Little League Elbow | Symptoms & Causes

Elbow joints are made up of three bones — the upper arm bone is connected to the two bones in the forearm by a joint that works like a hinge. Around all these bones are muscles, ligaments, and tendons that keep the keep it all together, and help the arm bend and move. 

Pitching too much and too often, or simply throwing in a way that hurts the arm, can put a lot of stress on these tendons, ligaments, and bones. There are several little soft areas of cartilage, called apophyses, at each end of most bones, and as older children stop growing, these areas turn into bone and harden. But before they harden, they are very easy to injure, and when players — mostly ages 9 to 14 — throw too much, these areas can get inflamed and sore.

This is the anatomy of an elbow.Signs and symptoms of Little League Elbow

Little League Elbow symptoms may include:

  • pain in any part of the elbow
  • swelling
  • difficulty straightening the arm all the way
  • sometimes, a bump appears on the inside of the elbow
  • a locked or stiff elbow  

Without treatment, the ligaments and tendons may tear away from the bone or parts of the bone can separate from each other. Continuing to play through this kind of pain can make the injury worse, and your child should stop throwing and see a doctor if he has the above symptoms.

Throwing guidelines

One of the most important things to know about Little League elbow is that it can be prevented. Just by limiting the amount your child throws, you can prevent injury from happening. Even if your child already has Little League elbow, these prevention guidelines can help him stay healthy when he returns to the sport. 

USA Baseball has come up with pitch counts for young athletes. These guidelines should be applied to practices, games, and multiple leagues as well. For proper reset, pitchers should not pitch on consecutive days, and should have three months a year without pitching.

9- to 10-year-old pitchers:  

11- to 12-year-old pitchers:  

13- to 14-year-old pitchers: 

  • 50 pitches per game 
  • 75 pitches per week 
  • 1,000 pitches per season 
  • 2,000 pitches per year 
  • 75 pitches per game 
  • 100 pitches per week 
  • 1,000 pitches per season 
  • 3,000 pitches per year 
  • 75 pitches per game
  • 125 pitches per week
  • 1,000 pitches per season
  • 3,000 pitches per year
  • More guidelines have been established in order to ensure proper rest time between pitching as well:

    For pitchers age 7 to 16:

    For pitchers age 17 to 18:

    Pitches in a day               Rest time
    61 or more                     4 days
    41-60                               3 days
    21-40                               2 days
    1-20                                 1 day
    Pitches in a day             Rest time
    76 or more                     4 days
    51-75                               3 days
    26-50                               2 days
    1-25                                 1 day