A common problem among young adolescent baseball players, little league elbow is a growth plate injury to the inner part of the elbow that occurs as a result of repetitive throwing motions. Most patients are able to return to their favorite sport pain-free after a period of rest and conservative treatments.
A common problem among young adolescent baseball players, little league elbow is a growth plate injury to the medial (inner) part of the elbow that occurs as a result of repetitive throwing motions. The growth plate is the attachment site for the group of muscles that flex the wrist and rotate the forearm.
Little league elbow is most often the result of repetitive throwing motions, which can create an overload or overstress injury to the medial elbow. During the throwing motion, a large amount of tension is placed on the medial elbow structures that can cause injury to the growth plate of the medial (inside) of the elbow.
If left untreated, little league elbow can become more severe, causing ligaments and tendons tears. In addition, tearing may cause tiny bone fragments to break off and travel to other areas of the elbow joint, disrupting normal bone growth, resulting in deformity.
Patients suffering from little league elbow often report a gradual increase of medial elbow pain and stiffness, particularly while throwing. As the condition progresses, the child will often experience a decrease in throwing velocity and effectiveness.
Adolescent pitchers, and other adolescent players who throw repetitively, have a high risk of developing little league elbow. If left untreated, little league elbow can lead to major complications and jeopardize a child’s ability to remain active in a sport, such as softball. Other factors that contribute to the development of little league elbow and the increased injury rates seen in pediatric athlete include:
However, overuse injuries, such as little league elbow, can often be prevented. Prevention techniques include:
If caught early enough and treated properly by a pediatric orthopaedic physician, little league elbow will heal completely and not cause any permanent elbow damage. To ensure a proper diagnosis, the orthoapedic physician will review the patient’s symptoms, clinical examination results, and x-rays.
Little league elbow treatment options are dependent on the extent of the growth plate injury. Left untreated, throwing injuries in the elbow can be very complex. However, younger children tend to respond better to non-surgical treatments, such as:
If pain persists after a few days of complete rest of the affected arm, or if pain recurs when throwing is resumed, it is recommended that the child stop the activity until cleared by a pediatric orthopaedic physician. Based on the severity of the injury, a 6-week period of rest may be recommended. Upon approval from the physician, a slow progressive throwing program may be instituted over the next 6-8 weeks. While rare, surgery or casting is occasionally necessary to relieve pain symptoms.
Dr. Drew Warnick and Dr. Paul Benfanti are board-certified sports medicine specialists at Children’s Orthopaedic and Scoliosis Surgery Associates, renowned for their high quality care in the treatment of pediatric sports injuries. To learn more about Children’s Orthopaedic’s sports medicine specialties, schedule an appointment at one their four Tampa Area offices.
Little League Elbow is a common problem among young adolescent baseball players.
It is a growth plate injury to the medial (inside) part of the elbow that occurs as a result of repetitive throwing motions. The growth plate is the attachment site for the ulnar collateral ligament and the group of muscles that flex the wrist and rotate the forearm.
Injury occurs when repetitive throwing motions create an overload or overstress injury to the medial elbow. During the throwing motion, a large amount of tension is placed on the medial elbow structures. With overuse, this tension causes injury to the growth plate of the medial (inside) of the elbow.
Little League Elbow can be serious if it be-comes aggravated. Repeated pulling can tear ligaments and tendons away from the bone. The tearing may pull tiny bone fragments with it in the same way a plant takes soil with it when it is uprooted. The tearing can disrupt normal bone growth, resulting in deformity.
Patients report a gradually increasing onset of medial elbow pain and stiffness, particularly with throwing. Eventually, the child will experience a decrease in throwing velocity and effectiveness.
Treatment for Little League Elbow is completely stopping any throwing activity. Up to 3 months of rest may be necessary. A slow progressive throw-ing program may be instituted when the elbow is healed.
Watch for fatigue (eg, decreased ball velocity, de-creased accuracy, upright trunk during pitching, dropped elbow during pitching, or increased time between pitches). If a youth pitcher complains of fatigue or looks fatigued, rest is rec-ommended.
Make sure to have an off season. No overhead throwing of any kind for 4 months a year. No com-petitive baseball pitching for at least 4 months per year.
Do not pitch more than 100 innings in games in any calendar year.
Follow limits for pitch counts and days rest.
Avoid pitching on multiple teams with overlapping seasons.
Learn good throwing mechanics as soon as possible. The first steps should be basic throwing, fastball pitching and changeup pitching.
Avoid using radar guns.
A pitcher should not also be a catcher for his team. The pitcher-catcher combination results in many throws and may increase the risk of injury.
If a player complains of pain in his elbow or shoul-der, discontinue pitching until evaluated by a sports medicine physician.
Inspire youth player to have fun playing baseball and other sports!
Your doctor diagnoses Little League Elbow based on your symptoms, clinical examination, and x-rays. X-rays may be ordered by your doctor to confirm the diagnosis or to exclude other prob-lems.
Usually Little League Elbow does not cause permanent damage. If caught early enough and treated properly by an orthopaedic physician, Little League Elbow will heal completely.
