Little League elbow is known medically has medial epicondyle apophysitis. This term describes the location of pain (the medial epicondyle is the bump on the inside of the elbow) and what is injured (the growth plate, or apophysis, on that bump is being pulled apart). It most frequently affects pitchers between 9 and 14 years of age, but any athlete who throws overhead can be at risk (in sports such as baseball, water polo, volleyball and football).
The injury typically results from overuse (lots of throwing), but can be associated with an acute injury as well. This bump gets injured because it is the attachment site for the forearm muscles used in throwing and one of the most important ligaments in elbow stability. Unchecked, this problem can result in tearing of that ligament or fracturing the bump from the arm bone.
Symptoms of Little League elbow include:
- Pain on the inner side of the elbow with throwing.
- Swelling at the elbow.
- Difficulty extending (straightening) the elbow completely all the way.
- Decrease in ability to throw the ball as fast or as accurately.
Symptoms, athletic (throwing) history and exam of the elbow will most likely lead to the diagnosis. X-rays are important to be sure that there is no fracture.
Treatment of medial epicondyle apophysitis is rest of the arm. Stopping all throwing (including any throwing outside organized sports) is key to a full recovery and to help prevent recurrence throughout childhood. The duration of rest should be at least six weeks, but may be longer depending on the pain. Ice and anti-inflammatory medications may help reduce the inflammation. If necessary, a cast can be used to stop your child from using the elbow.
Return to throwing is allowed when full motion of the elbow without pain is present. A gradual return to throwing should be undertaken. Pitching should not resume for a year from the time of initial clinic visit. Return to throwing too soon or throwing with pain can worsen the apophysitis, or result in permanent elbow pain and difficulty playing sports.