Medial apophysitis (Little League elbow)

Back to Patient education: elbow

What is medial apophysitis?

Medial apophysitis, also known as Little League elbow, is an overuse injury to the growth plate (apophysis) on the inner side of the elbow (medial epicondyle). Growth plates are weaker areas of bone highly vulnerable to injury in developing children.

Medial apophysitis is called Little League elbow because it primarily impacts youngsters who engage in repeated throwing activities. The condition is on the rise as more and more children participate in year-round, single-sport training. Longer competitive seasons coupled with higher intensity play at younger ages lead to increased injury rates.

What causes medial apophysitis?

Little League elbow occurs when repetitive throwing creates an excessively strong pull on the tendons and ligaments in the elbow, causing them to pull away from the bone. The tearing may also pull tiny bone fragments with it, which can disrupt normal bone growth. Left untreated, this can result in deformity.

What are the symptoms?

The symptoms of Little League elbow include elbow pain and tenderness, especially on the inside of the elbow; limited range of motion; and locking of the elbow joint.

If your child experiences any of these symptoms, he or she should stop throwing, and you should consult a physician promptly.

How is medial apophysitis diagnosed?

In addition to a physical exam and patient history, your child’s doctor may order an X-ray to confirm the diagnosis and determine the extent of the injury.

What is the treatment?

The majority of cases of Little League elbow respond to non-surgical treatment. The most important first step is to make sure your child rests from throwing for several weeks. This gives the growth plate time to heal. Your physician may also recommend physical therapy to improve muscle strength and endurance and refine your child’s throwing technique, which can help prevent re-injury. Occasionally, surgery is necessary to remove loose bone fragments or reattach a ligament back to the bone.