Carlos R. Rodriguez, MD
Little leaguer's elbow or medial apophysitis is a condition seen in young throwing athletes and very familiar to our physicians at the Johns Hopkins All Children's Sports Medicine clinic. This condition causes pain that is located on the inner side of the elbow and is essentially caused by too much throwing.
The elbow joint in young athletes is quite complex and contains several ligaments and growth plates that can be injured due to the stresses cause by repetitive throwing. In little leaguer's elbow the growth plate in the inside part of the elbow (called the medial apophysis) is pulled and stressed by the muscles of the forearm that bend the wrist.
In children the muscles and ligaments are stronger than the growth plates so this increased stress causes the growth plate to get irritated, inflamed and in some cases separated from the rest of the elbow.
Our physician's at the Johns Hopkins All Children's Sports Medicine clinic will ask you about your symptoms, examine your elbow and order some x-rays of your elbow.
Treatment is based on the amount of inflammation and a referral to orthopedics may be needed if the growth plate has suffered significant separation. The most important part of the treatment for this condition is to stop throwing. Ice can be applied to the area for 15-20 minutes 3-4 times a day until the pain goes away. An elbow sleeve can be recommended for support as well as a prescription for anti-inflammatory medication. A rehabilitation and throwing program will be started once your condition has improved.
Our goal is to return you safely and quickly to your activity. However we do not want to return you too soon as this can lead to permanent damage to the elbow. In general the longer you have symptoms, the longer it will take to get better.
The best way to prevent Little Leaguer's elbow is to limit the amount of throwing a child does. Pitch counts and rest between games are necessary to allow the elbow to recover. We have developed an education card for coaches, parents and athletes to help them understand this condition and provide information regarding pitch counts.