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Little League Elbow: Tips For Keeping Your Young Pitcher Healthy

Written by Chris 

Published on February 22, 2024

Have you ever been concerned about your child's safety while playing youth sports? I know I have. One injury that often goes undiagnosed is Little League elbow. Just like the name implies, this injury is most often seen in young players involved in Little League Baseball. If you're a parent of a young athlete, it's important to be aware of this type of injury and what you can do to prevent it.

What Is Little League Elbow? 

Little League elbow is a very common injury in young baseball players and is caused by repetitive stress on the elbow joint from activities such as pitching. This injury results from overuse of elbow muscles, leading to pain, typically medial, inflammation, and damage to cartilage and bones.

The elbow consists of several growth plates where growth cartilage connects different bone parts. At this age, the bones, muscles, and tendons around the elbow haven't fully developed, making them more prone to injury.


Most of those who suffer from this are young baseball players between the ages of 9 and 14. It's most common in baseball pitchers but can also occur in the infield and catcher positions.  

Elbow pain in general in the adolescent pitcher is not uncommon and occurs in up to 40% of throwers.


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Little League Elbow Symptoms

The symptoms of little league elbow can vary depending on how severe the injury is. In some cases, players experience swelling, pain, and limited elbow movement, with severe cases leading to arm strength loss. Symptoms can intensify over time, causing damage to the elbow's cartilage and bones.

Other Signs of Little League Elbow may include:

Swelling or elbow pain

Bump on the inside of the elbow

It’s difficult to extend or fully straighten the arm

If the elbow becomes stiff or locks up

If you ignore the painful elbow injury and forego rest or treatment, the tendons and ligaments could tear away from the bone. As a result of playing through the pain, you are only going to hurt yourself by making the injury worse.

When Should You See A Doctor?

If the pain does not get better with rest, it might be time to go see your doctor or an orthopedist. The doctor will examine the elbow and look for swelling and range of motion to determine where the pain is. They will likely take an X-ray to determine any cartilage issues or growth plate damage.


Most youth baseball players can treat pitcher's elbow with rest and physical therapy but some cases may require surgery. If your child has elbow pain, they should stop throwing and give their arm a break (4-6 weeks minimum). See if resting alleviates the pain, but consulting a medical professional might offer more peace of mind.


There are a few different treatment options but the most common ones are rest, ice, and compression. If none of those seem to work, more severe cases may require surgery.


IIf you suspect your child has an elbow injury, consult a doctor to rule out serious issues. With proper care, most children will make a full recovery and be able to return to playing baseball.
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Surgical Treatments

If the non-surgical options haven't helped reduce the pain, then surgery may be required to remove loose bone fragments and reattach ligaments. Every case of pitcher's elbow is different and surgery isn't necessary for each but arthroscopy is typically used to diagnose issues tied to this injury.


This minimally-invasive procedure, tailored to the athlete's age or issue, offers less pain and shorter recovery times than open procedures. Your doctor will discuss the options for your child based on these factors.

Preventing Little League Elbow

Kinetic Arm Youth Sleeve

Have your child participate in a proper warm-up routine before they start throwing.

Use the correct form when throwing. Coaches should teach their players how to throw a baseball the right way so that they put less stress on the elbow. 

Above all else, avoid pitching on back-to-back days and try to increase the amount of time between pitching sessions gradually.

Rest - Listen to your body and take breaks so that your elbows have time to rest between practices and games. Year-round baseball or playing on multiple teams at the same time can cause a greater risk of elbow injuries. Children should try to refrain from throwing for at least 2-4 months per year. 

Play multiple sports. This will help children avoid specializing in one sport at an early age. 

Strengthening the muscles around the elbow joint through exercises and stretching.

Make sure your child’s coach is following the pitch counts guidelines.

Pitch Count Ages 8 & Under
Age Pitches Per Game 0 Days Rest 1 Days Rest 2 Days Rest 3 Days Rest 4 Days Rest 5 Days Rest
7-8 50 1-20 21-35 36-50 NA NA NA

pitch smart

Pitch Count Ages 9-12
Age Pitches Per Game 0 Days Rest 1 Days Rest 2 Days Rest 3 Days Rest 4 Days Rest 5 Days Rest
9-10 75 1-20 21-35 36-50 51-65 66+ NA
11-12 80 1-20 21-35 36-50 51-65 66+ NA

Pitch Count Ages 13-18
Age Pitches Per Game 0 Days Rest 1 Days Rest 2 Days Rest 3 Days Rest 4 Days Rest 5 Days Rest
13-14 80 1-20 21-35 36-50 51-65 66+ NA
15-16 95 1-30 31-45 46-60 61-75 76+ NA
17-18 105 1-30 31-45 46-60 61-80 81+ NA

Who Is Most At Risk For Baseball Elbow Injuries?

While every player who throws is at risk for elbow injuries, young baseball pitchers who throw too many pitches in too many games without proper rest are more likely to get injured. Pitchers and catchers on multiple teams may pitch and catch more frequently than those in just one league.


Also, pitch type can contribute to this type of injury. Breaking pitches like curveballs, sliders, and split-fingered fastballs put more stress on the undeveloped elbow so they should be limited until the kids get a bit older. 


Kids are constantly growing and their bones grow first before the muscles and tendons can catch up. During extreme growth periods, young athletes will also be more prone to overuse injuries because their muscles will be tighter and less flexible.  

Conclusion: Preventing Little League Elbow

Elbow pain is a common complaint for young baseball players, and it can be difficult to know when the issue requires medical attention and when it can be treated with rest and rehabilitation.


In this article, we’ve outlined what causes little league elbow, some of the most common symptoms, and treatment for little league elbow. If your child is experiencing any of these symptoms, don’t hesitate to take them to the doctor. Early diagnosis and treatment are essential for preventing long-term damage to the throwing arm.

Frequently Asked Questions

How severe is little league elbow?

Little league elbow ranges from mild discomfort to severe pain based on injury extent and stress duration.

At what age does little league elbow usually occur?

Little league elbow commonly affects children between the ages of 9 to 12, coinciding with peak periods of participation in youth baseball.

Can one play with little league elbow?

It's not recommended to play with little league elbow, as continuing can worsen the injury and delay healing.

What test diagnoses little league elbow?

A physician typically conducts a physical examination for diagnosis, and sometimes orders imaging tests like X-rays or MRI.

How long for a little league elbow to heal?

Recovery time varies based on the severity of the injury, but rest and proper treatment typically lead to healing within a few weeks to several months.

Why does a 9-year-old's elbow hurt when throwing?

A 9-year-old's elbow pain when throwing may be due to little league elbow, which results from repetitive stress and overuse of the elbow joint.

How can I treat little league elbow?

Initial treatment involves rest, ice, and anti-inflammatory medications; in severe cases, physical therapy or even surgery might be necessary.

Which is better for little league elbow, heat or ice?

Ice is recommended immediately after activity or injury to reduce inflammation, while heat can be used to relax and loosen tissues and stimulate blood flow to the area.

What is the little league elbow return to play timeline?

The return to play timeline for little league elbow varies based on the severity of the injury; generally, after a period of rest and successful treatment, players may gradually return to activity over several weeks to months, under guidance from a medical professional.