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Ouch! My Kid Has Little League Elbow!

Written by Kara Carter, M.D. on Jul 30, 2018 8:02:00 AM

Gone are the days when young athletes play their sport for a few months a year and then take a long break. Year-round play is the new norm, and not only are kids playing year-round, they’re also competing at a higher level. This means that paying special attention to how your kid is playing, and for how long at a time, is important to help reduce injuries like little league elbow. 

Who’s at Risk?

Pitchers between the ages of 8 and 15 are the most common group afflicted with little league elbow, but it can strike any high-throwing-volume position, such as catcher or outfield, and it can occur up to the age of 17 if the growth plate has not yet fused. The injury is often characterized by pain at the inside of the elbow and occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments of the elbow. Left untreated, throwing injuries can become complicated conditions.

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Keep Count of Throws

Because little league elbow is an overuse injury, the most important step you can take to help prevent it is not to allow your child to overuse it. Some leagues have pitch counts and those should be strictly adhered to. If you’re in a league that doesn’t enforce pitch counts, talk to your child’s physician to find out what he or she recommends. According to the American Academy of Orthopaedic Surgeons, the general guideline for how many pitches a child can safely throw each week is 75 for 8- to 10-year-olds and 125 for 13- to14-year-olds. This includes practice and game play. When an athlete has reached the pitch quota, he or she either needs to be taken out of the game or moved to a position that doesn’t require the volume of throws that pitching does. In other words, it does no good to move the player from pitcher to catcher, or pitcher to shortstop.

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Active Rest and Proper Training Are Important

Active rest is important. It’s that period of time when the sport’s season is over and players take time off from it and do not throw, but still play other sports if they’d like to. 

Staying in shape during the off-season is important. It means players will have the strength to pick up where they left off at the end of the season, which may leave them at a lower risk for injury. Help young athletes recognize the benefits of year-round physical fitness and conditioning. 

Good mechanics are also important in preventing little league elbow, as are avoiding certain pitches. Research has shown that sliders and curveballs, because of the way they’re thrown, are more likely to cause injury than other pitches. Most professionals recommend that kids younger than 14 should only throw fastballs and changeups. After age 14, he or she can add curveballs, and after age 16, sliders can be added, because the growth plate is likely fused by then, putting the player at a lower risk for injury. 

Treatment Options

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Nonsurgical treatment is the first course of treatment for little league elbow and begins with resting the elbow, applying ice packs to bring down any swelling, participation in an individualized physical therapy program, and possibly refining throwing technique. 

Surgery is occasionally needed, especially in girls 12 and older and boys 15 and older. Depending upon a child’s injury, surgery may involve removing loose bone fragments, bone grafting, or reattaching a ligament back to the bone. 


Dr. Kara Carter is a board-certified pediatrician at Kelsey-Seybold’s Katy Clinic in Richmond, Texas. She’s a breastfeeding advocate and her clinical interests revolve around preventive care for her patients.



Topics: little league elbow, how is little league elbow treated, kids sports injury elbow

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