Common Overuse Injuries in Youth Athletes: Little League’s Elbow (Series)

Little League Elbow

What is it: The term “little league elbow” is used to describe a lesion or injury at the medial elbow. The area that is commonly injured is at the medial epicondyle of elbow. This area is a common attachment site for the muscles of the forearm. During the development of the bones in the growing child, the growth plate may become stressed. This may lead to accelerated or delayed growth of medial epicondyle. The type of injury and presentation may vary depending on age of child athlete.


Who is most at risk: This condition is one of the most common injuries in youth baseball, which is why it got the term “little league elbow”. The overhead throwing motion, worse if faulty mechanics present, applies stress to the medial epicondyle in the elbow. Some risk factors that increase risk for injury are improper throwing mechanics, age, and pitch count. Which makes it important to have a team effort with athlete, parents, coaches, and trainers to help prevent overuse and injury.  


What to look out for: The presentation and probable symptoms depend on the development of bone and age of the youth athlete. Younger children are more likely to have signs and symptoms of a apophysitis and older children epicondylar avulsion fracture. However, in both age ranges, medial elbow pain is a common presentation as well as tenderness to touch at medial epicondyle, possible swelling, and a decrease in throwing speed/distance.

Being aware of these signs and symptoms are vital for preventing further damage by early treatment. Youth baseball players with medial elbow pain should result in high suspicion of little league elbow.

How to treat or prevent: Prevention will include close watch of pitch count, assessing throwing mechanics, and strengthening and flexibility of shoulder/arm. Faulty throwing mechanics can be subtle however, stress the structures in the elbow over time can lead to injury

Treatment:  Conservative treatment has been widely adopted as the most preferred approach for little league elbow. This includes complete rest from throwing activities for 4-6 wks, NSAIDs (if aga appropriate), elbow extension brace (if necessary), and referral to physical therapy.

Physical Therapy: A physical therapist (PT) can play an integral role in the recovery of this condition. Treatments will be focused on strengthening appropriate muscles as well as obtaining optimal control of the arm throughout the throwing motion. They are able to assess throwing mechanics and develop a plan to address any impairments. Thus, a PT can help in the rehabilitation, prevention, and performance of the youth baseball athlete!

Surgical intervention is rare for the youth athlete with little league elbow.


Summary: Baseball is a very popular sport here in the USA as well as around the world. With increasing incidences of youth athletes (baseball players) developing this condition, prevention has been the focus. Through close watch of pitch count, optimizing throwing mechanics, and strengthening the appropriate muscles can help the youth athlete on the baseball field playing the sport they love.

Written by: Robert Rojas PT, DPT



  3. (Elbow photo)