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Weekend Doctor: Little Leage elbow

By Laura Durliat, OTR/L
Occupational Therapist, Julie A. Cole Rehab & Sports Medicine

It’s spring in northwest Ohio, and that means track, softball and baseball seasons are underway. Unfortunately, that also means injuries. A common injury, which occurs in young athletes, at this time of year is “little league elbow.” This occurs most commonly in the ages of nine to 14 because the bones of the elbow at this age are not fully developed. These young pitchers often have joint laxity, open growth plates and immature bones. Little league elbow occurs with overuse and repetitive throwing motions. This is an injury of the inside area (medial) elbow’s tendons, ligaments and or bones in the young throwing athlete. Repetitive throwing causes trauma and injury to the immature skeleton of young athletes causing an overload to the inside of the elbow. If left untreated, it could lead to a stress fracture (crack in the bone) at the head of the humerus caused by overuse.


The first sign of injury will often be pain on the inside area of your elbow, along with swelling and tenderness to touch. There will often be a noticeable decrease in throwing speed, accuracy and distance, along with decreased strength and possible limitations of motion. Diagnosis can be formally made by a qualified medical professional. This will be followed up by rest, occupational therapy, anti-inflammatory medications, diagnostic testing with X-rays/MRI and in severe cases surgery.

Risk factors could include throwing excessive pitches per game, multiple months of continuous pitching without a break, fast pitch speeds or continued pitching despite continued periods of pain and fatigue. Pain and fatigue should be a reason to stop or limit pitching. Poor body mechanics are often a cause for repetitive injury as this causes an undue force on the elbow joint. Monitoring pitch count, limiting curve balls and breaking pitches can help to lower the risk of injury. When possible, it is a good idea to rotate pitchers. It is important to rest between games and follow pitch count rules to help reduce the occurrence of little league elbow.

Recovery treatment begins with rest, modifications of activities (including limiting the number of innings pitched), maintaining the range of the elbow, applying ice during the day to limit the edema, anti-inflammatory medications, pain control and initiating occupational therapy.

Occupational therapy can help improve mobility, flexibility and strength of the arm while working to eliminate pain. Therapists will work with you on body mechanics, prevention and recovery.

Let’s play ball!