Little League Elbow: Prevention, Symptoms and Treatment

As spring rolls around each year, baseball and softball players are getting prepared for the new season.  During this time, our experts see many young athletes in our clinic with elbow pain or symptoms. Little League elbow, also known as medial epicondyle apophysitis, is one of the most common conditions causing elbow pain in young athletes involved in throwing sports. 

We caught up with Dennis Coonan, manager of the Sports Medicine Center, to learn more about what to look out for, how to prevent and how to treat Little League elbow. 

What is Little League elbow?

Little League elbow is an overuse condition caused by repetitive throwing, which causes stress to the elbow that leads to inflammation and irritation. This irritation specifically affects the growth plate on the inside of the elbow. This is especially harmful to kids that are still growing because the growth plate tends to be more vulnerable to injury than the ligaments and tendons that surround the elbow. 

Left untreated, it may result in growth plate damage, chronic pain and loss of range of motion. 

Who gets Little League elbow?

Most frequently, Little League elbow affects pitchers ages 9 to 14 but can also affect baseball players in other positions such as catcher or outfielder. Due to the name, Little League elbow is widely considered a baseball or softball injury. When in reality, athletes from sports such as volleyball and football can also suffer from the condition because of repeating spiking or throwing of the ball.

What are the symptoms of Little League elbow?

The symptoms of Little League elbow include:  

• Pain and inflammation on the inside of the elbow (the pinky side) 

• Swelling 

• Weak or painful grip strength 

• Stiffness 

• Dwindled throwing velocity or restricted range of motion 

• A popping or catching sensation when throwing 

• Increased fatigue 

• Numbness or tingling in the fingers or arm 

• Bruising 

How to prevent Little League elbow

Your child can reduce the risk of developing Little League elbow by adhering to pitch count and pitch type recommendations depending on athlete age. Throwing too many pitches, not taking enough rest days and throwing certain types of pitches such as sliders and curveballs at a young age can increase the risk of developing Little League elbow. Additionally, proper pitching and throwing mechanics are paramount in helping to prevent elbow injuries. 

To reduce the risk of Little League elbow and pitching related injuries, USA Baseball provides guidelines that can be used by coaches and parents to ensure proper pitching. 

What is the treatment for Little League elbow?

In young pitchers, prevention is truly the name of the game. That may include changing pitching style or addressing throwing techniques to catch possible errors in mechanics. Further, early recognition of this condition can reduce severity of injury and treatment options.  

Treatment options of Little League elbow include: 

• Rest: taking time away from throwing is the most important treatment, and may require time away from the sport to heal 

• Ice: applying ice 15 to 20 minutes at a time, a few times a day can reduce pain 

• Physical therapy: strengthen the muscles around the elbow/forearm to better protect elbow from injury 
• Surgery: in severe cases, surgery may be the best option when other treatments are ineffective