What is little league elbow?

Little league elbow is a common overuse injury seen in young athletes who play throwing sports, such as baseball. Also known as medial epicondyle apophysitis, little league elbow is caused by repetitive stress to the growth plate on the inside of the elbow. Children with growing bones are more prone to growth plate injuries because the growth plate is much weaker than the surrounding ligaments and tendons.

While little league elbow most commonly affects pitchers ages 9-14, it can also occur in catchers, infielders and outfielders. Infrequently, this elbow injury can occur in other overhead athletes, such as volleyball players and football quarterbacks. Little league elbow may also occur in skeletally immature athletes older than 14 if the growth plate has not fused.  

Little league elbow symptoms

The following symptoms may indicate the presence of little league elbow:

  • Aching, sharp pain and swelling on the inside of the elbow
  • Pain aggravated by throwing that worsens with continued use
  • Though less common, an athlete may suffer an acute injury to the elbow and feel a painful pop

Little league elbow diagnosis and treatment options

Little league elbow can be diagnosed with a physical examination and an x-ray of the growth plate. An x-ray can exclude other diagnoses and can determine if the open growth plate is showing signs of damage, such as widening, fragmentation or avulsion fracture. However, in some cases, patients experiencing pain may have a normal x-ray, which is why it is important to consult with your physician to help determine proper diagnosis.

The most effective treatment for a child diagnosed with little league elbow is rest from the activity causing the overuse injury. During this time, other activities not involving the overhead motion may be continued without causing additional injury. Ice and anti-inflammatory drugs can also help relieve pain and swelling with less severe cases.

For more severe cases, physical therapy is another treatment option for young athletes, including elbow range of motion and strength exercises with rehabilitation that may also include other parts of the arm, back and shoulders. 

Athletes can return to playing when they are pain-free and have full range of motion. However, a return to pitching and other activities should occur gradually to reduce the risk of additional injuries.

Steps to Prevent Little League Elbow

The risk of developing little league elbow can be reduced by following recommended guidelines for pitch count, pitch type and recovery days. Other preventative measures may include

  • Avoiding pitching through discomfort and pain
  • Practicing proper pitching and throwing mechanics
  • Taking active rest days to perform physical activities other than throwing
  • Year-round physical fitness, including conditioning and resistance training

Long-term outlook

While most cases of little league elbow can be resolved with rest and conservative pain management, recovery varies by the severity of the condition. Adhering to an individualized treatment plan will help ensure the prevention of future injuries that can have long-term consequences.

Learn more about growth plate injuries, and feel free to contact our Youth Sports Medicine clinic in Denver, Colorado for more questions or concerns.