According to the American Academy of Orthopaedic Surgeons, elbow injury occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments. Among baseball players, most elbow injuries occur in pitchers, but position players can suffer elbow injuries as well. The prevention of elbow injuries can be achieved by following strict pitch count limits and improving pitching mechanics, as well as never playing through elbow pain.
Little League Elbow
As the name implies, Little League elbow, or medial epicondylar apophysitis, generally affects pitchers ages 9 to 14. The medial epicondyle, the knobby bone on the inside of the elbow, is the attachment point of several muscles and a ligament that support the elbow during throwing. In immature players, the bone in this area is still soft and growing. According to Children's Memorial Hospital, repetitive pitching puts a large amount of stress on this growth plate, causing it to become inflamed and irritated. Symptoms of Little League elbow include pain and swelling of the inner portion of the elbow and occasionally an inability to straighten the arm completely. Treatment involves rest from throwing and ice to control inflammation. Young pitchers should adhere to strict pitching guidelines to prevent injuries from occurring.
Osteochondritis Dissecans
Osteochondritis dissecans is a fragmentation of the bone or cartilage. In the young throwing athlete, this is generally seen on the outside of the elbow where the bones are continually being compressed forcefully against each other. According to the American Academy of Orthopaedic Surgeons, this is a less common condition, but is caused by excessive throwing. Symptoms include pain and swelling near the outer bone of the elbow, and occasionally, locking of the joint. Treatment includes rest from throwing and ice to control inflammation. Surgery to remove a fragment of bone is sometimes required.
Ulnar Collateral Ligament Sprain
The ulnar collateral ligament holds the bones of the inner side of the elbow together during throwing motions. The stress of throwing can result in small, partial tears or a complete rupture of the ligament. Once the ligament is injured, the resulting movement of the elbow bones can irritate the ulnar nerve resulting in tingling of the arm and hand. According to the Johns Hopkins Medical Institutions, if the patient wishes to return to strenuous overhead or throwing activities and they do not respond to nonsurgical treatments, then surgical repair of the UCL is recommended. Surgery involves reconstructing the ligament using a graft generally taken from the patient's forearm tendon. Many months of rehabilitation follow surgery and nine months is generally the soonest a pitcher will be allowed to return to competition.
References
- The American Academy of Orthopaedic Surgeons: Throwing Injuries in the Elbow
- Children's Memorial Hospital: Little League Elbow
- The Mayo Clinic: Elbow Pain: Causes
- The American Academy of Family Physician: Evaluation of Elbow Overuse Injuries
- Johns Hopkins Medical Institutions: Patient Guide to UCL Injuries of the Elbow
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