Recent research has shown that nearly 40% of 7 to 18 year old baseball players endure elbow and shoulder pain during their baseball season. Nearly half of these injured players report their ongoing participation despite having pain. A recent epidemiological study of ulnar collateral ligament (UCL) injuries in athletes 17 to 20 years old reported the number of UCL reconstructions has increased dramatically for this age group. Early education and detection of elbow injuries in throwing sports may help reduce the number of overuse injuries from developing.
“Little league elbow,” or known as medial epicondyle apophysitis, is most commonly found in young throwers. Sports such as baseball, softball, tennis, or golf, can result in this overuse injury to the growth plate on the inside of the elbow. Repeated stress to the growth plates may cause inflammation and lead to pain or swelling. Serious injury may even result in separation of the growth plate from the rest of the bone. Players may also experience a reduced range of motion and a decreased ability to throw hard or far. A child experiencing any symptoms involving their arm should cease activity and see a pediatric specialist or their family physician. X-rays may be required to determine the extent of damage.
Prevention begins with identifying causative factors early in the season and adhering to strict guidelines such as the pitch count for young players and the duration of participation in a given year. Total body conditioning that involves strengthening the hip, back, and legs may help reduce the strain on the athlete’s arms. See below for exercises on how to stretch and strengthen the forearm.
The term “tendinitis” is frequently used by injured individuals, family practitioners, and medical specialists. Commonly present in the Achilles, lateral elbow, and rotator cuff tendons, many still believe that there is a large inflammatory component in overuse tendinitis and anti-inflammatory medication can be used to treat this condition.
According to Assistant Professor Khan of the Department of Family Practice at the University of British Columbia (2002), “ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs for treating painful conditions like Achilles and patellar tendinitis despite the lack of a biological rationale or clinical evidence for this approach.”
Patients who present with a painful overuse tendon condition more likely have a non-inflammatory pathology. Studies have revealed that the cause of tendon pain arises from collagen separation. Collagen is the main structural protein found in connective tissues. When these tendon fibrils become thin, frayed, and fragile, they begin to separate and become disrupted in cross section. This leads to an increase in tendon repair cells rather than inflammatory cells.
There is limited evidence of short term pain relief and no clear evidence of effectiveness when relying on anti-inflammatory medications. A more appropriate term would be to use “tendinopathy” to acknowledge that the overuse condition is not in fact tendinitis. Correctly utilizing this term provides patients with a more accurate description of their condition, prevent ineffective pharmacotherapy, avoid medical costs, and allow time for collagen to repair. Tendon disorders realistically take months rather than weeks to resolve. Allow time for rest and slowly incorporate exercises for area of concern. See a physiotherapist for proper diagnosis and treatment options.