Young baseball players, pitchers especially, are susceptible to an elbow injury called “Little League elbow.” Talented young pitchers are encouraged to train hard, but extensive training without paying attention to the young athletes’ biomechanics only puts them at higher risk of harm.  Excellence does not reduce the likelihood of injury, and it may even increase it. So how do we as coaches, physical therapists, and trainers protect our young athletes from elbow pain and injury?

In this blog, we explore the causes of Little League elbow, the difference in how the injury presents in adolescent players compared to adults, and steps sports medicine professionals can take to identify dysfunction to reduce the likelihood of injury using Applied Functional Science® (AFS). Keep reading to learn more.

What Is Little League Elbow?

Little League elbow is an overuse injury that damages the growth plate in the medial part of the elbow. Most adolescent baseball players begin to suffer from Little League elbow and elbow pain due to over-throwing, although Applied Functional Science tells us that the specific causes are much more complex and nuanced than simply too much repetitive throwing.

Youth who play the same sport year-round and train extensively are at a particular risk for Little League elbow. However, once you understand the factors that influence a player’s risk, you can help them maintain performance without compromising their health.

What Causes Little League Elbow Injuries?

While a large percentage of throwing injuries occur in the follow-through after the ball has been released, the greatest strain on the elbow occurs during the maximum biomechanical load phase. This phase is often referred to as the “late cocking phase” or the “maximum external rotation phase.” 

During this phase, the elbow is subject to extreme valgus torque, which is offset by muscle contraction, ligament tension, and bone compression. In the late cocking phase, the non-dominant leg and the lower body accelerate forward, creating the maximum load on the soft tissues of the arm. 

At Gray Institute, we call the separation of the lower body and the trunk from the arm “proximal acceleration load.”  It is an integral component of powerful movements in most sporting activities (for example, batting, golfing, javelin throwing, and more). The forces that create the velocity of the pitch can, over time, destroy the tissues under certain conditions, particularly when the proximal acceleration is compromised by dysfunction elsewhere in the body.

Injury Prevention Starts With Assessing the Kinetic Chain

The key to injury prevention is not only assessment, but the right assessment. Ask yourself:

  • Is your assessment functional?
  • Does it cover all three planes of motion?
  • Does it account for the body being a Chain Reaction®?
  • Does it include both mobility and stability of the body’s joints?

To understand the cause of the poor mechanics, trainers and coaches need to assess the entire kinetic chain of throwing. Otherwise, performance training programs will not address the root causes of Little League elbow injuries in order to prevent them in the first place.

The only assessment in the industry that accomplishes this is 3D Movement Analysis & Performance System (3DMAPS®).

RELATED: Use Applied Functional Science to Treat Tennis Elbow

Understand the Correlation Between “Opening up Too Soon” and Little League Elbow Injuries

Pitching, like many sports movements, requires great skill. Athletes often develop this without the requisite foundational physical capabilities they need to prevent injuries. 

Let’s use a pitching problem called “opening up too soon” as an example. This is a mechanical flaw that results in lost velocity and reduced accuracy of the pitch and abnormal stress to the elbow. The pitcher is encouraged to avoid this loss of proper mechanics, but often the problem is based in the body’s inability to produce and maintain the desired sequence. One study showed that when the pitcher’s trunk starts to come forward before the front leg hits the ground, the chances of suffering from “Little League elbow” are much higher. As a result, “opening up too soon” increases the stress on the elbow.

The challenge for anyone working with young baseball players is to find the cause or causes of this “out of sequence” flaw. Because the body is an interconnected system, and not a collection of isolated parts, the true cause is rarely in the arm. In fact, it could be anywhere in the body, even in a seemingly unrelated region. To understand and identify the dysfunction, you need a functional understanding of the body’s Chain Reactions.

At Gray Institute, determining mobility and stability is part of every assessment. Practitioners must be able to analyze both global body movements and sport-specific movements in which the body parts change direction. (These regions are called Transformational Zones and are a critical component of functional movement.) 

If “Little League elbow’ is created by “opening up too soon,” then the cause can range from limited motion in the foot, hips, or spine to weakness or lack of endurance in the abdominal muscles or anywhere else in the Chain Reaction of throwing.

Understand the Body’s Chain Reactions to Enhance Performance and Prevent Injury

All too often, movement professionals are encouraged and instructed to view the body as a compilation of parts, rather than as an interconnected whole.

We cover all this and more in our Chain Reaction seminar, the longest-running seminar in the movement industry that’s now in its 33rd year. If you’re ready to not only learn the truth but apply it with your athletes, it’s time to consider Chain Reaction with Gray Institute.

Take Your Movement Education to the Next Level With Gray Institute

To learn more about Chain Reaction, Applied Functional Science, or our approach, please don’t hesitate to reach out. We love speaking with passionate movement professionals and look forward to chatting about your goals and how we can help you meet them.