable to overuse.
What we check: Growth plate gap measurement at rest and under valgus stress; bone contour and early stress signs at the growth plate
Radiocapitellar joint
The joint on the outside of the elbow, where repetitive throwing stress can wear on cartilage and bone.
What we check: Joint swelling or fluid buildup
Ulnar nerve
The nerve that runs behind the elbow — the "funny bone" — which can become irritated with throwing.
Flexor tendon
The forearm tendons that help stabilize the elbow through the throwing motion.
What we check: Flexor tendon stress signs or injury
Imaging is always followed by a physical exam.
A scan captures the tissue at one moment. The physical exam shows how the whole body creates velocity, and where that's putting stress.
The scan tells us about the tissue. Watching the athlete move tells us the rest.
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.
Watching the arm across a whole 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.
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, it's 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 can help, and that's what The Collective PT & Performance is for — we'll refer you there. A one-time screening scan on an athlete who feels fine is a different story. Structural findings are common in healthy throwers, so without a baseline there's no way to tell what's normal for that athlete from an early warning sign. The useful information comes from watching how the tissue changes over a season against that baseline, so we sell a season rather than a single screen.
How long is a visit?
The ultrasound scan and physical exam are typically completed in about 45 minutes. Your written findings report is delivered 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 acute-vs-chronic workload, and flags when rest is warranted. It holds workload data only — no clinical records. Your findings reports are delivered separately through Carepatron, our HIPAA-secure clinical records system.
Open the Pitch Count Portal →What is Acute:Chronic Workload Ratio (ACWR)?
Acute:Chronic Workload Ratio compares an athlete's recent training load (the past 7 days) to their longer-term average load (their previous 28-day average) to estimate whether they're being pushed too hard, too fast. For throwers, workload can be measured in pitch counts and/or high-intent throws — and a spike in acute load relative to chronic load has been associated with increased injury risk, particularly at the shoulder and elbow. A single high-effort outing is not the problem. The body needs time to adapt, and a sudden jump from a normal week to a much heavier one can outpace it. ACWR gives coaches, parents, and clinicians an early, objective signal — a "yellow flag" — to build in recovery before that mismatch turns into an injury. While ACWR isn't a perfect predictor, it's one useful piece of a bigger monitoring picture, which is why PitchSight pairs workload data with a physical exam and imaging.