Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Little Leaguer’s Elbow

What is Little Leaguer’s Elbow

Little Leaguer’s Elbow is a childhood and adolescent condition involving the growth plate of the bone at the inner aspect of the humerus (arm bone) by the elbow.  Repetitive overload stress causes inflammation and injury of this growth plate.  This most commonly occurs with baseball pitching.  There are several muscles that control the forearm, wrist, and hand which attach to the bone at this growth plate, along with the medial collateral ligament of the elbow.  When winding up and throwing a pitch these muscles and the medial collateral ligament are under significant tension and stress.  The growth plate is the weakest link in this chain of structures.  The growth plate will close when an adolescent becomes skeletally mature.

Symptoms of Little Leaguer’s Elbow

Pain at the inner aspect of the elbow is very common.  The elbow pain may be exacerbated with motion of the elbow and wrist.  If continuing to pitch, there can be decreased velocity, accuracy, and distance, as well as greater injury.

Common Causes of Little Leaguer’s Elbow

As the name suggests, baseball pitching during childhood and adolescence is the primary cause of Little Leaguer’s Elbow.

Diagnosing Little Leaguer’s Elbow

Discussion with the patient and parent to understand the level of competition, frequency of pitching, and number of pitches thrown per game and week is important not only for diagnostic reasons, but also for tailoring the rehabilitation regimen.  A careful physical exam will also aid in diagnosis.  An x-ray is obtained to evaluate for bony abnormalities, such as widening of the growth plate or stress fracture of the bone.

Treatment of Little Leaguer’s Elbow

The mainstay of treatment for Little Leaguer’s Elbow is rest.  A period of cooling down and not pitching allows the body to heal in most cases.  A progressive rehabilitation regimen is instituted not only the elbow, but the entire upper extremity and to optimize pitching mechanics by addressing the core and lower extremities as well.  Once a patient return to pitching, the frequency of pitching and pitch counts need to be maintained in an acceptable range for a patient’s age to avoid re-injury in the future.  If left untreated, Little Leaguer’s Elbow can cause permanent bony deformity, pain, and ulnar nerve irritation, requiring surgery.


With many children pitching with greater frequency throughout the year there is increasing prevalence of Little Leaguer’s Elbow.  Early treatment is important to allow quicker recovery and to improve pitching mechanics.  Call Dr. Pruzansky at 212-249-8700 to schedule an appointment.