What is Little League Elbow?

30 June, 2020
The term, "Little League Elbow" comes from baseball, but it can be caused by playing other sports too. It mainly affects children and teenagers. In this article, we'll tell you more about this condition.

The medical term for “Little League Elbow” is Medial Apophysitis, and the condition affects the growth plate located in the elbow. The reason it has this name is that it’s a common injury among children and teenagers who play little league baseball.

However, not everyone who plays baseball suffers from this condition. It’s more common in those that throw the ball with excessive force or overly frequently.

Sometimes in training, too much is expected of children by either parents or coaches. This can happen in any sport. As a child is asked to pitch more or faster or pitch using a particular technique, the risk of damaging the cartilage in the elbow increases.

Children can suffer from this condition normally between the ages of 10 and 15 years old. It’s more common in boys, but this is likely to be because there are more boys playing baseball than girls. The technique can be a very important factor, and those who don’t receive proper coaching are more likely to injure themselves.

What causes little league elbow?

Little league elbow is the name given to damage to the growth plate in the elbow as a result of pitching a baseball. The medical term for the growth cartilage the apophysis and the medical condition is medial apophysitis.

The growth plate covers a large, wide area located on the inner side of the elbow (medial epicondyle). When pitching a baseball, this region comes under strain, since the pitch mainly uses the muscles in the forearm.


When pitching, these muscles are working with greater speed and power than usual. This creates tension where they attach to the inner side of the elbow.

A man receiving treatment for little league elbow.


Repeating this action then causes small tears in the cartilage of the elbow and this becomes inflamed over time. In extreme cases, this tear can extend to the bone and rupture part of the epicondyle.


Although it doesn’t always happen, you may actually hear the tear at the moment the damage is done. However, this isn’t always the case and it often goes unnoticed.

There’s also the possibility that the child won’t say anything about the pain so that they can continue playing. They’re likely to be worried about being replaced and instead, keep quiet. This obviously means that it takes longer to detect the problem.

Aside from the sound of the tear itself, the main symptom is pain and swelling in the elbow. This is usually located on the inside of the elbow, which will increase in size as fluid accumulates. If the swelling doesn’t go down in a short period of time, moving the elbow will become more difficult.

Normally, a doctor will detect any damage using techniques such as radiography, tomography, or nuclear magnetic resonance imaging. This last one is possibly the most accurate method where the doctor will be able to see the damage in greater detail.


Treating little league elbow

The first step after a positive diagnosis will be to stop training or playing baseball. It’s important to rest the arm until the inflammation subsides.

However, in order for them to regain full functionality in the elbow, they’ll need a rehabilitation plan. To do this, you will probably need to consult with specialists and coaches so that the child can learn how to play again without overdoing it.

Besides rest, you can also apply a cold compress to the elbow or use anti-inflammatories, if prescribed by your doctor. But take care of anti-inflammatory drugs as they can have adverse side effects.

Once the elbow has recovered and rehabilitation is complete, your child will want to get back to pitching as soon as possible. It’s really important for their coach to bear their injury in mind as there is always the risk of it recurring in the future. A return to pitching simply has to be a gradual one to guarantee a full recovery.

A child batting a baseball.

If the growth plate is seriously damaged, surgery may be needed. This will then involve up to six months of recovery time and long-term physiotherapy.


Prevention is better than cure

Perhaps obviously, the best thing is to avoid little league elbow in the first place. There are many sports associations that can provide advice and teach children how to pitch correctly so as to prevent injury.

However, it’s ultimately down to adults to prevent sports injuries. If you have any suspicion that your child might be suffering from a potential injury, arrange an appointment with your doctor as soon as you can.

  • Fonseca, Leonardo Cebrián, and Norma Guerra Martínez. El proceso de recuperación de las lesiones deportivas en el beisbol. Un abordaje teórico (Revisión). Revista científica Olimpia 16.56 (2019): 97-108.
  • Committee on Sports Medicine and Fitness. American Academy of Pediatrics: Risk of injury from baseball and softball in children. Pediatrics. 2001;107(4):782-784.
  • Martínez, Alberto Martínez, et al. Hallazgos por imagen de las lesiones deportivas del miembro superior. Seram (2018).