What are the other Names for this Condition? (Also known as/Synonyms)

• Little League Elbow Syndrome
• Little Leaguer’s Elbow
• LLE (Little League Elbow)

What is Little League Elbow? (Definition/Background Information)

• Little Leaguer Elbow (LLE) is a common inflammatory condition in children that involves the growth plate of the humerus, near the inner elbow at the medial epicondyle. The elbow is a hinge joint comprising of 3 bones - the humerus, radius, and ulna
• It usually develops in baseball pitchers due to a combination of repetitive motion or overuse of the elbow, but may also develop in catchers, infielders, and outfielders
• Since growth plates in children are weaker than the surrounding ligaments and tendons, repetitive stress can lead to an injury of the growth plate and disrupt the normal growth of the bone
• Treatment for Little League Elbow depends on the severity of the injury. However, the condition may worsen leading to prolonged and chronic pain. The prognosis of Little League Elbow is usually excellent with appropriate treatment measures

Who gets Little League Elbow? (Age and Sex Distribution)

• Children of all ages, racial and ethnic groups, and both genders may develop Little League Elbow
• Boys are more likely to develop LLE due a higher incidence of they playing sports, such as baseball, that require repetitive overhead throwing of the ball
• Overall, young athletes, who participate in any sport that involves repetitive throwing motions, are more likely to develop an injury to the elbow
• In the United States, millions of children every year participate in little league activities, and Little League Elbow is often described in this context

What are the Risk Factors for Little League Elbow? (Predisposing Factors)

Common risk factors associated with Little League Elbow include:

• Children participating in a sport, such as baseball, which involves repetitive throwing action (i.e., pitching a baseball)
• In general, children between the ages of 10-15 years are more susceptible to Little League Elbow due to the flexibility of their bones
• Male children generally have a higher risk, since they are more likely to play sports that involve throwing actions

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Little League Elbow? (Etiology)

Little League Elbow is primarily caused by the repetitive throwing of a baseball (or pitching). It can also occur due to other sports of a similar nature that involves repetitive throwing action, which puts stress on one’s elbows.

What are the Signs and Symptoms of Little League Elbow?

The signs and symptoms of Little League Elbow may include:

• Pain and tenderness in the elbow
• Reduced range of motion in the elbow
• Inability to completely straighten the hand at the elbow joint
• Decreased speed and control when throwing a baseball

How is Little League Elbow Diagnosed?

Little League Elbow is diagnosed using the following methods:

• Physical examination: A physician will perform a thorough physical examination of the elbow for signs of any ligament or bone damage. Children are also expected to provide information on how the injury occurred and when the pain occurs. In addition to this, a complete medical history can aid in arriving at a definitive diagnosis
• X-ray of the elbow: X-rays use radiation to produce images of the elbow. It can also help the physician rule out other possible causes of elbow discomfort, such as a fracture
• Magnetic resonance imaging (MRI) of the elbow: An MRI scan is a more detailed imaging procedure that uses a magnetic field to produce images, which allows a physician to view any damage to the bones and soft tissue. This can help in confirming a diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Little League Elbow?

The complications of Little League Elbow may include:

• Prolonged and chronic elbow pain, if the condition is left untreated
• Recurrence of the injury
• Inability to straighten the elbow
• Growth plate fracture

How is Little League Elbow Treated?

Treatment of Little League Elbow may include both nonsurgical and surgical methods. However, surgery is rarely required to treat the condition.

• Any activity that aggravates the elbow condition further should be avoided. The physician may advise children to refrain from participating in any physical activities, until the pain or symptoms get better
• Applying ice to the elbow can help reduce pain and swelling
• Non-steroidal anti-inflammatory oral medications, such as ibuprofen and naproxen, can help reduce the pain and swelling in the elbow
• After the signs and symptoms have decreased, it is important to begin some light throwing motion exercises. The child may be advised by the physician or therapist to slowly progress to pitching

If the condition is severe, then depending on the child’s injury, a surgery may be required to reattach the ligament. Girls older than 12 years and boys older than 14 years are more likely to require surgery for an injured elbow.

How can Little League Elbow be Prevented?

A few recommendations to help prevent Little Leaguer’s Elbow include:

• Warming up, before throwing a baseball: This can include light aerobic exercise, such as jogging
• Stretch the muscles, before and after exercising
• Children are advised to limit the amount of pitches they throw (by keeping track of pitch count) and not overwork their elbows
• Learn and practice using correct pitching techniques

What is the Prognosis of Little League Elbow? (Outcomes/Resolutions)

• Little League Elbow can usually get better when the activity level is reduced. However, the symptoms may recur, if the child does not limit the activities that caused the pain
• More severe cases of Little League Elbow may require for children to stop or reduce sports activities for about 3-4 months

Additional and Relevant Useful Information for Little League Elbow:

• According to the American Academy of Pediatrics, it is recommended that the number of pitches be limited to 200 per week or 90 per game, for children
• However, general guidelines state that children between the ages of 8-10 years can safely throw 75 pitches each week; for children aged 11-12 years, the recommendation is 100 pitches per week; and for children aged 13-14 years, the recommendation is 125 pitches per week. This includes pitches during both practice and competitive play
• It is suggested that children should only pitch around 3 to 4 innings each game