Little Leaguers Elbow

By: Brad Homan, D.O.


Baseball is a very popular youth activity and, as with any other sport, the athletes participating in America’s favorite pastime are at risk for injury. The physical demands of baseball, particularly the throwing motion, are hard on any individual but can have even greater consequences in the little league athlete. The overhead throwing technique can place an excessive amount of stress on the structures of the upper body, especially the adolescent elbow.

Repetitive throwing places a lot of stress and tension on the inside of the elbow. The tendons, ligaments and bony structures are all susceptible to injury from this tension. The tendons and ligaments can become inflamed, tear and can pull away from the bone. In adolescents this can be particularly dangerous because the bones in this area haven’t fully matured and this type of damage can cause problems with bone growth. In addition to the stress on the inside of the elbow, there can be compressive forces on the outside of the elbow which can injure the bone. This condition is commonly referred to as little league elbow.

The symptoms of little league elbow are pain on the inside of the elbow, decreased range of motion, locking of the elbow, and swelling. Treatment includes rest from all throwing activities, ice, and if the elbow is swollen an elastic compression wrap can be applied. If the pain persists after a few days of conservative treatment follow-up with a physician is very important to confirm the diagnosis. Anti-inflammatory medications and physical therapy may be prescribed. In worst case scenarios surgery may be required.

The best way to avoid little league elbow is prevention. Make sure the athlete warms up before throwing, gradually increases throwing intensity to build up arm strength and endurance, and limits pitches to 200 per week. Little league pitchers should not pitch more than three to four innings per game. If your child starts to complain of elbow pain, don’t ignore this and don’t encourage trying to play through it. Give adequate rest and consider the use of a throwing coach to ensure proper mechanics. Allowing the elbow to heal with a brief rest period followed by a gradual return to throwing will get the player back to sport as soon as possible.