Little league elbow: Is your athlete’s season over ?

A heartbreaking moment…

LittleLeagueElbowIt’s a heartbreaking moment for a parent  – your son is on the mound in the playoff game and throwing strikes.  He looks great.  His mechanics seem appropriate.  His pitching coach has him dialed in as best as possible.  After throwing a fast ball, he grabs his elbow, rubs it a little, and throws the next pitch.  He grabs his elbow, looks at you and the coach and says I can’t pitch anymore !

Unfortunately, this is a common scenario.  Often a slow progress, but occasionally acute, the term little league elbow is used to describe an overuse injury of the inner aspect of the elbow.  This is caused by huge forces across the stabilizers of the elbow and creates an injury to the growing bone, the ligament that connects the arm and forearm, and the muscles that flex the wrist and fingers.

Young athletes that develop little league elbow will complain of pain over the inside of the elbow, often along with swelling and tenderness to touch.  Range of motion may be limited.  An X-ray may help check out the growth plates of the arm bone which are active at this age.  Sometimes an X-ray of the other normal elbow are needed to compare.  An MRI is usually not needed, but is informative to show the extent of inflammation.

Treating your aspiring ball player

This can be the hardest part:  Rest.  Resting the arm is so important for a quick recovery.  It may take several weeks for the injury to recover and depending on where you are in the season, this can be a season-ender for some.  While it is hard to be the bad guy, I remind parents, and athletes, that the goal is a lifelong ability to use the elbow normally and pushing too hard too early can result in more serious damage, possible surgery, and the inability to play in the future.   If the goal is to get back as soon as possible, and your child is trustworthy, they will understand and stop using the elbow.  If not so trustworthy, a cast will prevent the need to negotiate every activity at home and force them to rest! You know your athlete best !

Prevention is the best medicine

This is where pitch counts and careful monitoring of activities off the field is important.  While rules enforcing pitch counts are helpful, today’s athlete plays potentially multiple sports, practices several times a week, and is in constant motion using the arm.  Pay close attention to your young athlete’s activities and moderate throwing to keep the elbow in shape.  Get a pitching coach and focus on good mechanics to minimize stress to the elbow.  Work on core strength – Most power comes from your core  – to decrease elbow and should stress during a pitch.

When to be seen

I like to see these kids right away, take an X-ray, examine the elbow, and discuss the future.  If your young aspiring athlete complains of elbow pain, shut him down, and have him seen right away by an orthopedic surgeon experienced with sports injuries.

Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon, and little league parent and coach,  in San Diego, CA, Team Surgeon to the US Olympic Team.  He specializes in sports medicine and sports injuries, knee and shoulder surgery.

If you have questions about little league elbow, or your child’s elbow, please feel free to contact me at Ask Dr. Hacker or through my office.

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