Little league elbow is an overuse injury caused by overloaded stress to the inside- medial- aspect of an athlete’s elbow that has open growth plates. This is described as an excessive pull on the tendons and ligaments which could cause damage to the growth plate itself because growth plates are formed with cartilage cells that are soften and more vulnerable than mature bone cells. Growth plates close when an athlete reaches physical maturity after adolescence. Therefore, athletes with little league elbow are adolescents or younger.
Symptoms
- Pain on inner elbow
- Longer recovery times after throwing
- Decreased throwing velocity- or speed/force
- Locking of elbow
- Decreased range of motion
- Swelling
- Sometimes a “pop” is felt
Causes
- Excessive throwing in an athlete with open growth plates
- Poor throwing mechanics
- Repeated overhead throwing
- Lack of muscular strength and endurance
Risk Factors
- Athletes ages 8-15
- Pitchers
- Single sport athletes in an overhead throwing/hitting sport
- Year round throwing athletes
- Non-conditioned athletes beginning an overhead throwing sport
- Increased intensity in throwing at a young age
Prevention
- Adhere to pitch counts and guidelines
- Stop throwing if pain occurs
- Proper warm-up and cool-down
- Playing more than one position
- Playing more than one sport
- Not playing a sport for more than 4 months at a time
- Avoiding playing on multiple teams with overlapping seasons for the same sport
- Emphasize good throwing mechanics
Diagnosis
- Physical examination by physician
- X-rays performed to rule out other diagnosis
Treatment Options
Non-surgical
- Rest, ice, compression, elevation (R.I.C.E.)
- Physical therapy to improve technique and to strengthen muscles around elbow
- Significantly decrease amount of throwing (or complete rest)
- Slow gradual return to pitching
Surgical
- If an avulsion fracture occurs an arthroscopic surgery will be performed to clean out the joint space and reattach soft issue to bone.
- Epiphyseal fractures- growth plate fractures or “Salter Harris -Fractures”- may need surgical intervention to heal properly
