Treating Little League Elbow – Glastonbury, CT

Is Little League Elbow Serious?

Left untreated, LLE can become more severe, causing ligaments and tendons tears. In addition, tearing may cause tiny bone fragments to break off and travel to other areas of the elbow joint, disrupting normal bone growth, resulting in deformity. Also, while tension is placed on the medial side of the elbow, compression can simultaneously be placed on the lateral (outer) part of the elbow. Over time this compression can damage the joint cartilage and the underlying bone, resulting in osteochondritis dissecans. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Arthritis can develop later in life as a result.

Symptoms of LLE

Patients suffering from Little League elbow often report a gradual increase of medial elbow pain and stiffness, particularly while throwing. Pain can also develop on the lateral or outer part of the arm as well (early symptoms of osteochondritis dissecans). As the condition progresses, the child will often experience a decrease in throwing velocity and effectiveness.

Risk Factors for Developing LLE

Young players who throw repetitively have a high risk of developing LLE. If left untreated, LLE can lead to major complications and jeopardize a child's ability to remain active in a sport later in life, such as softball. Other common risk factors include:

• Increased single-sport participation with year-round training (no "off season")
• Throwing "breaking pitches" (e.g. curve balls) at too young an age
• Participation in higher intensity sports at younger ages
• Longer competitive seasons (including participation on more thence team in a single season)
• Conditioning and training errors, including poor throwing mechanics and muscle imbalances

Diagnosing LLE

The history and physical exam are critical. X-rays to assess for bone damage, and diagnostic ultrasound to evaluate the tendons and ligaments, are also necessary. MRI is rarely needed and is used more to assess for other issues.

Treatment for LLE

The hallmark of treatment for LLE is rest and physical therapy. Physical therapy should not only focus on relieving the pain and any swelling but also on identifying and addressing any muscle imbalances and functional deficits that could be causing poor throwing mechanics. When rest and therapy fail to help, more aggressive treatment may be necessary. Treatments such as Prolotherapy* and PRP* may be needed to stimulate the healing of the damaged ligaments and tendons. An injection of the patient's own stem cells* into the damaged bone may be needed in the case of osteochondritis dissecans to heal the bone. Surgery is always a last resort.

Preventing LLE

• Proper warm-up (including stretching, running, easy and gradual throwing)
• Rotate positions while on the field
• Concentrate on age-appropriate pitching
• Adhere to pitching count guidelines
• Avoid pitching on multiple teams with overlapping seasons (even the pros have an off-season!)
• In the event of elbow pain, do not pitch
• Communicate regularly about how your arm feels
• Emphasize control, accuracy, and good mechanics

(*NOTE: All Regenerative Medicine treatments, such as Prolotherapy, PRP, and stem cells, are performed by our affiliate practice, the New England Stem Cell Institute . Click HERE for a free e-book on Regenerative Medicine.)