A healthy living blog from Marshfield Clinic Health System

Stay in the game: Preventing Little League elbow

little league elbow commonly affects kids under 16Medial epicondyle apophysitis, more commonly known as Little League elbow, is an overuse injury usually seen in baseball pitchers younger than 16. Dr. Laurel Rudolph, sports medicine physician at Marshfield Clinic Health System, offers this information about the injury and how to prevent it.


Little League elbow is often associated with throwing. It affects kids who go through repetitive overhand throwing and participate in racket sports.

“These motions put stress on the inside of a child’s elbow, where bones are still growing and have not reached skeletal maturity,” said Dr. Rudolph.

What Little League elbow feels like

As is the case with many overuse injuries, Little League elbow usually comes on gradually. Players can experience aching or sharp pain. Throwers may also notice swelling on the inside of the elbow.

“Some kids may try to play through it, but early evaluation is key to preventing potential long-term problems and pain,” Dr. Rudolph said.


A clinical exam and X-ray are the most effective tools for diagnosing Little League elbow.


Most cases clear up without complicated interventions. The first step in any treatment plan is to rest from the sport that caused the injury. The rest period is often 4-6 weeks, although it can vary by patient. Your health care provider may restrict the athlete from throwing but there are numerous cross-training activities that the athlete can still participate in. Ice will help with pain and swelling.

“Some kids take acetaminophen or nonsteroidal anti-inflammatory drugs for pain, but those usually aren’t necessary if the athlete isn’t throwing,” said Dr. Rudolph.

As pain improves, physical therapy can be considered to focus on elbow and shoulder strengthening. The child can return to throwing, albeit gradually. Limitations should be set on how many throws/pitches are allowed as per written guidelines through sanctioned baseball organizations.


Parents should especially be careful with 11-12 year olds, as this is when Little League elbow is most prevalent. Appropriate rest is needed during the season between practices and games.

Little League elbow and other overuse injuries have received a lot of study in recent years. Pitch Smart Guidelines have been widely endorsed by baseball organizations and the medical community. They outline pitch counts based on age.

Check in with your child’s provider if he or she is experiencing pain or discomfort while participating in sports.

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