Elbow Injuries in the Youth Athlete
By Dr. Lance Snyder, MD
Why are Elbow Injuries in Youth Athletes Common?
Throwing sports, such as baseball have become a year round activity. This has led to an increased rate of injuries which has been documented in the literature. One area of anatomical weakness in the throwing motion is the elbow.
To learn more about elbow problems in athletes, go to: https://www.joionline.net/library/show/elbow_problems_in_athletes/
Anatomy of the Elbow
The elbow is made up of the humerus (the long bone in the upper arm), radius (large bone of the forearm that is connected to the elbow on the thumb side), and ulna (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.
Forces of the Elbow
The throwing motion is release of kinetic energy which starts in the toes and ends in the finger tips. During the throwing motion, the medial side (inside) of the elbow is place in 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
Medial epicondyle avulsion is a common injury in the pediatric athlete. There is often a perceived “pop” by the athlete during the throw. In an X-Ray, widening is often seen. The treatment is typically rest. If the widening is greater than 2mm, surgery may be needed.
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 tenderness over the ulna or humerus, 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. In addition, surgery is reserved for cases in which all conservative treatment has failed. However, if fragmentation of the lesion occurs, arthroscopic treatment may be indicated. A gradual return to sport should be supervised by an ATC or PT and a throwing program is recommended.
Lateral Injuries of the Elbow
Osteochondritis dissecans is seen in the capitellum. 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 along with 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 the youth athlete. Furthermore, elbow problems have also been associated with year round throwing as well as curve ball. Communication is very important, as a “struggling” pitcher may be more susceptible to injury.
JOI Rehab has biomechanical software (Dartfish) that can conduct a video analysis of a thrower’s mechanics and evaluate their deficiencies. JOI’s goal is to help improve the performance of athletes to reduce the risk of injury or re-injury. All of our rehab centers have clinicians to assist in throwing performance as well as 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 who specialize in orthopedic rehab. Our JOI team has the expertise and technological advances to get you back to your ideal level of function.
Dr. Lance Snyder is an orthopedic surgeon at the JOI Baptist South Location. To schedule an appointment with him, call JOI-2000.