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Little League Elbow: Overuse Injury of the Elbow

by Tyler Triggs MS, LAT, ATC

Key Points

  • Overuse Injury

  • Pain on the inside of the throwing arm

  • More common in youth athletes

  • Can become severe if not treated

  • Rest alone generally does not fix the problem


Little league elbow (medial apophysitis) is an overuse injury commonly seen in youth baseball players, but does also occur in other throwing sports, as well. The injury is an inflammation to the growth plate in the elbow. The causes of this injury vary from lack of rest, high pitch counts, muscle imbalances and improper pitching mechanics.


  • Pain on the inside of the elbow

  • Decreased throwing speed or accuracy

  • Gradual increase in pain/stiffness

  • Increased pain while throwing

  • No specific incident that caused injury

Athletic Trainer’s Take:

Little league elbow typically shows up without a specific throw or play that caused sudden pain. Pain gradually increases on the inside of the elbow over time and can lead to stiffness and loss of motion. At rest, the pain many times will go away, but returns when throwing again. Just resting, these injuries usually results in a return to pain when throwing again. The root cause needs to be fixed to reduce the chance of further missed time.

What you can do:

  1. Stop or reduce throwing while recovering

  2. Ice the inside of the elbow initially

  3. Do not stop all activity

  4. Improve mobility and flexibility of the elbow, shoulder and hips

  5. Strengthen the shoulder, core and hip muscles

When to contact an Athletic Trainer:

  • If you need help and advice on properly modifying your activity, an AT can provide you with ongoing support.

  • If you need direction with proper stretching and strengthening exercises, an AT can get you started on effective exercise progression and regressions.

  • If any pain worsens or is persistent, an AT can advise you on the right steps to take next.

*Contacting an ATC first can prevent unnecessary imaging or doctor visits. This will save you time, money and ensure the right steps are taken to get back to throwing pain free.

Disclaimer: These statements are a reflection of my education and experience. The suggested treatment options are not intended to diagnose an injury and have not been researched.

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