What Is A Medial Epicondyle Avulsion Fracture (Little League Elbow)?

A medial epicondyle avulsion fracture is commonly referred to as Little League Elbow. This injury most often occurs in young baseball players between the ages of 9 and 14. This is due to the fact that the body is in a state of rapid growth at this age. This means that the growth plate cartilage throughout the body is more susceptible to injury. This injury affects the bony protrusion on the inside of the elbow, which is the most common type of elbow injury that occurs during adolescence. There are non-surgical options for recovery; however, in severe fractures, the bony protrusion inside the elbow is displaced. If the displacement is large enough, it will need to be surgically reattached.

What Are The Signs And Symptoms Of Little League Elbow?

Little League elbow symptoms may include:

• Severe pain in the elbow after a pitch
• Popping sound or sensation at time of injury
• Numbness in the forearm and fingers
• Locked or stiff elbow
• Pain and difficulty straightening the arm
• Swelling or redness around the elbow

For anyone, especially athletes, it’s important to listen to the body’s natural cues. Prolonged pain is an indicator that something is wrong and changes need to be made. If your child is experiencing continuous pain after throwing, it is important to make sure you listen to those cues and stop any further throwing until a doctor is consulted. Never play or practice through pain!

How Will A Doctor Diagnose Little League Elbow?

Your child’s doctor will likely want to review their sports history. This can include asking questions regarding:

• How many sports they play a year
• How many throwing-specific sports they play a year
• How often they throw on a weekly basis and their rest schedule
• If they are on multiple leagues/teams in their sport

Your child’s doctor will also examine their elbow to see their range of motion and mobility, where the pain is, and if there is swelling around the elbow. This examination will typically include an x-ray to see if there have been disruptions to the cartilage around the bone or any damage to your child’s growth plate.

How Can We Treat Little League Elbow Without Surgery?

Surgery may be necessary depending on the severity of the injury but a regimen of rest and physical therapy can often rehabilitate the injury without the need for surgery.

Whether or not your child’s Little League Elbow will require surgery, the most important component of their treatment plan will be rest. Rest from throwing and activity can last for up to 6 weeks.   They should not resume throwing in games or practice until their tendons and ligaments are fully healed and cleared by the MD. If your child is still experiencing pain when they throw they should stop and you should revisit their treatment plan. In addition to rest, icing the elbow can help reduce pain and swelling.

Working with a physical therapist on a throwing rehabilitation program is also a great way to make sure your child is not overextending themselves and putting themselves at increased risk of reinjuring their elbow. This method of rehab will include strengthening the muscles not only around the elbow, but as well as the shoulder and whole kinetic chain.  

How Can Little League Elbow Be Prevented?

• Always warm up. Don’t let your child jump straight into throwing their fastest pitches. Warming up and gradually increasing the intensity of throws allows the muscles to stretch and adjust before they are put under the stress of more advanced throws.
• Use proper form. As with any form of exercise, proper form is critical for injury prevention. Make sure that your child’s throwing form is correct so that they do not place unnecessary strain on their muscles.
• Rest. As with treatment, an important part of prevention of Little League Elbow is rest. It is important to rest between throwing episodes and to not exceed the recommended guidelines for throwing quantity and pitch speed based on age. USA Baseball has resource guidelines to help prevent young throwers from over exerting themselves and increasing their risk of injury.
• Don’t play year round. It’s not just important to rest between individual throwing sessions, but it’s important to rest between seasons as well. This doesn’t mean that your athlete shouldn’t play a sport in their off season, it’s just important that they aren’t playing another throwing sport. Athletes that play year round should make sure there is variety in the motions they utilize in each sport to reduce risks of overuse and injury.
• Don’t play through pain! Last but certainly not least, never play through pain. The mentality to push through the pain will often lead to injury. An initial flare of pain may not necessarily mean

Where Can I Get Help In Treating My Child’s Little League Elbow in the Northern Virginia area?

At Advanced Kinetics Physical Therapy we offer both rehabilitation and preventive services in Falls Church and McLean, Virginia. If your child has already suffered from an elbow injury and is looking for rehabilitation services to prevent further injury and get them back on the field, we can help! Alternatively, if your child is in an overhead throwing sport and you’re worried about their risk of injury, we have an Overhead Throwers Injury Prevention program designed to address the specific needs of the overhead throwing athlete. If you’re interested in learning more about our overhead throwing prevention or rehabilitation options, please get in touch with us!