Little League elbow, also called medial epicondylar apophysitis, is inflammation of the growth plate on the inner side of the elbow.
The medial epicondylar growth plate is an area of relative weakness while it is still developing. Repeated stress from muscle contraction, overuse, or vigorous exercise can cause inflammation and interfere with normal development.
What Is Little League Elbow?
The muscles that bend the wrist attach to the medial epicondyle on the inner side of the elbow. During adolescence, the growth plate in this area is still developing and can be injured by repeated stress.
Little League elbow is caused by inflammation of this growth plate from repetitive injury. The condition is temporary and is uncommon after age 16.
Causes and Risk Factors
Little League elbow may result from stress or injury to the developing medial epicondyle growth plate caused by overuse or a fall.
Risk factors include:
- Throwing sports such as baseball
- Overzealous conditioning routines, including weightlifting
- Being overweight
- Boys between 11 and 18 years of age
- Rapid skeletal growth
- Poor physical conditioning, including strength and flexibility
Symptoms
Common signs and symptoms include:
- A slightly swollen, warm, and tender bump on the inner elbow
- Pain with activity, especially when bending the wrist against resistance, lifting, or throwing
- Pain after an extended period of vigorous exercise
- Pain with less vigorous activity in more severe cases
- Inability to throw at full speed
- Inability to fully straighten the elbow
Treatment
Initial treatment may include:
- Medication and ice to relieve pain
- Stretching and strengthening exercises, particularly for the muscles that bend the wrist
- Modification of activities
- Avoiding throwing and heavy lifting
Exercises may be performed at home for acute cases. Chronic cases may require evaluation and treatment by a physical therapist or athletic trainer.
Surgery is rarely necessary when conservative treatment fails in a growing patient. However, surgery is necessary if the growth plate separates completely and moves away from its normal position.
Nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen, or other pain relievers such as acetaminophen, may be recommended as directed by a physician. Corticosteroid injections are rarely, if ever, indicated because they may weaken tendons.
Cold may be used to relieve pain and inflammation. Heat may be used before prescribed stretching and strengthening activities.
Recovery and Outcomes
Mild cases may resolve with a slight reduction in activity. Moderate to severe cases may require significantly reduced activity for three to four months.
Potential complications include:
- Bone infection
- The growth plate pulling away from the arm bone and resulting in a fracture
- Persistent inability to fully straighten the elbow
Appropriate rest, conditioning, and gradual return to activity are important to recovery.
When to See Dr. Chudik
If a growing athlete develops inner elbow pain, swelling, tenderness, difficulty throwing at full speed, or difficulty fully straightening the elbow, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.r request an appointment online.