Little League Elbow

Little League Elbow is a common overuse injury that affects young baseball players, particularly those involved in repetitive throwing motions. Also known as medial epicondyle apophysitis, this condition primarily affects the growth plate on the inner side of the elbow. On this page, we will explore the causes, symptoms, diagnosis, treatment, and rehabilitation strategies associated with Little League Elbow.


Little League ElbowLittle League Elbow is caused by repetitive stress on the inner side of the elbow joint, which commonly occurs during overhead throwing motions. The repetitive throwing motion places excessive strain on the growth plate of the medial epicondyle, leading to inflammation, pain, and potential injury. Factors contributing to the development of Little League Elbow include:

  • Overuse: Engaging in excessive throwing without sufficient rest periods can increase the risk of developing this condition.
  • Poor Throwing Technique: Improper throwing mechanics, such as excessive sidearm or “flat” throwing, can contribute to the development of the Little League Elbow.
  • Growth Plate Vulnerability: The growth plate in young athletes is more susceptible to injury due to its developing and less resilient nature.


The symptoms of Little League Elbow can vary in severity and may include:

  • Pain on the inner side of the elbow during or after throwing.
  • Swelling and tenderness around the medial epicondyle.
  • Decreased throwing velocity or accuracy.
  • Limited range of motion in the elbow joint.
  • Weakness or discomfort when gripping objects.


A proper diagnosis of Little League Elbow involves a comprehensive evaluation by a healthcare professional, typically an orthopedic specialist or sports medicine physician. The diagnostic process may include:

  • Medical History: The doctor will discuss the individual’s symptoms, medical history, and any relevant information about their participation in baseball or other throwing sports.
  • Physical Examination: The doctor will perform a physical examination, assessing the range of motion, joint stability, and tenderness in the affected elbow.
  • Imaging Tests: Doctors want X-rays to evaluate the growth plate and rule out other potential causes of elbow pain. In some cases, a MRI (Magnetic Resonance Imaging) or ultrasound may obtain a more detailed view of the soft tissues and identify any associated injuries.


The treatment of Little League Elbow typically involves a combination of conservative measures to reduce pain, and inflammation, and promote healing. The recommended treatment options include:

  • Rest: Resting the affected elbow is essential to allow the injured growth plate to heal. This may involve refraining from throwing activities for a period of time.
  • Ice and Compression: Applying ice packs or cold compresses to the affected area can help reduce pain and inflammation. Compression sleeves or wraps may provide additional support.
  • Pain Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may alleviate pain and reduce inflammation. However, it is important to consult a healthcare professional before taking any medication.
  • Physical Therapy: A physical therapist can guide the individual through specific exercises and stretching routines to improve flexibility, strengthen the surrounding muscles, and correct any throwing mechanics issues.


Rehabilitation plays a crucial role in the recovery process of Little League Elbow. The rehabilitation program may include:

  • Gradual Return to Throwing:

    After a period of rest and recovery, a gradual return-to-throwing program is implemented under the guidance of a physical therapist or athletic trainer. For example, this program should include progressive throwing drills and techniques to allow the elbow to adapt and regain strength. Strength and Conditioning: Strengthening the muscles around the elbow and shoulder is vital to prevent future injuries. A structured strength and conditioning program designed by a physical therapist or sports trainer can target specific muscle groups and improve overall throwing mechanics.

  • Flexibility and Range of Motion Exercises:

    Stretching exercises help maintain or improve flexibility, which is essential for proper throwing mechanics. The physical therapist may incorporate various stretching techniques to enhance the range of motion and prevent muscle imbalances.

  • Technique Modification:

    Working with a qualified coach or throwing specialist can help identify any flaws in throwing mechanics and make necessary adjustments. The proper technique reduces the stress placed on the elbow and minimizes the risk of re-injury.

  • Education and Injury Prevention:

    Education about the importance of proper warm-up exercises, rest periods, and overall injury prevention strategies is crucial. Athletes, coaches, and parents should recognize the signs of overuse injuries and take appropriate measures to prevent them.

  • Gradual Return to Play:

    Returning to full activity on a gradual basis will allow the elbow adequate time to adapt and strengthen. The timeline for return to play varies for each individual and depends on factors such as the severity of the injury, response to treatment, and overall progress in rehabilitation.

It is important to note that in severe cases of Little League Elbow, where conservative measures do not provide relief, doctors may consider surgical intervention. However, surgery is generally reserved for cases where there is significant damage to the growth plate or other associated complications.


Preventing Little League Elbow involves implementing proper training techniques, maintaining appropriate rest intervals, and following injury prevention strategies. Here are some preventive measures:

  • Proper Warm-up: Engage in a thorough warm-up routine that includes dynamic stretching and exercises to prepare the muscles and joints for throwing.
  • Controlled Throwing: Avoid excessive throwing or pitching volumes, especially in young athletes. Encourage regular rest periods and participation in other sports or activities to diversify movement patterns and reduce repetitive stress.
  • Strength and Conditioning: Include regular strength and conditioning exercises that target the muscles involved in throwing, focusing on balanced muscle development and proper body mechanics.
  • Technique Training: Emphasize proper throwing mechanics and technique. Therefore, parents should seek guidance from knowledgeable coaches or instructors to ensure correct form and minimize unnecessary stress on the elbow.
  • Rest and Recovery: Allow adequate rest between throwing sessions, especially during periods of growth spurts. Avoid year-round specialization in baseball and incorporate off-season breaks to allow the body to recover.


Little League Elbow is a common overuse injury that can affect young baseball players. Early recognition, proper diagnosis, and timely intervention are crucial for effective management and prevention of long-term complications. Finally, implementing proper training techniques, ensuring adequate rest, and incorporating rehabilitation and injury prevention strategies can help young athletes recover from Little League Elbow, reduce the risk of re-injury, and continue to enjoy their participation in baseball while prioritizing their long-term health and well-being.


Kids Health: Little League Elbow