Little League Elbow
(Elbow, Little League; Medial Apophysitis; Overuse Elbow Injury Related to Throwing)
by Cynthia M. Johnson, MA
Little League elbow is pain in the elbow joint due to repetitive throwing. This injury occurs in young baseball pitchers before puberty.
This injury happens when the ligament attached to the inner side of the elbow starts to pull one of the growth plates away from the rest of the bone. Growth plates are weak and easily injured when a child's bones are still growing. Certain types of throwing may lead to this problem, such as:
This problem is more common in boys who are 10 to 15 years of age. The risk is higher in those who are pitchers, especially those who throw curve balls or sliders.
Problems may be:
The doctor will ask about your child's symptoms and health history. You will also be asked about your child's activities. A physical exam will be done. It will focus on the elbow.
Images may be taken. This can be done with:
The goal of treatment is to ease pain and promote healing. Recovery time ranges from 6 weeks to 3 months.
Some children may need surgery. This is not common.
The risk of this problem may be lowered by:
Family Doctor—American Academy of Family Physicians
Ortho Info— American Academy of Orthopaedic Surgeons
About Kids Health—The Hospital for Sick Children
Canadian Orthopaedic Foundation
Griffith TB, Kercher J, et al. Elbow Injuries in the Adolescent Thrower. Curr Rev Musculoskelet Med. 2018 Mar;11(1):35-47.
Management of throwing injuries of the elbow. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-throwing-injuries-of-the-elbow. Accessed January 29, 2021.
Throwing injuries in the elbow in children. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/throwing-injuries-in-the-elbow-in-children. Accessed January 29, 2021.
Why counting pitches counts. The National Athletic Trainers' Association website. Available at:
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Accessed January 29, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 1/29/2021