Little League elbow is a prevalent type of overuse injury linked with throwing. The injury is quite common among pitchers but also occur among infielders, catchers and outfielders.
The condition is the result of continuous stress to the growth plate on the interior of the elbow. Significant stress occurs throughout the acceleration stage of throwing a baseball. It is important to note that developing bones are readily damaged since the growth plate is weaker than the muscles and ligaments that are attached to it. Once the growth plates merge, athletes are more prone to damage the tendons and ligaments instead.
What are the indications?
Little League elbow usually starts gradually without a specific injury but a distinct painful pop can be felt occasionally. Young athletes often attempt to reduce the symptoms to continue playing.
There is sharp, aching pain and swelling on the interior of the elbow. These symptoms might only occur while pitching but can progress to a point in which throwing triggers pain.
The advanced stages of the condition might include small-sized fractures on the growth plates, loose fragments or bone chips or early arthritis and bone spur formation.
Who are at risk?
The condition is prevalent between the ages 8-15 but can develop up to 17 years of age if the growth plate has not merged. It is usually seen often among pitchers as well as those who engage in high-velocity throwing positions.
Management
The treatment for Little League elbow is comprised of 3 phases – rest, rehab and return to pitching.
Rest
Initially, take a break from all throwing activities. The application of ice can be useful to alleviate the pain and swelling. Non-steroidal anti-inflammatory drugs (NSAIDs) can be given but not required if the athlete is not engaged in throwing activities.
Rehab
Physical therapy is tailored to the condition of the child and highly useful for young baseball players. The program must include range of motion and strength exercises for the elbow and later include strengthening of the upper arm, forearm, back, shoulder and core.
Return to pitching
One can resume throwing if free from pain and regained full range of motion and strength. It is vital to progress in a gradual manner from non-throwing positions, less throwing positions and full throwing positions.
In most cases of Little League elbow, it settles with adequate rest and conservative care. Nevertheless, the phase for recovery just like with other overuse injuries varies for each athlete. If the treatment plan is not strictly followed, it can lead to lasting disability or deformity including conditions such as osteoarthritis.