The posterior (back) aspect of the elbow is also subjected to significantly increased forces during throwing and, like the medial side of the elbow, can experience injuries ranging from stress fractures to avulsion fractures. The patient may experience pain in the back of the elbow as well as increased discomfort when attempting to extend the elbow against force. X-rays show changes, particularly a widening or fragmentation of the growth center (Fig. 3). Treatment consists of immobilization until the pain and tenderness have resolved. If, however, the fracture fragment has shifted away from the bone, surgery may be required to replace it.