Little Leaguers Elbow

It’s springtime.  Time for pitchers and catchers.  If your child is one of the more than 2 million kids participating in little league this year, then did you know that he or she has a 20-25% chance of developing symptomatic elbow pain?  You may want to read on.

The term little leaguers elbow refers to elbow injuries which are unique to the immature and still growing athlete.  As the term would imply, these athletes are most often participating in little league baseball, but similar injuries can also be sustained by such immature athletes participating in softball, tennis, golf, and gymnastics.

These injuries are usually overuse injuries as opposed to acute fracture or sprain.  One common elbow injury is referred to as apophysitis.  An apophysis is a bony outgrowth and area for attachment to a tendon.  This region is generally weaker than the attaching tendons and so becomes the region most prone to failure from overuse.  Portions of this apophysis may be gradually pulled off during repetitive throwing, causing pain along the inner side of the elbow.

Throwers will often begin to complain of an inability to throw as hard or as far as usual.  Swelling, inner elbow tenderness, and a loss of elbow motion may also occur.  When such symptoms arise, these throwers need to shut it down and discontinue throwing immediately.  They should be assessed by a sports medicine specialist.  Typically, x-rays and occasionally an MRI will be ordered to assess the underlying damage to the joint.  If the damage is minimal, conservative treatment is generally recommended.  This would include several weeks of rest (i.e., no throwing).  Physical therapy is also helpful in resolving pain, swelling and restoring normal joint motion.  In severe cases, surgery may be required to stabilize the region.

Another common elbow injury may involve the development of loose bodies or bone/cartilage fragments (known as osteochondritis dissecans.  Often, such loose bodies would need to be removed arthroscopically.  Pain and tenderness for this condition is more typically experienced into the outer aspect of the throwing elbow.

Prevention is key for such overuse injuries.  Sound preventative measures would include proper preseason conditioning, good throwing mechanics, and proper warm-up exercises.  The main culprit for such overuse elbow injuries in throwers, however, is young throwers making too many throws.  Recommended guidelines should restrict pitchers ages 9-12 to no more than six innings each week, and no more than nine innings each week for those over 13 years of age.

The staff here at Physical Solutions will be happy to work with your thrower to help recover from these types of elbow injuries if they have already occurred.  We would be happier still to work with them before any complaints arise by getting them on a conditioning program to help them strengthen their core and loosen up their arms.  Give our office a call today.

Play ball.