Little League Elbow

Little league elbow also called as medial apophysitis, is an overuse condition that occurs when there is overstress or injury to the inside portion of the elbow. It is commonly seen in children involved in sports activities that require repetitive throwing such as baseball.

Children make use of the elbow joint repetitively to throw the baseball which creates stress on the muscles and ligaments that are attached to the inner side of the elbow. The growth plate present at the bone ends become inflamed or in severe case it may break from the upper arm. One of the risk factor which causes this disease is misguided training regime.

The most common symptoms include elbow pain, tenderness, swelling on the inner side of the elbow, restricted motion, and locking of elbow joint. Pain is increased upon pressing the inner side of the elbow.

Your doctor will perform physical examination of your child’s elbow. Further your doctor may also request for an X-ray which shows the break in the growth plate.

Immediately following an injury and before being evaluated by a doctor, you should initiate the PRICE method of treatment.

• Protection: The purpose of protection is to avoid further injury. You can protect the injury by applying bandage, aluminum splint, protective tape, or braces.
• Rest: Rest the elbow as more damage could result from putting pressure on the injured area. If the injury is not treated it can lead to complications such as ligament tear, cartilage injury, and growth disturbance.
• Ice: Applying ice packs to the injured area will help to diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin.
• Compression: Wrapping the elbow with an elastic bandage which will help to minimize the swelling and support the elbow.
• Elevation: Ensure that your child elevates the elbow above heart level will also reduce swelling and pain.

The treatment options include non-surgical and surgical treatment. The conservative or the non-surgical options include

• Medications such as nonsteroidal anti-inflammatory drugs will be prescribed to provide relief from pain and inflammation.
• After the pain has subsided, your doctor may suggest initiation of rehabilitation program which includes strengthening and stretching exercises to develop strength and muscle control.

Surgical treatment may be required in severe cases if there is a break in the bone. Surgery is done in girls above 12 years and boys above 14 years. Surgical method involves removal of loose fragments of the bone, bone grafting, and reattachment of ligament back to the bone.

Some of the measures to prevent little leaguer’s elbow include reduction in number of pitches a child throws. Before starting with the activity, your child should perform warm up exercises.

For more information, please visit the American Academy of Orthopaedic Surgeons Patient Education website: http://orthoinfo.aaos.org/topic.cfm?topic=A00328.