Little League Elbow is a common overuse injury in kids involved in overhand throwing sports, principally baseball. Little League elbow is treated by Dr. Peter G. Fitzgibbons, MD at The Centers for Advanced Orthopaedics: Maryland Orthopedic Specialists Division. Dr. Fitzgibbons performed fellowship-training in hand, wrist, and elbow surgery through the Harvard Hand & Upper Extremity Fellowship based at Brigham & Women’s Hospital in Boston. With locations in both Germantown, Rockville, and Bethesda, Maryland, he and a team of orthopaedists, hand therapists, and physical therapists offer a comprehensive range of services covering the diagnosis and treatment of Little League Elbow.
Throwing places significant stress on the elbow as the arm accelerates and puts tension on the inside of the elbow and compressive force on the outside. In adults, the stress is concentrated on the medial collateral ligament on the inside of the elbow, which is the ligament that many high-level pitchers will have reconstructed with “Tommy John” surgery. Kids have a growth plate on the inside of the elbow which is where that same stress is concentrated, and this can lead to pain, stiffness, and sometimes fracture – Little League elbow. Compression on the outside of the elbow can also cause problems with a
stress-related reaction in the bone.
Little League elbow is an overuse injury, and the principal initial treatment is a period of rest for at least six weeks, usually accompanied by physical therapy to work on range of motion and/or strengthening. This is followed by a period of gradual return to throwing assuming pain is gone and motion is full. Throwing mechanics can play a role in avoiding undue stress on the elbow, and often some time spent with a pitching coach to improve the throwing motion can be helpful. In rare cases, surgery can be warranted for persistent symptoms, usually when small bone fragments or cartilage defects have developed
Surgery for Little League elbow is unusual but when needed is performed as an outpatient procedure and is done with general anesthesia. The surgery itself will vary depending on the exact symptoms and pathology. Dr. Fitzgibbons performs most of these procedures at the Massachusetts Avenue Surgery Center or Shady Grove Hospital.