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Little League, Big Problem

Baseball is America’s favorite pastime. Every April, eager spectators flock to ballparks throughout the nation, filling every available seat hoping to see their favorite players lead their home team to victory. At Fenway Park, Neil Diamond’s Sweet Caroline is piped through the stadium speakers, endless boxes of Cracker Jacks are consumed, and necks crane as number 34 steps up to the plate, year after year.

This well-loved sport is played by over two million Little Leaguers each year, as reported by Many young athletes aspire to play in the major leagues one day, and often, they try to train and play just as hard as their professional idols. However, pushing their limits in the game too early can leave them on the sidelines later on.

As the start of baseball season approaches, it’s important for parents, coaches, and athletes to be mindful of overuse injuries like Little League Elbow, which is caused by reoccurring stress to the growth plate inside the elbow. Growing bones are more easily injured than developed ones, and if warning signs are ignored, permanent damage can occur.

Little League Elbow most commonly affects pitchers between the ages of 8 – 15 years old. The condition can also occur in pitchers, catchers, infielders, and outfielders. Symptoms usually begin progressively without a specific injury. Athletes may begin to feel discomfort when throwing or hear a popping sound when their elbow is engaged in motion. Eventually, athletes may experience sharp pain and swelling inside the elbow. If the player continues to throw through the pain, the ligament may separate from the bone, cause small fractures, and bone chips. Long-term issues such as deformities and osteoarthritis can occur overtime. For more information provided by the American Academy of Pediatrics, visit:

Tommy John Surgery is a surgical graft procedure in which the damaged Ulner Collateral Ligament (UCL) is replaced with a tendon from another part of the body. At the time of the first notable Tommy John Surgery, which is coined for the major league pitcher who received it, the odds of returning to the game were 1 in 100. Today, the odds are much better, and over 85% of patients make a full recovery, according to Major League Baseball. (

For competitive athletes, elbow injuries can have devastating consequences. The Boston Red Sox recently announced that the team’s number one catcher, Christian Vazquez, would be ending the season before it started to undergo the surgical procedure. Player Brady Aiken, who was projected to be a top major league draft pick in 2015, experienced elbow discomfort during a college game only to find that he had torn his UCL, and would need to undergo Tommy John Surgery. For a full list of players that have received Tommy John Surgery, visit:

If your Little League player is experiencing pain or limited range of motion, X-rays can determine if the gap in the elbow’s growth plate has widened and locate any fractures or bone fragments. Nonsurgical treatment includes taking a break from pitching or throwing activities, icing the affected area to bring down swelling, and engaging in physical therapy to improve strength.

To prevent problems before they begin, coaches should enforce pitching guidelines provided by the American Sports Medicine Institute (, which regulates how many times an adolescent throws during a game. Focusing on proper mechanics before speed will help take stress off the shoulders and arms, reducing injuries. Players should also use age-appropriate techniques during competitions and practice. Breaking pitches like curveballs and sliders put the most stress on the body and are not recommended until ages 14 and 16, respectively.

Other prevention methods recommended by the Academy of Pediatrics include consistent physical activity throughout the year to improve core strength through resistance training. Active rest during the sports off-months is important, though athletes may participate in other activities that avoid pitching. The average active rest time should be three to six months for adequate recovery.  For additional information, visit:

Even though your Little Leaguer may be serious about his or her training, reinforcing the love of the game and the enjoyment that comes with participating in a team sport may help take the focus off the pressures to compete competitively and help the player stay in the game for many seasons to come.

South County Physical Therapy, Inc. (SCPT) is an active member of STOP Sports Injuries, which is an organization committed to raising awareness regarding the long-range consequences of overuse and trauma injury. Over the years, SCPT has treated thousands of children from 8-18 for sports-related injuries. As a leader in sports medicine for 30 years, SCPT is an expert on treating the symptoms of sports-related injuries to help members of the sports community keep doing what they love. For more information, visit SCPT online at