Little League elbow is unfortunately very common. Find out everything you need to know about the condition.
What is Little League Elbow?
You talk to old-timers and they’ll tell you 20 years ago there was no such thing as
“Little League elbow” and that the ailment it refers to is the result of zealous coaches overusing young pitchers desperately trying to win games that in the grand scheme of things don’t matter. You talk to pediatric orthopedics and they’ll tell you kids are not throwing with the proper mechanics, along with the overuse issue.
Regardless of the cause, my 10-year old son started complaining of pain in his elbow after pitching in the first game of his fall travel season last year. We brought him to a pediatric orthopedic specialist who took a few X-rays and proclaimed he had Little League elbow.
Apophysitis is the Medical Term for Little League Elbow
Apophysitis, a medical term that you likely have never heard of before, is an inflammation injury that is specific to children and adolescents, because it occurs on areas on or around growth plates. When apophysitis arises in the tibia, they call it Osgood Schlatter disease. When it happens in the patella, they call it Sinding-Larsen–Johanson disease, And when it occurs around the elbow, they call it Little League elbow.
The way it was explained to me by a doctor is that I should think of my son’s bones like a tree. Like a tree grows, the bones of a child expands at the ends. The areas where the growth takes place is referred to as growth plates.
Apophysitis is an irritation of the part of the bone that is doing the growing. And it can occur anywhere where a muscle or tendon attaches to the section of bone where the growth plate is located including the bony inner parts of the elbow.
The good news about Little League elbow is that it has absolutely nothing to do with the more serious elbow injuries such as the UCL tear that we refer to as Tommy John. Theoretically, a kid might alter his mechanics because of the pain caused by Little League elbow and that could lead to something more serious, but Little League elbow in and of itself is not a warning sign or precursor for Tommy John.
Apophysitis is most common in boys aged 12-16 , which tracks with the puberty years. But younger kids are also at risk. My son was 10 when he got Little League elbow.
How Do You Get Little League Elbow?
Not surprisingly, Little League elbow commonly occurs in kids who perform stressful and repetitive physical tasks like repeatedly throwing a baseball from a pitchers mound during travel games. Muscles stiffen and pull on the growth plates leading to the inflammation. Kids who throw harder and more violently are more at risk for the injury.
Additionally, pitching through pain increases the risk for Little League elbow. This is where you have to teach kids to be able to recognize the difference between the regular aches and pains that come from all physical activity and the ones that might lead to long term injuries.
After my son got diagnosed with Little League elbow, my wife said she regularly saw him rubbing his elbow after coming off the mound. I myself had never seen this, probably because I was so enjoying watching him pitch well that I didn’t want to see it.
If my son had tried to tap out of one of our playoff games complaining of arm discomfort, I frankly might have encouraged him to push through it.
This is where both parents and kids and coaches have to be aware of the difference between the common muscle pain along the forearm and more serious elbow pain.
When a kid’s elbow hurts, he has to come out. I know there are kids out there who fake elbow injuries when they’re not doing well in a game, and it has lead to adults being skeptical of injuries. But you have to err on the side of caution.
How Do You Treat Little League Elbow?
When I took my son to the doctor, he recommended that he be shut down from throwing for six weeks and go to physical therapy — and this is the standard treatment for Little League elbow. Note that you can swing the bat with Little League elbow, and my son was able to be a designated hitter for the fall season. This was both a blessing and a curse, because while it was great that he could continue with the team, not being able to play the field was tough on him, especially when he got in a hitting slump.
If your kid is in a lot of pain from Little League elbow, you can treat the pain with Advil or other non-steroidal anti-inflammatory drugs (NSAIDs).
You can also apply an ice pack to the elbow a few times a day.
A thing to remember here is that since Little League elbow is caused by inflammation to your kid’s growth plates, it by definition will eventually end. When your kid gets older and his bones fuse, he will no longer have or be at risk for Little League elbow.
Check out this Cleveland Clinic piece about Sever’s disease (which is like Little League elbow but affects kid’s heels) and it concludes that the condition resolves when patients get older and that it doesn’t cause any long term damage.
Invest in Some JBands
Once your kid goes to physical therapy, you’ll find that they use the same types of bands for stretching exercises that pitching coaches use to strengthen arm muscles. So if you don’t have one already, invest in some JBands so your kid can do the stretching exercises at home. As an added benefit, these drills will also help increase your kid’s pitching velocity when he returns to the mound.
How Do You Prevent Little League Elbow?
The prevention strategies are what you might expect:
- Limit your kids to the appropriate pitch counts for their age (e.g., 9-10 year olds, 50 pitches max per game; 11-14 year olds, 75 pitches max per game).
- Not have your kid throw at all for two days per week (“mandatory off days”)
- Have your kid learn the right mechanics. -and-
- Make sure your kid stretches his arm muscles before throwing (as stiff muscles lead to Little League elbow).
Some of these are easier to keep to than others. But these are goals to aim for. And like I touched on above, you also have to honest conversations with your kids about any pain they’re experiencing. It’s normal and expected to have some soreness in the muscles around the arm, but pain in the elbow and shoulder should be treated seriously and warrant coming out of a game.
What Do You Do When Your Kid’s Little League Elbow Is Not Getting Better?
After my son’s diagnosis, we shut him down from throwing and started physical therapy. I was hoping he’d be back for the playoffs at the end of the season. Yet he was still experiencing pain two months later even after weeks of PT.
I started to get concerned when we reached four months since the injury and he still couldn’t throw without pain. Our physical therapist, a former baseball player who I trusted, had no idea why he hadn’t healed. At a follow up appointment with the orthopedic doctor, he had nothing new to say except that we should continue to rest it and keep going to physical therapy. I felt like we were in an endless loop.
Finally, when it had been roughly six months since he had been shut down, I called the doctor and asked if it wasn’t time to get an MRI on his elbow to make sure we weren’t missing something more serious. The doctor agreed and we scheduled the MRI.
Thankfully, the results showed no tear or any serious injury — and that he had apophysitis (Little League elbow) I spoke to the orthopedist and he slightly changed his opinion, saying that it was okay if he a little pain when throwing and that we should send him back to his pitching coach because he thought he likely had a flaw in his throwing motion which was aggravating the injury.
We followed that advice and my son is now throwing at around 80 percent with only mild pain. Part of me feels it helped my son psychologically to get the MRI and know that he doesn’t have a more serious injury. We’re hoping he’ll be back on the mound in about a month.
HAVE ANY ADVICE ABOUT LITTLE LEAGUE ELBOW? LET US KNOW IN THE COMMENTS.
For more on pitching, see:
- 4 Ways To Increase Your Kid’s Pitching Velocity
- Is the Circle Change Dangerous for Youth Pitchers?
- Why I Don’t Let My Son Pitch in Little League
- Pitching and Head Injuries: What You Need to Know
- How to Make Sure Your Kid Isn’t Overpitched in Baseball
For information about the emotional side of baseball, see:
- How to Manage Your Kid’s Baseball Tantrums and Meltdowns
- 4 Ways to Respond to a Coach Playing Favorites
- How to Stop Being a Crazy Baseball Dad
- How to Be a Good Baseball Dad in the Backyard
- Is It Now Fashionable to Hate On Baseball Dads?
- Are Local Little Leagues Bad for Baseball?
For information on hitting, see:
- How to Get Out of a Hitting Slump
- 4 Best Baseball Batting Aids (No. 3 is Free)
- 4 Hitting Drills You Need to Do Before Every Game
- 4 Old School Baseball Drills You Need to Be Using
- 6 Mistakes to Avoid When Buying a Baseball Bat
For baseball speed drills, see:
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