Keeping Your Little Slugger in the Game

Picture yourself at the ball park, sitting on a lawn chair with the taste of sunflower seeds in your mouth. The sun is shining and you can smell the refreshing scent of freshly cut green grass. It’s a perfect way to spend a Saturday afternoon. This is what spring is all about to numerous young aspiring baseball players. In 2008, the Little League Baseball and Softball participation statistics reported that there were close to 2.6 million boy and girl players in little league baseball worldwide. That is why we at Children’s Bone and Spine feel it is so crucial to both be aware of possible overuse injuries and apply the correct prevention methods to insure a knock out season.

Throwing injuries are most common, usually affecting the elbow joint. This joint is comprised of a hinge and pivot component. The hinge lets the arm to bend, similar to that of a door. The pivot portion allows the lower forearm to twist and rotate. There are various important tendons, muscles, and nerves which cross over the elbow and can be injured during baseball.

The most common mechanism of injury is through repetitive throwing, commonly known as “little leaguer’s elbow” or medial apophysitis. The repetitive motion of pitching causes a strong pull on the tendons and ligaments around the elbow. Continuous repetition can actually cause the tendon to pull away from the bone, which disrupts normal bone growth and can cause deformity. Your little leaguer may complain of pain on the inside bump of the elbow and stiffness when trying to straighten the arm.

Pain on the outside of the elbow with a pitcher can arise from the elbow joint being compressed and the joint can crush immature bone against bone, causing a condition called osteochondritis dissecans. Although less common, this condition can still occur and cause pain to your little leaguer.

As a parent it is important to recognize the key symptoms of throwing injuries so as to avoid jeopardizing your child’s ability to continue in active sporting events. Have your child stop throwing and seek medical attention if he or she experiences elbow pain, locking of the elbow, or decreased range of motion.


  • Warm up and stretch your muscles: this promotes elasticity in your muscles, thus further preventing muscle cramping and straining.
  • Limit number of pitches thrown: The American Academy of Orthopedic Surgeons suggests a child limit his or her pitches to 200 a week. Furthermore, AAOS suggests pitchers only play three to four innings each game.
  • Stay hydrated: this is especially important here in Las Vegas where temperatures can easily rise over 100 degrees on an afternoon. Parents must realize that children dehydrate much quicker than adults, thus getting enough water is that much more important for your little leaguer.
  • Treating pain: ice can help with immediate swelling and rest is also helpful methods to treat immediate symptoms until medical attention can be attained.

1) Van Auken, Lance and Robin. Play Ball: The Story of Little League Baseball, Pennsylvania State University Press, 2001.

2) Huntington Medical Foundation. Preparing for Spring Sports: How to stay in the game. Pasadena, CA. 2010.

3) American Academy of Orthopaedic Surgeons. Throwing injuries in the elbow. 2008.

4) Micheli, Lyle J. The Sports Medicine Bible for Young Athletes. Elbow Injuries. Sourcebooks Inc: IL. 2001. Pg 210-213.


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Children’s Bone & Spine Surgery

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