Elbow Injuries In Youth Athletes

By Dr. Lance Snyder, MD

Why are Elbow Injuries in Youth Athletes Common?

Throwing sports, such as baseball, has become a year round activity. This has led to an increased rate of elbow injuries in youth athletes. One area of anatomical weakness in the throwing motion is the elbow. Growing bones are easily injured because the growth plate is weaker than the muscles and ligaments that attach to it.  If you want to learn more about the correct way to throw a baseball, please go to this ARTICLE. 

 

To learn more about elbow problems in athletes, go to Elbow Pain.

Elbow Injuries In Youth Athletes- Elbow Anatomy

The elbow includes the humerus or the long bone in the upper arm.  In the lower arm the radius or large bone of the forearm.  It is connected to the elbow on the thumb side and ulna or the large bone of the forearm that is connected to the elbow on the smallest finger side. The collaterals along the inside (medial) and outside (lateral) help provide stability. Muscles and the capsule help provide further stability.

The throwing motion is the release of kinetic energy, which starts in the toes and ends at the fingertips. During the throwing motion, the medial side (inside) of the elbow has tension. The lateral side (outside) of the elbow is placed in compression, and the posterior aspect is placed in shear.

Medial Injuries of the Elbow or Little League Elbow

Little league elbow is a common overuse injury in youth sports. The injury is most common in pitchers, but can also occur with catchers, outfielders, and infielders. The injury is the result of repetitive stress on the growth plate on the inside of the elbow. This injury is most common for ages of 8 to 15 but can happen up to 17.  Medial epicondyle avulsion is a common injury in pediatric athletes. There is often a perceived “pop” by the athlete during the throw. X-rays of the elbow help diagnose if the growth plate is still opened and widened. The treatment is typically rest. If the widening is greater than 2mm, surgery may be needed.

Symptoms of Little League Elbow

• A painful “pop”
• Sharp pain
• Aching pain
• Swelling on outside of the elbow

Ulnar collateral ligament tears can occur as well. The anterior portion of the ligament is the most important and can rupture with a significant torque. There is often a point of tenderness over the ulna or humerus.  Also, there is a loss of speed and pain with throwing. An MRI is often helpful with the diagnosis.

How Do You Treat Little League Elbow?

• Rest – is initial treatment along with physical therapy and evaluation of the throwing mechanics.
• Rehab – physical therapy is the most useful treatment for young baseball players
• Return to the sport.  An ATC or PT should supervise a gradual return to sport, and a throwing program is recommended.

The majority of little league elbow injuries improve with rest and a physical therapy program. It is important to follow the treatment plan prescribed by your doctor and physical therapist. Not following the customized plan can lead to long-term deformity or disability, including conditions like osteoarthritis.

Lateral Injuries of the Elbow

Osteochondritis dissecans are seen in the capitellum. Therefore, it is associated with the compression forces that occur on the outside of the elbow with throwing. An MRI often shows an area of swelling of the tissues in the bone and the area of necrosis (death of living cells in tissue). The exact cause is unknown.

Prevention of Elbow Injuries

Pitch counts have been somewhat effective in preventing elbow problems in youth athletes. Furthermore, elbow problems have also been associated with year-round throwing as well as a curveball. Communication is critical, as a “struggling” pitcher may be more susceptible to injury. Prevention measures include:

• Year-round training program to include physical fitness and conditioning
• Active rest -3-6 months where they do not throw, but play other sports
• Pitching guidelines – pitch counts are critical
• Proper mechanics

Elbow Injuries In Youth Athletes- JOI Rehab

JOI Rehab has biomechanical software (Dartfish) that can conduct video analysis of a thrower’s mechanics and evaluate their deficiencies. JOI’s goal is to help improve athletes’ performance to reduce the risk of injury or re-injury. All of our rehab centers have clinicians to assist in throwing performance and our sports center. If your baseball team is interested in a custom throwing session to improve throwing mechanics and techniques, call (904) 858-7045. 

JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL, specializing in orthopedic rehab. Our JOI team has the expertise and technological advances to get you back to your ideal function level.  To read more about the biomechanics of throwing, go to this ARTICLE.

Related Article: What is Tendonitis?

Dr. Lance Snyder is an orthopedic surgeon at the JOI Baptist South Location.  To schedule an appointment with him, call 904-JOI-2000 or schedule online.

By: Dr. Lance Snyder

During the current crisis, JOI and JOI Rehab are making our clinics as safe as possible.  To read more about what we are doing to keep you and our employees safe, go to JOI4U.