Throwing injuries in the elbow are common among young athletes, especially baseball and softball players.

Epicondyle Apophysitis (Little Leaguer’s Elbow)

This is the most common elbow injury in young throwers caused by repetitive stress on the tendons and ligaments that attach to the growth plate (apophysis) on the inner elbow. It results in pain on the inner side of the elbow that worsens with throwing. Ignoring the pain can lead to tearing of ligaments/tendons from the bone and disruption of normal bone growth.

Osteochondritis Dissecans (OCD)

OCD is an injury to the cartilage and underlying bone in the elbow joint caused by repetitive compression forces from throwing. It produces gradual onset of pain, usually on the outer aspect of the elbow during the throwing motion. Later symptoms can include swelling, joint locking/stiffness.

Other Common Injuries

• Ulnar collateral ligament (UCL) tears from repetitive stress can cause severe pain and instability.
• Tendinitis or muscle strains in the flexor-pronator muscles can occur from overuse.
• Acute fractures and dislocations within the elbow joint are less common but serious injuries.

Risk Factors

• Injuries are more common in pitchers but can occur in any position that involves repetitive throwing.
• Most cases happen between ages 8-15 when growth plates are still open.
• Overuse from throwing too much is the primary culprit.

Treatment

• Rest from throwing for an extended period (often 6+ weeks) is the first line of treatment.
• Ice, anti-inflammatory medication, physical therapy exercises are used to reduce pain/swelling.
• Surgery may be needed for severe UCL tears or loose bone fragments.

Prevention

• Following pitch count guidelines and limiting total throws is critical.
• Proper conditioning, throwing mechanics, and warm-up exercises are emphasized.
• Taking extended breaks from throwing (3-6 months per year) is recommended.
• The key is recognizing symptoms early and resting to allow proper healing, as continued throwing can lead to serious, permanent damage.