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Little Leaguer’s Elbow (Medial Apophysitis), Sports Medicine

Robert Hosey, MD, FACSM, CAQSM and Andrew Schleihauf, DO, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Classic definition: valgus stress lesion of the medial epicondylar physis

  • On a continuum with avulsion fracture of the medial epicondyle

  • Now, Little League elbow (LLE) used as a catch-...

DIAGNOSIS

HISTORY

  • Age: important because of the different ages at which each growth center appears and/or closes

  • Location: Most commonly, pain is located at medial epicondyle; however, sometimes pain pr...

TREATMENT

  • Long-term treatment 3[C]:

    • Pitch-count guidelines:

      • Most recent guidelines 2016

      • Ages <8 yr (50 pitches per game), 9 to 10 yr (75 pitches), 11 to 12 yr (85 pitches), 13 to 14 yr (95 pitches)

  • Acu...

ONGOING CARE

Closed reduction is associated with pseudoarthrosis, causing pain and instability as well as formation of double epicondylar epiphyses. 

REFERENCES

1
Marsh D. Little League elbow: risk factors and prevention strategies. Strength Cond J.  2010;32(6):22–37.
2
Wu M, Fallon R, Heyworth BE. Overuse injuries in the pediatric population. Sp...

ADDITIONAL READING

  • Benjamin HJ, Briner WWJr. Little League elbow. Clin J Sport Med.  2005;15(1):37–40.

  • Klingele KE, Kocher MS. Little League elbow: valgus overload injury in the paediatric athlete...

CLINICAL PEARLS

  • LLE or medial epicondylar apophysitis is the most common elbow injury in childhood and the most common cause of medial elbow pain in young baseball pitchers.

  • At present, baseball youth ...

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