Little League Elbow

Play ball! The baseball season is in full swing. Arm injuries are not uncommon in baseball players, including your little ace.

Little League elbow is an overuse arm injury most commonly seen in adolescent baseball players. This is most common in a pitcher but may occur in any young thrower.

Little league elbow is the result of repetitive stress on the medial epicondyle and growth plate of the inner (medial) elbow. In a growing child, the growth plates are weaker than ligaments and tendons, and are more susceptible to injury. In a skeletally mature young adult or adult with closed growth plates, the ligaments and tendons are more susceptible injury.

Little league elbow is most commonly seen between 8 and 15 years of age but can occur up to the time of closure of the growth plate of the medial epicondyle.

The diagnosis is suspected in an adolescent with focal medial elbow pain with throwing and is usually made on clinical exam. The majority of the radiographs in Little League elbow are normal. However, radiographs may be ordered to assess if the growth plate is still open. Widening and irregularity or even a fracture of the growth plate or searching for avulsion of a bone chip can be seen. Sometimes an MRI can be performed in evaluation of the other medial supporting structures not shown on radiographs, such as the ulnar collateral ligament (made famous from Tommy John surgery). USA Baseball and Little League Baseball have published pitch count guidelines according to age for reduced risk of arm injuries. Be sure to talk to your physician about any pain or discomfort your child may be feeling.

Image: 12-year-old male with right elbow pain that started three weeks prior during pitching practice. Small bone chip or avulsion (orange arrow) from the inferior margin of the medial epicondyle.

Contributed by Dr. Christopher G. Anton and edited by Michelle Gramke, (ADV TECH_US)