Anatomy & Background
Little Leaguer’s elbow is a condition that compromises the structures in the medial (inside) area of the elbow, typically due to overuse and stress placed on the elbow joint by repetitive athletic movements. It most often occurs in adolescent baseball or softball players, and is most commonly seen in baseball pitchers due to the repetitive overhand motion involved in throwing the ball.
The elbow joint connects three bones in the arm, the humerus (upper arm bone) and the radium and ulna (forearm bones). Within the joint, there are strong, fibrous connective tissue that attach bones to one another. They allow the elbow to move properly and provide strength and stability to the joint. When ligaments are stretched, strained, sprained or torn, it results in pain and instability in the joint.
Little Leaguer’s elbow results in damage to the inside of the elbow, including the medial collateral ligament, as well as the medial epicondyle and the medial epicondylar aphophysis. The medial epicondyle is the growth plate on the inside end of the elbow, and this often becomes inflamed in adolescents experiencing Little Leaguer’s elbow.
Little Leaguer’s elbow is typically a result of repetitive movement and overuse of the elbow by adolescent aged baseball and softball players, particularly pitchers. Stress and strain on the medial structures in the elbow can result due to the repeated cocking and following through motions involved in pitching a ball. This can lead to ligament laxity (looseness), which can result in sprains or tears of the ligaments in the elbow. Inflammation of the growth plate in the elbow can also occur.
Causes that lead to Little Leaguer’s elbow include:
- Year round playing of baseball or softball, especially pitching, as well as continuous athletic training involving overhand throwing motions.
- Pitching more than the recommended number of pitches per game or per week for an individual’s age.
- Some pitches place more strain on the ligaments in the elbow, including curve balls, sliders and breaking balls.
- Lack of adequate rest between pitching.
- Improper warm-up prior to pitching or improper conditioning.
- Poor throwing mechanics.
Signs and Symptoms of Little League’s Elbow
Symptoms can vary based on how severe the condition is, but generally include:
- Pain, which is usually moderate to severe in nature. The pain may increase when attempting to throw a ball or when throwing more than the recommended number of pitches in a game.
- Tenderness on the inside of the elbow, closer to the upper arm. This is the location of the growth plate.
- Weakness of the elbow, accompanied by possible loss of motion of the elbow joint, although this is not typical unless severe damage has occurred.
- Stiffness of the elbow.
- Redness, bruising or other discoloration where the injury occurs. A noticeable deformity over the medial epicondyle may also be seen.
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