Sports Medicine: Little League Elbow

What is little league elbow?

Little league elbow (Medial epicondyle apophysitis) is an overuse injury of the inner side of the elbow. This condition is a disruption of the growth plate at a part of the arm bone (humerus) that is closest to the elbow. Little league elbow affects young athletes that are still growing.

What causes little league elbow?

Little league elbow is caused by repetitive stress to the inner side of the elbow from throwing, causing inflammation to the growth plate. This injury is most often seen in baseball, but it can also be seen in other sports with a lot of throwing.

What are the symptoms of little league elbow?

The primary symptom of little league elbow is pain while throwing. This pain usually gets worse with an increased number of throws or when trying to throw with more velocity. Pain afterwards can last for several days. A loss of extension is often one of the earliest signs of little league elbow as well. The athlete may also say their elbow feels weak and that they have less control over their throws. In severe cases, the elbow may “pop” or be visibly swollen.

How is little league elbow diagnosed?

A physician will use a thorough history and physical examination to determine if an athlete has little league elbow. X-rays and/or MRI may be ordered to determine the severity of the injury and to evaluate for damage to surrounding structures. The physician may also order x-rays of the uninjured elbow to compare to the injured elbow, looking for changes in the growth plate.

What is the treatment for little league elbow?

Rest is the most effective treatment for little league elbow; how much rest depends on the severity of the injury. Physical therapy will be used to strengthen the muscles surrounding the elbow for a return to throwing. Once an athlete is released to begin throwing, a throwing progression should be used in order to slowly build up the elbow’s endurance. In severe cases, the medial epicondyle may be significantly separated from the humerus, and surgery may be required to reattach it.

What is the long term outlook for an athlete with little league elbow?

With proper treatment and rehabilitation, full return to activity is expected. The earlier little league elbow is diagnosed, the shorter the recovery time. If left untreated, this problem may cause long-term damage, including early growth plate closure, joint surface injury and inability to return to throwing.

It is important to follow pitch count guidelines for young athletes to help prevent little league elbow. Pitch count guidelines can be found on www.littleleague.org under the “rules and regulation changes” tab.