Baseball Elbow (Little Leaguer’s Elbow)


Little Leaguer’s Elbow is an overuse injury that affects the inside (medial side) of the elbow in growing athletes—most commonly baseball pitchers, but also catchers, quarterbacks, gymnasts, and tennis players.

In kids and teens, the bones are still growing. The growth plate on the inside of the elbow is weaker than the surrounding muscles and ligaments, so repetitive throwing stress pulls on this area and causes irritation, inflammation, or even small separations.

Common Symptoms

  • Pain or soreness on the inside of the elbow

  • Pain that worsens during or after throwing

  • Decreased throwing velocity or accuracy

  • Elbow stiffness or swelling

  • Sometimes numbness or tingling into the forearm or hand

🚨 Important: Pain in young throwers is not normal and should never be “thrown through.”

What Causes It?

  • Repetitive throwing without adequate rest

  • Poor throwing mechanics

  • Pitching too frequently or year-round

  • Not enough shoulder, core, or hip strength

  • Growth spurts (bones grow faster than muscles adapt)

Why Early Care Matters

If ignored, Little Leaguer’s Elbow can lead to:

  • Growth plate damage

  • Avulsion fractures

  • Long-term elbow instability

  • Missed seasons—or worse, missed development years

The good news? With early care and proper rehab, most athletes recover fully.

Rehab & Recovery Protocols

(General guidelines—always progress based on symptoms and professional guidance)

Phase 1: Calm the Irritation (Weeks 0–2)

Goals: Reduce pain and protect the growth plate

  • Complete rest from throwing

  • Ice 10–15 minutes after activity (if sore)

  • Gentle elbow and wrist range-of-motion exercises

  • Focus on posture and shoulder positioning

Avoid: Throwing, pitching, long toss, or pain-provoking activities

Phase 2: Restore Mobility & Control (Weeks 2–4)

Goals: Normalize motion and improve stability

Exercises (2–3x/week):

  • Wrist flexor & extensor stretches (pain-free)

  • Forearm pronation/supination with light resistance

  • Scapular retraction exercises

  • Shoulder external rotation with bands

  • Core stability (planks, dead bugs)

✔️ All exercises should be pain-free

Phase 3: Strength & Throwing Prep (Weeks 4–6)

Goals: Build resilience through the entire chain

Add:

  • Light dumbbell wrist curls & reverse curls

  • Shoulder strengthening (Y-T-W patterns)

  • Rotator cuff endurance work

  • Hip and glute strengthening

  • Medicine-ball or cable rotation drills (age-appropriate)

❗ Still no pitching yet

Phase 4: Return to Throwing (Weeks 6–8+)

Goals: Gradual, controlled return to sport

  • Begin structured throwing program

  • Start with short, light tosses

  • Progress distance and intensity slowly

  • No pain during or after throwing

  • Pitch counts and rest days must be respected

⚾ Pitching is reintroduced last—not first

Prevention Going Forward

  • Follow age-appropriate pitch count guidelines

  • Take at least 3–4 months off from throwing each year

  • Avoid playing on multiple teams simultaneously

  • Strengthen shoulders, core, hips—not just the arm

  • Address mechanics early

  • Never ignore elbow pain

Final Thought

Little Leaguer’s Elbow isn’t just an “elbow problem”—it’s a whole-body issue involving mechanics, workload, and growth. When addressed early and properly, young athletes can heal, grow stronger, and return to the sport they love—without long-term damage.