Author: Jorge Velez, M.D., Orthopedics, Kelsey-Seybold Clinic – Cypress, Fort Bend Medical and Diagnostic Center, and Katy
Gone are the days when young athletes play their sport for a few months a year and then take a long break. Year-round play is the new norm, and not only are kids now playing year-round, but they’re also competing at a higher level. This means that paying special attention to how your kid is playing, and for how long at a time, is important to help reduce injuries like little league elbow.
Who’s at Risk?
Pitchers between the ages of 8 and 15 are the group most commonly afflicted with little league elbow, but it can strike any high-throwing-volume position, such as catcher or outfielder, and it can occur in older kids if their growth plates have not yet fused. The injury is often characterized by pain at the inside of the elbow and occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow. Left untreated, throwing injuries can become complicated conditions.
Keep Count of Throws
Because little league elbow is an overuse injury, the most important step you can take to help prevent it is not to allow your child to overuse the elbow. Some leagues have pitch counts and those should be strictly adhered to. If you’re in a league that doesn’t enforce pitch counts, talk to your child’s physician to find out what he or she recommends. According to the American Academy of Orthopaedic Surgeons, the general guideline for how many pitches a child can safely throw each week is 75 for 8- to 10-year-olds and 125 for 13- to14-year-olds. This includes practice and game play. When an athlete has reached the pitch quota, he or she either needs to be taken out of the game or moved to a position that doesn’t require the volume of throws that pitching does. In other words, it does no good to move the player from pitcher to catcher, or pitcher to shortstop.
Active Rest and Proper Training Are Important
Active rest is important. It’s that period of time when the sports season is over and players take time off and do not throw but still play other sports if they’d like to.
Staying in shape during the off-season is important. It means players will have the strength to pick up where they left off at the end of the season, which may leave them at a lower risk for injury. Help young athletes recognize the benefits of year-round physical fitness and conditioning.
Good mechanics are also important in preventing little league elbow, as are avoiding certain pitches. Research has shown that sliders and curveballs, because of the way they’re thrown, are more likely to cause injury than other pitches. Many professionals recommend that kids younger than 14 should only throw fastballs and changeups. Once more skeletally mature, curveballs and sliders can be added, because after the growth plates are fused players are at a lower risk for injury.
Treatment Options
Nonsurgical treatment is the first course of treatment for little league elbow and begins with resting the elbow, applying ice packs to bring down any swelling, participation in an individualized physical therapy program, and possibly refining throwing technique.
Surgery is rarely needed. Depending upon a child’s injury, surgery may involve removing loose bone fragments, bone grafting, or reattaching a ligament back to the bone.