Health Column: Little League Elbow: It may be more than just growing pains

By Beth Emeterio
Blount Memorial Hospital

Young baseball and softball players, or any athlete who throws in his or her sport, may develop elbow problems from a heavy pitching or throwing schedule.

The growth plates of young athletes, especially those at the elbow, hip and knee, are susceptible to acute and overuse injuries. Either of these types of injuries can lead to long-term problems if they are not properly treated. Furthermore, a youth’s ability to develop strength depends on his or her physical maturity, not necessarily on the training regimen.

Therefore, baseball and softball players who train too hard or progress their training too quickly are at risk for elbow problems.

Although a little leaguer throws fewer pitches in a week than a college or professional pitcher, he or she may throw hard on days between games, which is something that is not done at the college or professional level. Outfielders also may be at risk if they are throwing long distances before properly training or warming-up. Elbow trouble of this type usually has a slow onset, where symptoms occur early but are subtle. These young athletes may fail to report elbow pain to their coaches or parents. Occasionally, this discomfort at the elbow may be reported, but is dismissed as growing pains.

Most problems begin at the inside of the elbow, which is the side closest to the body. It is at this site that the stress of throwing may actually cause part of the bone to be pulled away at the site where the tendon attaches to the growth plate. More serious problems then can develop at the outside of the elbow where repeated jamming together of the bones can cause much more severe and longstanding problems, often requiring surgical intervention. Problems tend to surface after the athlete has been involved in organized sports for several years and is around an average age of 12-13.

To help prevent elbow problems in young ball players, good throwing mechanics must be taught and good techniques used. Youngsters should especially avoid throwing with just the arm. Gradual increases in the amount of time, distance thrown and velocity - or speed of the throw - should be used in the conditioning process. Each practice and game, the athlete should warm up with gradual increases in distance and velocity of throws. It’s also important to remember that an athlete, no matter his or her age, cannot resume playing at the conditioning level where he or she ended last season. At the beginning of each season, the athlete must recondition the muscles and tendons to avoid injury.

Any player with soreness in his or her shoulder or elbow should ice for 20 minutes after each practice and game. This will minimize the aggravation caused by the workout. All players, especially pitchers, should be encouraged to report elbow soreness promptly. Any time elbow soreness is reported, it should be thoroughly investigated and the level of activity reduced until a causative determination is made.

Beth Emeterio is a certified athletic trainer with Blount Memorial Sports Medicine and the Outpatient Rehabilitation Center at Springbrook.

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