Throwing Injuries in the Elbow

With the start of the baseball season each spring, doctors frequently see an increase in elbow problems in young baseball players. A common elbow problem is Little Leaguer’s Elbow.The elbow is the joint where the upper arm bone (humerus) meets the two bones of the lower arm (ulna and radius). The elbow is a combination hinge and pivot joint. The hinge part of the joint lets the arm bend like the hinge of a door; the pivot part lets the lower arm twist and rotate. The rounded ends of the upper arm bone give the elbow its two “knobs” or bumps (epicondyle). Several muscles, nerves and tendons (connective tissues between muscles and bones) cross at the elbow.

Injury occurs when the repetitive throwing creates an excessively strong pull on elbow tendons and ligaments. The young player feels pain at the knobby bump on the inside of the elbow.

Little Leaguer’s Elbow can be serious if it becomes aggravated. Repeated pulling can tear the ligament and tendon away from the bone. The tearing may pull tiny bone fragments with it in the same way a plant takes soil with it when it is uprooted. This can disrupt normal bone growth, resulting in deformity.

Osteochondrosis dissecans is a less common condition that is also caused by excessive throwing and may be the source of the pain on the outside of the elbow.

Muscles work in pairs. In the elbow, if there is pulling on one side, there is pushing on the other side. As the elbow is compressed, the joint smashes immature bones together. This can loosen or fragment the bone and cartilage. The resulting condition is called osteochondrosis dissecans.

Risk Factors / Prevention

Little Leaguer’s Elbow affects pitchers and other players who throw repetitively. Continuing to throw may lead to major complications and jeopardize a youngster’s ability to remain active in a sport that requires throwing.


Little Leaguer’s Elbow may cause pain on the inside of the elbow. A child should stop throwing if any of the following symptoms appear:

  • Elbow pain
  • Restricted range of motion
  • Locking of the elbow joint

Treatment Options

If left untreated, osteochondrosis dissecans can become a complicated condition. Younger children tend to respond better to nonsurgical treatments.

Rest the affected area.

Apply ice packs to bring down any swelling.

If pain persists after a few days of complete rest of the affected area or if pain recurs when throwing is resumed, stop the activity again until the youngster gets treatment.

Return to throwing.

Treatment Options: Surgical

Surgery may be necessary, especially in girls more than 12 years old and boys more than 14 years old.