Pitcher’s Elbow – Little League Elbow

Introduction

Pitcher’s elbow, also called Little League elbow, results from excessive throwing motions used in sports. It most frequently occurs in baseball, but is associated with other sports that involve throwing. Pitcher’s elbow causes pain and interferes with motion. Many cases of pitcher’s elbow respond to rest and nonoperative treatment. Pitcher’s elbow, if left untreated, can lead to significant problems that require surgery.

Anatomy

The two bones in your forearm, the ulna and radius, and your upper arm bone, the humerus, form your elbow joints. Muscles, nerves, tendons, and ligaments allow your elbow joints to bend, straighten, and rotate. Tendons are strong fibers that attach your muscles to your bones, and ligaments connect your bones to each other.

Causes

Pitcher’s elbow occurs in players that participate in sports that require repetitive throwing. It most frequently affects pitchers, but may also develop in outfielders, catchers, and infielders. Pitcher’s elbow is associated with other sports as well, including tennis and football.
Pitcher’s elbow is also known as Little League elbow because it occurs in children and teenagers that play sports. The condition is especially concerning for this population because their bones are growing and injuries can affect the growth process. Additionally, their skeletal systems may not be developed enough for the demands of competitive sports.
Pitcher’s elbow results when repetitive throwing puts an excessive strain on the tendons and ligaments in the elbow. The strong movements can cause the ligaments and tendons to stretch, tear, or pull away from the bone. If some of the bone is also torn away in the process, it can interfere with normal bone growth and cause deformity. If the forces are great enough, the bones may slam together, causing the bones or cartilage to fracture, and resulting in a condition called osteochondrosis dissecans.

Symptoms

Pitcher’s elbow causes pain on the inner side of the elbow. Your elbow joint may feel like it locks or gets stuck. It may be difficult to move the elbow as you did before, and it will affect your pitching performance.

Diagnosis

Your doctor can diagnose pitcher’s elbow by reviewing your medical history and examining your elbow. You should tell your doctor about your sports participation, the number of throws you typically perform, and the length of your practice or playing season. This information will help your doctor determine the magnitude of stress on your elbow. X-rays or magnetic resonance imaging (MRI) scans will be ordered to view your elbow structures.

Treatment

You should stop performing throwing activities and allow your elbow to rest if you experience pain. Ice packs may help relieve pain and swelling. Following rest, throwing should be returned to gradually. Therapy can be helpful, and sometimes a review of your pitching motion may be beneficial. If your pain persists or recurs with throwing activities, Ultrasound Guided Cortisone injection are often used.

If conservative Treatment and Physical Therapy Failed:
Ultrasound Guided Platelet rich plasma injection or Stem Cells injection for regeneration is promising (not FDA approved) but supported by multiple Studies.

Prevention

You may prevent pitcher’s elbow by taking breaks from pitching, limiting the amount of throwing that you do, and altering your throwing motion, if necessary. Be sure to warm-up before pitching. Exercise to keep your arm strong and flexible.