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Little Leaguer's Elbow

Excessive pitching or inappropriate training, especially in the young pitcher, can result in permanent damage of the elbow.

Children are pressured to compete at sports. While such competition is healthy and a part of education, over-ambitious parents and coaches may be responsible for creating injuries. Little Leaguers' elbow occurring in young baseball players as a result of the repetitive stresses of throwing has been recognized in North America for over 20 years.

The incidence of this problem is unknown and varies widely in reported series. In 1972, before major rule changes were adopted to protect the youngsters, Little Leaguers' elbow was present in up to 90% of little league pitchers between the ages of 9 and 14 in Southern California. These same changes were seen in fewer than 10% of children of the same age who did not play baseball.


Little Leaguers' elbow has come to encompass all of the stress changes involved in youth pitching. It is the syndrome of overuse injuries involving the flexor tendons of the wrist as they originate at the elbow and the triceps as they insert at the elbow. It is related to the repeated trauma of pitching, and this stress is greatly increased by throwing curve balls and other breaking pitches, which require more forceful pronation of the wrist.

Symptoms of Little Leaguers' elbow include pain and tenderness at the bony prominence on the inside and back of the elbow. Pain increases with forceful throwing or gripping. It is important to recognize this condition early, since adequate rest from repeated stresses may allow resolution of the problems.


Therapy is aimed at decreasing inflammation with ice and rest, as dictated by signs and symptoms.

Active range-of-motion therapy commences in the whirlpool and progresses to gradual strengthening of the muscles involved. In more elite athletes, resistive exercises are started. Strengthening with surgical tubing or free weights is begun, progressing to isokinetic strengthening, push-ups, and pull-ups. Shoulder range-of-motion and isometric exercises are performed throughout the rehabilitation period.


Injuries in throwing sports are decreased and prevented by attention to flexibility, length of time a player throws, and correcting the throwing technique.

The importance of pre-exercise stretching and limbering up cannot be over-stressed. Care of the throwing arm includes gently stretching and massaging the elbow and shoulder before throwing. You can stretch the flexor tendons by holding your hand open with palm facing away, and gently pulling backwards on the fingers and hand.

In throwing and racquet sports correct technique is all-important. Incorrect technique, poor performance and the increased incidence of injury are interralted.

Proper use of body mechanics will alter the technique, thus reducing stress on the elbow. Overhead rather than sidearm and curve ball throws should be taught because less stress will be placed on the smaller arms and hands of young pitchers. Whipping and snapping of the elbow should be discouraged. Pitchers should be taught to use their lower body to generate speed during the windup and deceleration during the follow through.

The frequency and length of time each player is allowed to pitch should be less than an adult. While wearing a warm-up jacket, commence with gentle throwing at short distances. Gradually increase length and velocity during warm-up and ice the arm afterwards.

Emphasis must be placed on stretching and conditioning the arm. An overhead style of throwing rather than a sidearm style should be encouraged since less stress will be placed on the shoulder, elbow and wrist. Coaches should encourage a young pitcher to work on ball control (location & speed) and forbid the curveball or any other breaking pitch to be thrown. Coaches should also not forget that warm-up, throwing during infield or outfield practice an/or pitching batting practice should be counted towards the maximum number of pitches. Also, egos, those of the players, coaches and parents should not be taken to Little League games. All of these together will help decrease on immature elbows.

Therapy Services Associates
Hours: Monday - Friday :: 8am - 5pm
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Two Offices
Google+ Link Hobbs
2700 N Grimes
Hobbs, NM 88240
(575) 392-4129
FAX (575) 392-3835

Google+ Link Lovington
Located inside Nor Lea Hospital
1600 N Main
Lovington, NM 88260
(575) 396-5227
FAX (575) 396-7193

We serve Lea and Eddy Counties in New Mexico, as well as Yoakum and Gaines Counties in West Texas.