Avoiding Throwing Injuries In Young Athletes Reed L Bartz, MD

The term “little leaguer’s elbow” has been Again, early recognition is important. Shoulder and used to describe multiple causes of pain in Treatment consists of rest and range of elbow problems in the adolescent thrower’s elbow (including motion exercises until pain resolves the youth baseball followed by a rotator cuff strengthening pitcher are common. In fact, a recent study tendonitis, loose bodies, or osteochondritis program. of little leaguers from fifteen youth baseball dessicans). The adolescent thrower may leagues revealed that approximately fifty The best treatment for both of these present with pain during or after throwing, conditions is prevention! percent of players experienced shoulder or as well as loss of pitch control. Early elbow pain in a single season. An detection is paramount in the treatment of increased incidence of shoulder and elbow “little leaguer’s elbow.” If radiographs are pain was noted in pitchers who threw normal, conservative treatment with rest, curveballs and sliders. Although the risk of ice and stretching is usually successful. injury to a pitcher is known to increase with Adolescent pitchers should not be allowed age and level of competition, many pitching to resume throwing until all symptoms have injuries requiring medical attention in the resolved. If elbow radiographs reveal more elite level of pitcher are thought to degenerative changes or loose bodies, result from cumulative stresses that begin surgery may be required. with throwing at the youth level. The youth thrower is more at risk for stress The Best Treatment Is related injuries, as the growth plates in the Prevention shoulder and elbow are open and susceptible to the high rotation forces “Little leaguer’s shoulder” refers to an injury generated by throwing a baseball. involving a growth plate in the proximal Although upper extremity muscle soreness humerus bone that occurs due to the high is normal in the development of a youth torsional stresses placed on the shoulder pitcher, joint pain (such as in the shoulder with repetitive pitching. The young pitcher and elbow) is not, and should be evaluated with this injury usually experiences a by a medical professional. several month history of mild shoulder pain that escalates to severe shoulder pain during a pitching outing. The coach may notice a loss of pitching control or velocity.