Little League Elbow
(Elbow, Little League; Medial Apophysitis; Overuse Elbow Injury Related to Throwing)
Little League elbow is pain in the elbow joint due to repetitive throwing. This injury occurs in young baseball pitchers before puberty.
The Elbow Joint
During this injury, the ligament attached to the inner side of the elbow begins to pull one of the growth plates away from the rest of the bone. Because the bones are still growing, the growth plates are weak and susceptible to injury. Certain types of throwing may lead to this condition, such as:
- Throwing too hard and too often
- Increasing the number of pitches per week too quickly
- Throwing too many curves or sliders at a young age
- Changing to a league where the pitcher's mound is farther away from home plate or the mound is elevated
These factors increase your chance of developing Little League elbow. Tell your doctor if you or your child have any of these risk factors:
- Age: 10-15 years old
- Sex: male (more boys than girls are baseball pitchers)
- Baseball pitching, especially throwing curve balls or sliders
- Pain around the bony knob on the inner side of the elbow
- Swelling (possibly)
- Pain when throwing overhand
- Pain with gripping or carrying heavy objects (sometimes)
The doctor will ask about:
- How the injury occurred
- When the pain began
- Any prior elbow injuries
The doctor will also:
Treatment and recovery depend on the severity of the injury. Recovery time ranges from 6 weeks to 3 months.
- Rest—Do not pitch or do activities that cause elbow pain. Do not play sports until the pain is gone.
- Cold—Apply ice or a cold pack to the outside of the elbow. Do this for 15-20 minutes, four times a day, for several days. Wrap the ice or cold pack in a towel. Do not apply ice directly to your skin.
- Medication—Ask your doctor about pain medications]]> because they can mask symptoms. If you or your child has elbow pain, be sure to call the doctor.
- Physical therapy—After the pain is gone, ask your doctor about ]]>strength exercises]]> .
- Gradual return to pitching—Begin throwing motions. Gradually progress to pitching as recommended by your doctor. Your coach should also know about your treatment.
- Surgery—This may be needed to reattach the ligament and bony fragment. This is rarely needed.
To reduce your chance of getting Little League elbow, take the following steps:
- Warm up before pitching with light aerobic exercise]]> (eg, jogging).
- Stretch your muscles slowly and gently before pitching.
- Follow the pitching rules of your baseball league. Do not play in two leagues at the same time.
Limit your pitching to a maximum of 4-10 innings per week.
- In general, aim for no more than 80-100 pitches per game, or 30-40 pitches per practice.
- Learn and practice good pitching techniques.
- Do not throw curve balls and sliders until high school. This is when the growth plate in your elbow is fused with the bone.
American Academy of Orthopaedic Surgeons
American Academy of Pediatrics
American Orthopaedic Society for Sports Medicine
About Kids Health
Canadian Orthopaedic Association
Aydt S. Little league baseball and the pitch count. The National Athletic Trainers' Association website. Available at: http://www.nata.org/ . Accessed July 22, 2008.
Don’t let injuries keep your child in the dugout. Orthopaedic surgeons provide tips to prevent youth baseball and softball injuries. American Academy of Orthopaedic Surgeons website. Available at: http://www6.aaos.org/news/PEMR/press_release.cfm?PRNumber=468 . Published April 2006. Accessed July 22, 2008.
Overuse elbow injury related to throwing. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 2008. Accessed July 23, 2008.
Professional Team Physicians, Inc. website. Available at: http://www.straws.com/ptp.htm . Accessed July 22, 2008.
Risk of injury from baseball and softball in children 5 to 14 years of age. American Academy of Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/content/abstract/93/4/690 . Published April 1994. Accessed July 22, 2008.
Last reviewed November 2008 by ]]>John C. Keel, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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