Little League Elbow is a spectrum of disorders which are characterized by pain around the elbow in someone who typically plays baseball, but can also be involved in other throwing motion sports such as tennis and football. At the one end of the spectrum are the youngest kids who present with pain on the inside of their elbow. This is usually from flexor tendonitis or a stress fracture of the medial epicondyle. If ignored, this can lead to an acute fracture of the medial epicondyle which sometimes requires surgical intervention. This usually occurs in the adolescent in association with an injury to the ulnar collateral ligament. As the thrower becomes older, their pain will change and localize to the outside of the elbow. This can be extremely serious. This is usually osteochondritis dissecans (OCD) of the capitellum or the radial head. OCD can lead to loose bodies in the joint, arthritis, and permanent disability.

Pitchers have a higher incidence of elbow disorders because pitching places the most stress on the elbow during play, but all other positions may also develop elbow problems.

What are the physical exam findings?
Most patients will not be able to fully extend the elbow, they may or may not have swelling, and the location of the pain will be variable.

Will x-rays be taken?
Usually x-rays are taken when either acute or chronic pain exists in someone who throws repetitively. A CT scan or MRI may also be ordered.

What is the treatment?
The treatment depends on the age of the patient and the cause of the pain. Treatment can be from rest to casting to surgery depending on the nature of the injury. It is extremely important that the physician's instructions are followed regarding both the acute care of the elbow as well as the instructions for return to play. Elbow injuries in the adolescent are serious and can have long-term sequelae if treatment is ignored.