We have all heard of the term “little leaguers elbow,” but what does it really mean? Essentially, it’s a term for the various pediatric elbow disorders that can result from overuse and poor mechanics with throwing. What you may not know, is that repetitive stress to the growth plate in the elbow of young baseball players, caused by the throwing motion can lead to significant injury.

At the ages between 9-15, as children are still growing, the bones are susceptible to this repetitive load. This is mostly since the growth plate and bone is weaker than the ligaments and tendon/muscles that attach to the bone. Specifically, the medial epicondyle is the last physes at the elbow to close (10-14 years of age).

Unfortunately once the growth plate matures, ligament and tendon injuries are much more common, as is seen in adult and professional baseball players.

Athletes require a strong core, hip stability, scapular stability, rotator cuff strength and endurance in the muscles. At a young age, most if not all of these are not finely tuned yet, contributing to the stress on the elbow.

One of the top Physical Therapist and researches in our field, Kevin Wilk, who works with many pro athletes states the best way to avoid arm injuries in youth overhead athletes is: pitch counts, rest with no year round pitching, endurance (not pitching when tired, proper conditioning (PT!) and proper neuromuscular control and mechanics.

Below is the suggested pitching guidelines that all levels of baseball can follow.

There are many clinical signs that may be present that indicate your child may already have an injury or are susceptible to injury. As mentioned briefly, there is a lot more that goes into throwing than just the shoulder and elbow. If your son or daughter plays an overhead sport, and you are unsure if they are safe or a susceptible for injury, have them come in and see us at Fitzgerald PT!

– Written by Nick Napoli, DPT and Physical Therapist at Fitzgerald PT who specializes in working with overhead athletes. He was also a collegiate baseball player and now coaches. He enjoys working with orthopedic and sports injuries, as well as neurologic, pediatric and geriatric patients. Read more about him now.