Posterior elbow pain may be caused by mechanical abutment of bone or soft tissues in the olecranon fossa which leads to osteophyte formation, loose bodies and is often associated with UCL instability. This overuse condition is generally caused by repetitive hyperextension, valgus and supination and is characterized by posteromedial olecranon osteophytes, chondromalacia of the medial wall of the olecranon fossa, tension on the medial ulnar collateral ligament and compression of the radiocapitellar joint. This valgus extension overload syndrome is commonly found in tennis players, boxers, weightlifters, gymnasts, martial arts and football lineman, but the most common diagnosis is in baseball players.

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