With baseball season officially upon us, injuries are inevitable. (Much like allergies.) In fact, doctors see an increase in elbow conditions among young baseball players during this time. One of the most common elbow conditions is medial epicondylar apophysitis, generally known as Little League elbow.
What is Little League elbow?
Little League elbow is categorized as an overuse injury (injury sustained to a part of the body from a repeated action) that affects a growth plate found on the inside of the elbow. Growth plates are easily injured on children. Damage to growth plates can result in the improper or misshapen growth of the bone.
Who gets Little League elbow?
Little League elbow is most frequently found in pitchers but has also been seen in outfielders, infielders and catchers. It typically occurs in children between the ages of 8 and 15, and may even be seen in adolescents as old as 17 (if the bones haven’t finished growing).
This condition is directly linked to a certain number of throws each week, including games and practice time. The general guidelines are as follows:
- 75 pitches a week for 8 to 10 year-olds
- 100 for 11 to 12 year-olds
- 125 for 13 years and above
The injury typically occurs when a child exceeds the number of throws for his/her age range. Little League elbow is especially prominent in baseball players who participate in the sport year-round, as well as those who play for more than one team.
What are the symptoms of Little League elbow?
A child should stop playing immediately if any of the following symptoms appear during or after a game/practice:
- Aching or sharp pain on the inside of the elbow
- Locking of the elbow joint
- Restricted range of motion
- Swelling of the elbow
How is Little League elbow treated?
In the majority of cases, Little League elbow can be effectively managed with conservative treatment, which is done in three stages:
Rest. It is initially recommended that all throwing activities cease and the elbow be allowed to rest. Ice and nonsteroidal anti-inflammatory medication (i.e., Aleve®) can help relieve swelling and pain.
Rehabilitation. Your child’s doctor may recommend physical therapy exercises to help heal the injury and prevent it from reoccurring. This may include range of motion and strength exercises for the forearm, upper arm, back and shoulder.
Return to play. Children may return to playing when the pain is completely gone and they have full range of motion. This should include a gradual change over time from non-throwing positions (such as a designated hitter) to full throwing positions, like pitching.
As a treatment, surgery is rarely necessary. In such cases, it is only designed for girls over 12 and boys over 14. Depending on the type of injury the child sustains, surgery may include:
- Bone grafting to replace missing bone from the elbow
- Reattaching a ligament
- Removing loose bone fragments that tore away from the growth plate due to a detached ligament or tendon
How can Little League Elbow be prevented?
Though there is no 100 percent guarantee that Little League elbow can be prevented, a child’s risk may be reduced considerably by taking the following precautions:
- Always warm up before throwing
- Avoid certain types of throws, such as curve balls and breaking pitches until the age of 14. (With these types of throws, it is difficult to successfully execute the spin the ball requires. Children compensate for their inability to hold the ball properly, resulting in awkward twisting of the arm and elbow)
- Count pitches to ensure a safe range (the coach should count, too)
- Avoid playing other full-throwing positions on pitching days
- Stop playing if pain occurs and see a doctor as soon as possible
- Rest for a solid 24 to 48 hours after playing, including practice
For information on Little League elbow or other overuse injuries, or to schedule an appointment with one of our sports medicine specialists, contact Northeast Orthopedics and Sports Medicine today.