Little Leaguer's Elbow

Little Leaguer's Elbow: Prevention & Treatment

-Dr. Andy Harmon, DC


It's that  time of year again. Nothing says springtime like Little League baseball. As a kid, I could hardly wait for the sunny weather, the smell of freshly cut grass, and most of all, playing baseball again. As a physician, this is also the time of year that we see a significant influx of young patients, typically 6-15 years-old, complaining of elbow and shoulder pain.

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What is Little Leaguer's Elbow?

Little Leaguer's Elbow, also called medial apophysitis, is a painful condition most commonly seen in children involved in throwing sports, such as baseball. The condition is associated with pain at the medial elbow (the side of the elbow that is closest to the body. This pain can become chronic (long-standing) if the condition is not treated appropriately.

The bump on the inside of the elbow is called an epicondyle. Muscles that flex the wrist attach at this point. In a child, the bones grow from areas called growth plates. There is a growth plate at the medial epicondyle called the medial apophysis. In Little Leaguer's Elbow this growth plate is irritated, inflamed, and can even be fractured.  

How does it Occur?

Little Leaguer's elbow is caused by too much throwing. Too much throwing puts stress on the muscles that attach to the inner side of the elbow. The growth plate becomes inflamed. In severe cases, the growth plate may actually break way from the upper arm.  

How is it diagnosed?

Your health care provider will examine your child's arm and elbow. There will be tenderness along the medial epicondyle. Your child will feel pain when he or she throws a ball for the provider. X-rays may show irritation or a break in the growth plate.

 

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Treatment

The most important treatment for Little Leaguer's elbow is to not throw if the growth plate is inflamed.

  • Ice packs should be placed on the elbow for 20 minutes every 3 to 4 hours for 2 to 3 days to reduce inflammation.
  • Myofascial Release Technique can treat the muscles pulling on the medial elbow to reduce the stress on the epicondyle. This will promote healing and pain reduction.
  • Kinesio-Tape may be applied to support proper biomechanics and muscle function.
  • Your child will be given rehabilitation exercises.
  • Your child's medical provider may recommend an anti-inflammatory medicine.
  • In severe cases of Little Leaguer's elbow where there is a break in the bone, surgical consultation may be needed.
  • Returning to baseball should be gradual. Throwing through pain is never appropriate for Little Leaguers.






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Prevention is the Best Medicine

This is especially true in youth sports. Over-ambitious parents and coaches can allow children to place so much stress on their arm that the condition becomes a serious and long-term problem.

Pitch-counts: The most accurate way to monitor the volume of stress placed on a pitcher is by counting the number of pitches thrown. The American Sports Medicine Institute has contributed in developing the current Little League pitch count regulations. This information is available at http://www.littleleague.org/ and can be accessed by clicking on the 'Rules' tab and selecting 'Pitch Count Resource Page.' Limiting the number of pitches per day and per week has dramatically reduced the occurrence of throwing injuries in children.

 

Encouraging healthy competition is important in youth sports, however, this should not be at the cost of a child's health. Throwing through pain is never appropriate for Little Leaguers.

-Dr. Andy is a sports chiropractor in Boulder, CO who specializes in the diagnosis and management  of soft tissue injuries.

 

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