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Marketplace Physical Therapist Chino Hills Sees Sharp Increase in Little League Elbow

Marketplace Physical Therapist Chino Hills Treats Children with Little League Elbow

I know that we have all heard the old adage “Practice Makes Perfect”. I use that one a lot with my 11 year old son Jared. Marketplace Physical Therapist Chino Hills, Dr. Courtney Ellstrom, Doctorate of Physical Therapy, has seen a sharp increase in Little League Elbow. The medical term for Little League Elbow is Medial Epicondylar Apophysitis. Little League elbow is an injury that usually affects pitchers from 9 to 14 years old, thus the name. It can also occur to children in other sports who throw a lot like football, water polo, and volleyball. Pain is caused by an increased amount of pressure on a growth plate in the forearm.

Anatomy of the forearm and elbow

Why does it occur?

With Sports Stars notoriety and salary increasing significantly, parents and children are pushing harder than ever for success. In simple terms, children do not have the muscle or ligament structure to support a major league work load. If you want a more technical version: The medial epicondyle is where the forearm muscles attach to the bone and is the ligament that stabilizes the elbow in the throwing motion. In children the medial epicondyle contains a growth plate of immature cartilage cells, which is significantly more likely to be injured compared to mature bone. You must be extremely careful with this injury because if ignored the growth plate can actually tear off from the upper arm.

This is a great example of the pressure placed on the elbow during a throw.

Symptoms of Little League Elbow

Symptoms can present themselves during sports and non-sports activities. The patient will experience pain on the side of the elbow when throwing which can result in a decrease in speed or accuracy. One of the Pitchers on my son’s baseball team started demonstrating symptoms when he was writing in class or doing homework. You might think they are just trying to get out of class work, but any movement involving the forearm can cause pain.


Ignoring this injury is a recipe for disaster and can limit your child’s future in their sport. Marketplace Physical Therapy Chino Hills recommends seeing a Physical Therapist immediately. You can schedule a free consultation with on of our Physical Therapists in Chino, Riverside, Corona, Redlands or Beaumont. At that point here are some recommendations the Physical Therapist might make depending on the severity of the injury.

1. Ice the elbow three times a day for 15 minutes each.

2. Treat the injury with Interferential Stimulation and Ultrasound

3. Develop a strength and conditioning program to increase the endurance and capacity of the forearm muscles.

4. If the injury is severe, your Physical Therapist could recommend cessation of the sport for a maximum of 6 weeks. This evaluation is made on a case-by-case basis and can be averted with adherence to a Physical Therapy program.

5. Referral to a Physician for an X-Ray to determine severity.

6. Forearm braces might also be recommended to immobilize the arm.

As always Pitchers should have rest days between high throwing days. Here is the schedule we followed for my son’s baseball team.

For pitchers age 7 to 16:
Pitches in a day Rest time
61 or more 4 days
41-60 3 days
21-40 2 days
1-20 1 day

For pitchers age 17 to 18:
Pitches in a day Rest time
76 or more 4 days
51-75 3 days
26-50 2 days
1-25 1 day

Please contact us if you have any questions and let us know if you liked this article.


Michael Rappaport

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