"Little League elbow" is the common name for elbow pain on the inside of the joint in young baseball players, especially children and teenagers who throw a lot. Parents search for it when a child says their arm hurts after pitching, and coaches search for it when they want to protect players. This page explains in plain English what the term usually means, what symptoms people describe, why young throwers are more at risk, and what general steps are widely recommended to lower the risk.
Important: this is general information, not medical advice. Elbow pain in a child needs to be checked by a doctor, preferably one who works with young athletes. Do not use this page to diagnose or treat a player.
What is Little League elbow?
The term describes an overuse problem at the inner side of the elbow in young throwers. In children and teenagers, the bones are still growing, and the areas where tendons and ligaments attach to the bone are softer than they will be in adulthood. Repeated throwing puts stress on those growth areas on the inside of the elbow. Over time, this stress can cause pain, swelling and, in some cases, small changes to the bone that a doctor can see on an image.
The name comes from youth baseball, but the same kind of pain can happen in other throwing and racket sports, and in players who are not in any official league. Doctors may use more precise medical terms, so it is common to hear different names for related problems. Only a medical professional can tell which one applies.
Symptoms people commonly describe
Symptoms vary, and a child may not always say clearly where it hurts. Things that parents and coaches often notice include:
- Pain or tenderness on the inside of the elbow, often during or after throwing.
- Pain that gets worse with throwing and gets better with rest.
- Swelling or warmth near the inner elbow.
- A child who throws less hard, with less accuracy or for a shorter time than usual.
- Stiffness or difficulty fully straightening the arm.
- A child who starts to avoid throwing or hides discomfort.
Pain that appears suddenly, a "pop" while throwing, numbness or tingling in the hand, or an arm that looks out of shape are reasons to get medical advice promptly. Any ongoing pain should also be checked, even if it eases with rest.
Why do young throwers get it?
The usual explanation is a combination of growth and workload.
- Growing bones. The growth areas near the elbow are the weak point while a child is still growing.
- Repetitive throwing. Many throws, especially hard throws, put repeated stress on the inner elbow.
- Too little rest. Without enough time between sessions, the area does not recover.
- Playing on several teams. A child who pitches for a school team, a club team and in showcases may throw far more than anyone realizes.
- Throwing while tired. Form tends to break down as fatigue builds, which can increase the load on the arm.
- Pitching types that stress the elbow. Some coaches and doctors advise caution with pitches that a young player cannot throw with good mechanics. Our guide to pitch grips explains the basic grips, and a coach can advise which are suitable for a player's age.
None of these factors proves that a particular child will get hurt, and a child can have pain without doing anything wrong. They are the patterns that doctors and youth organizations most often highlight.
What happens if a child has elbow pain?
The usual advice is simple: stop throwing and have it examined. A doctor may ask about the child's throwing habits, examine the elbow and may order an image to see the growth areas. Treatment depends on the cause and the severity, and the doctor decides it. In many cases, doctors advise a period of rest from throwing and a gradual, supervised return. Players should not rush back or "play through" the pain, since that can make the problem worse.
If you are a coach, follow the child's doctor's instructions and the rules of your organization. If you are a parent, a child's honest report of pain is more important than a game.
General ways to lower the risk
The following are widely shared principles. Specific limits differ by organization and age, so check the current rules of your league and talk to your child's doctor or coach.
- Follow your league's pitch limits and rest rules. Many youth baseball organizations publish pitch count and rest guidelines by age. Use the current ones from your own league rather than numbers from an article.
- Rest during the year. Players benefit from time off from throwing, and playing other sports can help.
- Avoid pitching on more than one team at the same time. Keep track of total throws across all teams.
- Warm up and build up gradually. Stretching, light throwing and a gradual increase in distance and effort are standard practice.
- Work on mechanics. A coach with experience in youth pitching can help a player throw in a way that does not overload the elbow.
- Stop when it hurts. Encourage players to tell an adult about any arm pain right away, with no penalty.
- Do not let a tired player keep pitching. Fatigue is a signal to take a break.
- Choose age-appropriate equipment. A properly sized ball and glove make the game easier on a young body. See our glove size chart for fit.
What coaches and parents can do
Coaches can keep a simple log of each pitcher's throws, make sure a player's pitching is counted across teams and make it clear that reporting pain will not cost anyone their spot. Parents can ask a child how their arm feels after games, keep an eye on the total amount of throwing in a week and a season and avoid pushing a child to play through discomfort. Both groups can learn the rules in baseball for beginners, which also helps explain how often pitchers are used in a game.
When to see a doctor
See a doctor if a child has elbow pain that does not go away after rest, pain that returns every time they throw, swelling, a locked or stiff elbow, numbness or tingling, or any pain after a sudden injury. A doctor can tell whether the pain is a simple overuse problem or something that needs more attention.
FAQ
What is Little League elbow?
It is the common name for pain on the inside of the elbow in young throwers, usually from repeated stress on the growing parts of the bone. A doctor can diagnose the exact cause.
What are the symptoms of Little League elbow?
Commonly described symptoms include inner-elbow pain with throwing, tenderness, swelling, stiffness and a drop in throwing speed or accuracy. Any elbow pain in a child should be checked.
How do you prevent Little League elbow?
The usual advice is to follow your league's pitch limits and rest rules, avoid pitching for several teams at once, take time off from throwing each year, warm up properly and stop when there is pain.
Can a child keep playing with elbow pain?
Pain is a signal to stop throwing and get checked by a doctor. Playing through it can make the problem worse, so wait for medical advice before returning.
Does only Little League cause it?
No. The name is historical. Young players in any throwing sport, in any league or none, can have the same kind of overuse pain.