Behavior & Development • Mar 30, 2016

Shoulder and elbow pain in baseball and softball players: Three tips to keep your player on the field

As spring baseball and softball seasons come into full swing, so will shoulder and elbow injuries. These injuries can range from strains to fractures to overuse injuries.  Kids start playing tee-ball as early as 3, and can begin pitching as early as 5 or 6 – which can put lots of stress on little arms that may not be ready for it. I saw an 8 year old in the office that was pitching every day of the week— three days of  formal practice, and he practiced for an hour in the backyard on his off-days.  It is no surprise that he had developed significant shoulder pain.

We see two common “overuse” injuries—meaning there wasn’t a fall or some particular incident that caused the injury, the patient just used the arm too much or in the wrong way. They are both named after the most common sport where they happen: Little League baseball (but they can happen in softball or any other throwing sport).

  • “Little League shoulder”—Patients, usually between the ages of 11-16, experience pain at the top of the large upper arm bone, the humerus. Kids have a growing area here that can become injured with too much throwing, or throwing with the wrong technique. They will complain of pain at the top of the arm, near the shoulder, while throwing or pitching. Eventually the arm may hurt all the time, even with just lifting it overhead. Sometimes there can even be a little swelling in the area.
  • “Little League elbow”—This is pain over the bump on the middle side of the elbow and most commonly happens between the ages of 8-15. Little league elbow is also pain over another growing area that can cause pain when throwing or pitching.  Kids may notice swelling over the bump or trouble fully bending and straightening the elbow.

If a child is experiencing this type of pain while throwing, it is best for them to stop throwing completely and ice the area. If it is becoming worse or happening every time they go to practice, it is best to stop and see a doctor. The doctor will likely get x-rays of the area to check on the growth plate.

Treatment for both Little League elbow and shoulder is rest from throwing. The growth plate needs time to heal before it is stressed again with lots of pitching or throwing. This can take anywhere from a few weeks to a few months, depending on how the severity of the injury. After resting, your doctor may suggest some physical therapy to strengthen the elbow or shoulder and then a SLOW return to throwing.

As with most “overuse” injuries, prevention is the key!  There are many things that parents, athletes and coaches can do to lower the risk of Little League shoulder and elbow.

  1. Set limits—Kids who love baseball or softball would happily throw every day, every game, all year long. Coaches would also love this! The reality is that kids’ arms aren’t meant to take all of that repetition. Little league baseball has set forth a set of rules in regards to how many pitches, how many games and how many days of rest a pitcher should have. Visit littleleague.org to find these rules. Talk to coaches about how much your child is throwing.
  2. Develop proper technique—How a child throws or pitches a ball can put unnecessary stress on the shoulder and elbow. Have a skilled coach take a look and correct if needed. Start at a young age so they will always have proper technique.
  3. Take time off!—In some areas, kids play baseball year-round. Players should take time off between seasons to rest and allow the body to heal. They can try other sports like soccer, football or hockey that use different muscles and don’t involve throwing.

It is always important to take any complaints of shoulder or elbow pain seriously.  Using the above guidelines may help keep your child healthy and on the field.

If you would like more information on rehabilitation of throwing injuries from a pediatric sports physical therapist, visit our Young Athlete Center website. You can also attend our upcoming Injury Prevention in Youth Sports and Sports Psychology in the Adolescent Athlete lecture series. The next lecture will take place on Tuesday, April 12, from 6:30 – 8 p.m. Click here to register or to learn more.

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