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Little league elbow is a term used to describe a sports injury in the medial aspect of the elbow in preadolescent and adolescent baseball pitchers. This is most commonly seen in children aged 10-17. The phenomenon is correlated to chronic forces of valgus overload produced during the early and late cocking phases of throwing. These valgus force places tension on the medial structures (medial epicondyle, medial epicondylar apophysis, medial collateral ligament) and compression of the lateral structures.
Little league elbow encompasses delayed or accelerated growth of the medial epicondyle, medial epicondylar fragmentation, and medial epicondylitis. The type of injury pattern depends on the stage of the developing elbow, and recent studies show there is about a 20-25% frequency of elbow pain in youth baseball players.
Microtrauma from overuse or improper throwing mechanics can cause injury. The predominant risk factors for elbow injuries that require surgery in young baseball players during high school and college are regularly pitching with arm fatigue, competitively pitching for more than eight months a year, and averaging more than 80 pitches per appearance.
Surgery is only utilized as a last resort when conservative treatment has not improved symptoms. Universally, the BEST treatment is prevention through patient education and/or early diagnosis with proper treatment
It is actually not common to see ligamentous or flexor/pronator injuries in children, which is commonly misdiagnosed. This is another reason why it is important to get a thorough examination by a sports based physician.
Common Symptoms are
- Medial-sided elbow pain
- Decreased throwing speed or distance
- Point tenderness
- Joint Swelling
- Widening and/or fragmentation of apophysis on radiographs
The term “Little League Elbow” is meant to include prevention and includes the physician, coach, trainer, and parents. Also, it should be noted that proper throwing mechanics and adherence to pitch counts should be emphasized at a young age. Rest alone will not fix this, and a multi-modal approach is required to return the athlete to high-level performance.
Treatment typically includes:
- Shockwave therapy
- Winback Tecar therapy
- Soft tissue therapy
- IASTM (instrument-assisted soft tissue mobilization)
- Reduce load for the time being by >50%
- Use heat, not ice
- Strengthen, not stretch the affected area
- Eccentric-focused exercises
- Return to Throwing Protocol
For those that concerned about their medial elbow pain, Strength & Spine Chiropractic is here for you. We are so much more than your regular chiropractors and would love to help get you back to performing your best. Schedule a FREE discovery visit online at strengthchiro.com to see how we can help.
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