Fri, Nov 27 2009

Published: May 01, 2009 05:30 am    PrintThis  

Hardball facts about Little League Elbow

On the Mend
Joe Divincenzo

Within the next few weeks, kids everywhere will take to the baseball field. The start of the season brings excitement and the hope of victory, but unfortunately, injuries as well. One of the most common injuries in children who participate in throwing sports like baseball and softball is Little League Elbow.

Little League Elbow (LLE) is a problem that develops predominately in young, throwing athletes between the ages of eight and fifteen. Pain typically begins at the inside of the elbow, usually right at the bony tip. In many cases, pain will travel down the inside of the forearm and often into the little or ring finger. Severe cases may cause a loss of grip strength or an inability to hold objects in the hand. This pain is often made worse by throwing at higher velocities or gripping things (like a bat) too tightly.

Little League Elbow most commonly develops in the beginning part of the season, usually during the first two or three games or practices, and the explanation for this is simple.

During the early part of the season, the bones, ligaments and muscles are not used to enduring high amounts of stress, specifically, the stress encountered when throwing a ball hard. Because the muscles cannot handle this sort of stress so early on, the ligaments and nerves in the elbow become strained. These ligaments and nerves respond quite poorly to this strain, and thus produce pain and symptoms.

The Medial Collateral Ligament (MCL) is often the one that is damaged in LLE. This ligament prevents the bones of the forearm from moving on the humerus (upper arm bone). If these bones move excessively, like with hard throwing or with certain types of pitches, they may sheer and compress a very sensitive nerve called the Ulnar Nerve (it's your funny bone nerve).

Furthermore, children are continuously growing, and it is conceivable that within a four-month season, a child could grow an inch or more. We often forget that kids grow in all directions, not just up, so we must remember that the bones and muscles of the forearm may need more time to accommodate their new size.

Throwing sports place high demands on young arms, and these injuries can follow a player for the rest of his or her athletic career. Here are a few tips that will help keep Little League Elbow at bay:

Warming up doesn't mean taking a lap around the field. When professional baseball players warm up before a game, they throw long distances after ten or fifteen minutes of close-range tossing.

As a rule of thumb, children shouldn't throw curve balls until they're old enough to shave. At about this time, the muscles and ligaments of the elbow have matured enough to handle the elbow-snapping associated with curve balls, and curve balls should definitely not be thrown prior to age twelve.

Forearm strength is key. Continually strengthening the forearms throughout the season by doing wrist-curls and wrist-extensions with light weight is a great way to support the elbow with strong muscles.

Sixty pitches per game, and no more. Young arms have trouble enduring high loads for long periods of time. After sixty pitches, consider your pitcher done for the night.

Young pitchers should pitch once per week and then transition to another position with minimal throwing, i.e. first or second-base for the rest of that week.

Start Physical Therapy at the first sign of a failing-elbow. If left to its own devices, LLE can be a nasty, long-term injury.

Following these simple tips should be enough to keep your players on the field and out of the clinic. But if your child experiences elbow pain, bring them in for an evaluation — physical therapists play hardball with Little League Elbow.

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Photos


Rachel Grant stretches towards home with a pitch that could strain her elbow if not properly warmed-up. None/Courtesy photo (Click for larger image)


Jacob Grant steps off the mound delivering a fastball to home plate. Throwing hard too soon can place extra stress on an elbow in a compromised position. None/Courtesy photo (Click for larger image)

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