Little League elbow, also known as medial epicondyle apophysitis, or pitcher’s elbow, is a common injury that occurs among young baseball players. It is caused by overuse and repetitive motion. Little League elbow causes pain and swelling on the inside of the elbow. The condition can limit range of motion and will make it hard or impossible to throw a ball.
Causes
The forceful and repetitive nature of overhand throwing can cause inflammation of the elbow’s growth plate (area of new growth in the bones of children and teens). This overuse can result in Little League elbow. Youth baseball players are most likely to experience this injury because their elbow structure (including their bones, growth plates, and ligaments) is not fully developed.
The following risk factors contribute to Little League elbow:
- Age. Baseball players between the ages of 9 and 14 are at greater risk. Their elbow joints are not fully developed, and their bones are less mature. Looseness of the ligaments, open growth plates (areas of new bone growth that is still occurring in children and teens), and undeveloped musculature are common in youth baseball players and increase their risk for overuse injuries.
- Pitching too many games. Coaches and parents should carefully monitor the number of games pitched and follow the league's pitch count rules. Research has proven overuse in baseball contributes to injuries such as Little League elbow. Specifically, there is evidence Little League elbow can occur:
- During a game with 75 pitches or more in the game.
- In a season with 1,000 pitches or more per season.
- Or in a year where the pitcher throws more than 3,000 pitches.
- Curveballs and breaking pitches. These two pitch types may put more stress on the growth plate than other pitches. This can be due to poor pitch mechanics. Youth pitchers, especially those between the ages of 9 and 14, should limit the number of these types of pitches.
- Improper mechanics. Improper throwing mechanics can put undue force on the elbow joint. Proper throwing mechanics can help a young player avoid unnecessary injury and develop proper techniques that improve their game. Coaches or other qualified instructors may be used as a resource to ensure that you have learned proper mechanics.
Limiting pitching to eight months or less in a year is advised. If pain occurs before the pitch count limit is reached, the player should stop immediately. Additionally, pitching should be stopped if fatigue is experienced during a game. Rotating pitchers within a game is a good idea to ensure that each pitcher gets adequate rest.
More About Pitch Count
Follow these tips to prevent pitcher’s elbow:
- No multiple pitching appearances in a single game. Your child should not make more than one pitching appearance in one game (or pitch, change positions, then pitch again).
- No circumventing pitch count rules by pitching in multiple leagues. Most youths now play in multiple leagues, and the number of pitches can only be tracked for each individual league. It is important to avoid violating the pitch count restrictions by pitching in multiple leagues.
- No pitching at home after having pitched in a game. To limit the total number of overall pitches thrown, players are advised not to pitch at home after having pitched in a game.
- Get appropriate rest between pitching performances. See recommended pitch count rules.
- Follow the recommended throwing distance for pitchers by age. See recommended pitching distances.
How a Physical Therapist Can Help
Physical therapists are experts in restoring and improving mobility and motion and eliminating pain. They can work with athletes of any age to help prevent injuries.
In addition to following the guidelines for pitch counts, pitching distance, and rest periods, a physical therapist will help baseball players prevent Little League elbow by teaching them stretching and strengthening exercises specific to their needs. They also will teach the athlete proper body mechanics. Everybody is different, which means Little League elbow may occur for different reasons for each person.
A physical therapist can help players recover from Little League elbow by designing a personalized treatment plan to help them regain range of motion, flexibility, and strength.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
