Little Leaguer Elbow was termed way back in 1960. It is now used as a diagnosis to describe the progression of overuse injuries to the medial elbow of pre-teens and teenagers.
Medial elbow pain affects 20-58% of youth baseball players. These types of injuries are predictable based on the athlete's bony development. When the youth athlete still is skeletally immature, the growth plate at the base of the medial elbow is the weakest link.
When under stress the skeletally immature athletic leads to traction of the growth plate on the medial elbow. As the medial growth plate fuses to the humerus, vulnerability shifts to the bone-ligament interface, so ligament damage becomes more likely damaged.
The primary cause of youth medial elbow damage is pitch count. Children throwing over 600 pitches per season are more than double their risk for an elbow injury. Young pitchers should not pitch on consecutive days or multiple times per day. Pitchers should not be utilized in high throwing positions such as catchers on “off days.” Players should also avoid pitching on multiple teams. Players also need to have a several-month “off-season” that is minimal in throwing.
Historically, it has been educated to medical professionals, coaches, and parents that curveballs and other forms of off-speed pitches should be avoided until high school.
Recently research suggested that other factors;
- Such as pitch count
- Rest in between pitch outings
- Proper body mechanics are more important consideration.
- Pitch type does not affect elbow injury rates; in particular, curveballs are no more hazardous than any other pitch.
The classic presentation for Little Leaguer Elbow is the young athlete complaining of medial elbow pain in their throwing arm. Pain and discomfort can start anytime but often starts mid to late season, as pitch counts, workload increases, and rest is decreases. Or it could be seen after a single game with an increased pitch count without appropriate rest.
Little Leaguer Elbow typically responds well to conservative management. Rest and anti-inflammatory modalities are the most common forms of early treatment. Similar to other overuse injuries, elimination of the aggravating factor is the key to treatment.
Even though it is unpopular, the most effective treatment requires that the athlete stop all throwing for a short period of time. Athletes may need to selectively restrict throwing for up to four to six weeks. Even though we want to rest the elbow the athletes should remain active to maintain fitness levels.
If your child is having elbow pain - do not let them play through the pain. Let’s get them in and assess their movement patterns. At Impact Health and Performance, we work closely with coaching professionals to ensure that they can continue to play injury and pain-free.