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One, Two, Three Strikes you’re Out… with Little League Elbow

As school comes to a close and summer begins, many young athletes will begin new athletic ventures. From kicking the ball around the pitch, to throwing fastballs from the mound, injuries can happen at any age and in any sport. One of the common injuries amongst youngsters in the world of baseball is “Little League Elbow”.

What is Little League Elbow?

Little League Elbow is a term used to describe pain or discomfort in a young throwing athlete’s elbow. It is often related to injuries of the muscles, tendons, ligaments and/or bones. Typically, Little League Elbow is classified as an overuse injury, and often occurs when athletes are playing on numerous days per week, potentially with multiple teams at a time. This can be further aggravated by poor throwing technique and inadequate recovery. Most often, Little League Elbow is seen in pitchers due to the large amount of throwing they perform and is most common amongst growing children between the ages of 8 and 14.

What are the causes of Little League Elbow?

As mentioned above, Little League Elbow is often caused by excessive overuse. During an overhead throw, the arm moves through several extreme positions at high speed, putting the elbow under significant stress and strain. Excessive throwing, combined with inadequate recovery may cause irritation and injury to the surrounding muscles, tendons and ligaments. In severe circumstances, you may also see tearing of tissue (avulsion injuries), as well as damage to the growth plates within bones.

What are the Signs & Symptoms of Little League Elbow?

  • pain in any part of the elbow that worsens over time

  • a popping/catching sensation when throwing

  • unexplained loss of throwing velocity

  • swelling around the elbow; loss of range of motion

  • locking or stiffening elbow

How to prevent Little League Elbow?

Prevention of elbow injuries in overhead throwing athletes can occur on various levels.

  • Parents: Monitor your child during overhead throwing sports. Encourage appropriate rest, as well as participation in a variety of sports to develop well-rounded and resilient athletes.

  • Athletes: Do not play through elbow pain. Talk to your parents or coaches if you are dealing with any discomfort or symptoms while throwing. Ensure you complete a proper warm-up and cool-down during game and practices.

  • Coaches: Ensure athletes utilize proper technique when throwing. Encourage general conditioning, strength and mobility. Provide proper rest and follow any mandated pitching guidelines. Pitch counts are crucial in the prevention of Little League Elbow.

More information on Pitching Guidelines in Baseball and Softball can be found here:

How to treat Little League Elbow?

The number one line of defense in resolving Little League Elbow is rest and modifying activities. Taking a break from throwing will eliminate the repetitive strain on the elbow’s muscles, ligaments and tendons. The length of rest often depends on the severity of symptoms, clinical findings and upcoming scheduled games/practices.

In addition to active rest, icing the elbow post-game or practice can help to diminish symptoms of pain and inflammation. This can also be done multiple times per day, especially during multi-game tournaments.

When in doubt, it is always helpful to seek the opinion of a healthcare professional. Physiotherapy and rehabilitation can play a crucial role in the prevention and treatment of Little League Elbow. A physiotherapist can help to reduce pain in the elbow, restore full strength and mobility of the throwing arm, improve biomechanics to decrease stress on the elbow and prepare the arm for return to sport with the stresses/demands of throwing.

For assistance in the assessment and treatment of your athletic injuries, please consider giving us a call, email or booking online for your next appointment at K-TOWN Physiotherapy.


K-TOWN Physiotherapy is proud to be the medical provider for the upcoming 2024 Canadian Little League Championship. The event will take place at the newly restored Cricket Field in Kingston’s historic City Park from July 30 th -August 8 th , 2024. Come out to watch some great Little Leaguers and your local K-TOWN Physiotherapists in action!

Written by: Michael O’Meara, Registered Physiotherapist; Sport PT Dip.; RISPT


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