Saturday August 18 2018
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Q&A: Little League Elbow

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In pediatric sports medicine almost half of all injuries are due to overuse. This can be especially true in baseball. As kids train year-round for sports, now is a good time to prepare for this summer sport.

Q: My 11-year-old son is a pitcher on his baseball team. I’ve read about the rise in “Little League elbow.” How can my son keep his throwing arm healthy?
A: “Little League elbow” – a constellation of symptoms, rather than one injury in particular – occurs in young pitchers whose skeletons have not yet matured. Physicians notice a peak incidence of Little League elbow during baseball season, in the spring and summer.

Kids used to play sports; now they train for sports year-round. All young athletes need to have a rest phase at some point, or injuries related to overuse, such as Little League elbow, will develop.

Risks highest during growth spurt
Repetitive throwing by young pitchers often leads to the trademark inner elbow pain, swelling and redness. Ten- to 15-year-old pitchers are especially susceptible because they may be in a growth spurt.

Little League elbow often involves the “growth plate” in the forearm bone, which makes up part of the elbow. Growth plates are weak areas at the ends of our long bones that determine their eventual size and shape. They harden in adulthood.

Strengthen the core, regulate pitches
There are important steps your son can take to prevent pitching injuries. One tip is to work on his core strength to generate force from the body, rather than just the arm. Core strengthening is to the athlete’s advantage; it decreases overall injury rates significantly. Good strengthening and conditioning are keys to staying healthy.

During games, the types and number of pitches that a young player throws can lead to Little League elbow. You and the coach should help your son regulate his throws.

Young pitchers should avoid breaking balls and curve balls until they reach the age of 14 or 15. We see a clear-cut, exponential increase in the injury rate when younger children throw these pitches. Breaking balls and curve balls increase the chance of injury three- to four-fold in young bodies that are still developing.

Little League Baseball has also taken action by limiting the number of pitches, rather than the number of innings, that a child pitches. Younger players should throw no more than 50 to 60 pitches per day. The organization also has guidelines regulating the number of days young pitchers rest between games. Your son should probably rest three full days after he pitches before throwing again.

For more information about safe baseball practices, go to

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