Dr. Metzl’s Guide to Understanding Little League Elbow

What’s cool about the elbow?
The elbow is a fascinating part of the body.  Three bones meet to form the joint that connects the lower arm to the upper arm.  The ulna and radius are the two bones that come from the forearm and the humerus is the long strong bone of the upper arm.  In children and adolescents, the ends of these bones are made up of rapid cell producing cartilage plates called growth plates.  As children grow into adults their growth plates are gradually replaced by solid bone and growth stops.

What is Little League Elbow?
“Little league” elbow refers to a group of elbow injuries related to the stress of repetitive throwing in kids with open growth plates.  These injuries result from repetitively throwing a ball, which can lead t o tissue breakdown that is too fast for the body to repair.  This is called an overuse injury.  Overuse injuries are very common in the young athlete and they result from doing one activity over and over again.

Growth plates are the weakest part of a developing elbow because they are made of cartilage, which is softer than bone.  During the acceleration of the throwing motion, a large amount of tension is placed on the inner (medial) structures of the elbow.  In order to compensate for this, the outer (lateral) elbow structures become compressed.  Repetitive microtrauma to the growth plates from performing too many throwing motions results in little league elbow.

Warning Signs
The age range of young athletes most susceptible to little league elbow is 9-16 years old.  Overuse injuries typically have a gradual onset and get progressively worse as athletes try to throw though the pain.  The pain sets in with throwing or arm swinging motions and the discomfort can remain for several days.  Young athletes most commonly complain of elbow pain on the medial (inside part) of the elbow.  Baseball players, especially pitchers, are most susceptible to injury, however little league elbow injuries also occur in football players and tennis and squash players.

What should I do if I think I have little league elbow?
If you are feeling pain when you throw, it is important to let your coach or your parent know.  Elbow injuries should be taken seriously.  With the proper attention and strengthening, most of these injuries are fixable.  Ignoring the problem and delaying treatment can end a young athlete’s career.  Early detection is crucial.  If it hurts, get it checked out.

How is Little League Elbow treated?
Rest!.  Stop throwing until the symptoms subside.  This is the most important thing you can do for your injured elbow.  For the first 2 days, use ice packs every 4 hours for 20-30 minutes to reduce pain and swelling.  Anti-inflammatory medications can be used for a few days to help relieve acute pain.  Try not to take medication for more than a few days, however, because this may trick you into thinking you can go back to your sport before you are ready.  Typically, 2-4 weeks of rest are necessary.

It is important to begin a physical therapy program.  Weakness in the shoulder girdle can contribute to stress in a throwing elbow.  Using lower weights and higher repetitions will help improve strength and flexibility of the shoulder and relieve tension off of the elbow.  Follow your work-out with 20 minutes of icing and rest.

How do I prevent Little League Elbow?
Strengthening and proper throwing technique are the keys to preventing little league elbow.  It is important to fix the mechanics of a young athlete’s throwing.  A pitching coach can usually help with this, and we have throwing and strengthening programs that can help as well.

Pitch Count and Pitch Type: Find your age in the tables below to see what is safe when it comes to how any pitches you can throw and what type

*USA baseball Medical and Safety Advisory Committee Position Statement on Youth B Baseball Injuries.

Lessons for young athletes to remember:
    * Always warm-up before practice or a game
    * Never throw through pain

For more information please visit our website at drjordanmetzl.com