What is Little League Elbow?
Little League Elbow is an overuse injury affecting the growth plate (apophysis) on the inner side of the elbow in young throwing athletes. The repetitive stress of throwing causes irritation, inflammation, and sometimes separation of the medial epicondyle growth plate.
Unlike adults whose bones are fully formed, children have open growth plates that are weaker than the surrounding ligaments and tendons. This makes young athletes vulnerable to growth plate injuries when they throw too much, too hard, or with improper technique.
The condition is most common in baseball pitchers aged 9-14, but can occur in any young athlete who throws repetitively - including cricket bowlers, javelin throwers, and tennis players.
Symptoms
Risk Factors
9-14 years old (growth plates still open)
Throwing too many pitches per game/week
No rest period between seasons
Curveballs/sliders before age-appropriate
Improper throwing technique
Continuing to throw when tired
Pitch Count Guidelines
Following proper pitch counts is the most effective way to prevent Little League Elbow
| Age | Max Per Game | Max Per Week | Required Rest |
|---|---|---|---|
| 7-8 years | 50 pitches | 75 pitches | 1 day after 21+ pitches |
| 9-10 years | 75 pitches | 100 pitches | 1 day after 36+ pitches |
| 11-12 years | 85 pitches | 115 pitches | 2 days after 46+ pitches |
| 13-14 years | 95 pitches | 125 pitches | 3 days after 61+ pitches |
Treatment
- Complete rest from throwing (4-6 weeks minimum)
- Ice application for pain and swelling
- Anti-inflammatory medication if needed
- Physical therapy for flexibility and strength
- Gradual return-to-throw program
- Only for displaced growth plate fragments
- Fixation of separated apophysis
- Removal of loose fragments
- Recovery: 4-6 months before throwing
Important for Parents & Coaches
Never let a young athlete "pitch through" elbow pain. Pain is the body's warning signal that damage is occurring. Ignoring these warnings can lead to permanent growth plate damage and lifelong elbow problems. When in doubt, rest.