We see an increasing number of Little League elbow injuries in young baseball players in our office. Many heal with a combination of rehabilitation and rest while others require surgery. These players are usually between 8 and 15 years old. And they're almost always boys, because the round-house motion used by female softball pitchers doesn't create stress on the elbow the way pitching a baseball overhand does. We know this problem comes from two basic factors -- the physical immaturity of adolescents and overuse. Between the ages of 8 and 14, growth plates of the bones are weaker than the tendons. Boys are still maturing physically. Little League elbow is preventable, especially if one follows these tips:

•  Warm Up

Coaches need to educate players to the importance of and techniques for stretching and strengthening the arms and shoulders. Always take time to warm up and stretch. Research has proven that cold muscles are more prone to injury. The American Academy of Orthopaedic Surgeons (AOS) suggests warming up with jumping jacks, stationary cycling, running or walking in place for three to five minutes, followed by slow, gentle stretching, holding each stretch for 30 seconds.

•  Throw Less

A broad recommendation, shared by Dr. Joe Congeni, director of Akron Children's Hospital's sports medicine center, is that pitchers base their number of pitches each week by multiplying their age by 10, so a 9-year-old would limit his pitches to 90 per week. A 13-year-old would throw no more than 130. The American Academy of Orthopaedic Surgeons recommends limiting the number of pitches per game to 60 to 100, with no more than 30 to 40 in a single practice session, adding that innings pitched should be limited to about four per week, with a minimum of three days’ rest between starts.

•  Throw Correctly

Poor throwing motions put too much stress on the elbow. Discourage sidearm throwing because it is three times more likely to cause injury.

•  Master the Basics

Between the ages of 8 and 14, work on three phases -- gaining control, increasing velocity and developing a command of the strike zone, throwing only fast balls.

•  Recognize Injuries When They Occur

Any persistent pain, loss of range of motion (especially extension) or X-ray abnormalities should keep a player on the sidelines until the symptoms disappear or a doctor clears the players. Little League elbow is also known as medial apophysitis, because it's always on the inner side, or medial side, of the elbow. So, not all elbow pain is Little League elbow. Be sure to consult a medical professional at the Idaho Hand Institute before beginning any treatment plan. For more information, please contact the Idaho Hand Institute at (208) 235-4263 or at any of our four locations: Pocatello, Blackfoot and Soda Springs and our newest location in Idaho Falls (Mountain Falls Quick Care Clinic at 1995 E 17th St #1, Idaho Falls, ID 83404).