Elbow pain in the young pitcher is a unique problem. The term little league elbow is a non specific diagnosis referring to elbow pain in a throwing arm that is usually felt medially. The pain could be coming from a tendon, ligament, bone or nerve. However the root cause of the pain is never the elbow its how the body creates and dissipates the forces associated with throwing. It is typically seen in pitchers and catchers but can happen to any player.
The most common reason is with a player who creates more force than he/she can control. Think of a Ferrari with faulty brakes and steering. Lots of power without the necessary control. There are going to be dents in that car. This player usually has pain as the ball is leaving the hand. Another common reason is the child just doesn’t move well. If the shoulder rotation involved with throwing isn’t well controlled the elbow gaps sideways and eventually begins to hurt. This player usually has pain during the loading phase of the throw when the hand is behind the body.
Some players feel it at both times. Regardless, every little league elbow requires a whole-body exam not an elbow exam. The elbow part is easy. The rest of it takes some sleuthing. We always play catch with our players once able to do so and provide guidance on a return to throwing progression and will also provide coaching on throwing mechanics as needed.