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It’s an issue for a newer generation of kids – young baseball players who, unlike previous generations, feel the need or desire to specialize in not just a single sport, but a single position. It’s a trend, says Tacoma physical therapist Chad McCann, that’s led to a much greater incidence of stress and injury to young elbows.
“We call it Little League elbow,” said McCann, a physical therapist at 3Dimensional Physical Therapy & Sports Conditioning in Tacoma. “It’s a precursor to a Tommy John tear.”
By “Tommy John tear,” of course, McCann means a tear in the ulnar collateral ligament in the elbow. A tear in this ligament was a career-ender until, in 1974, an innovative surgery was used to successfully reconstruct the ligament of a Major League pitcher named Tommy John, essentially giving him his career back.
Today, the procedure is common among professional pitchers, but it’s also become all-too-common among teens, as well. In fact, nearly 57 percent of Tommy John surgeries in the U.S. are currently being performed on ballplayers 15 to 19 years old, says the American Journal of Sports Medicine.
Knowing the signs that a young baseball player may be on the road to Tommy John surgery while taking steps to ensure proper throwing form as well as proper rest, can help reduce these numbers, McCann says.
One sign of Little League elbow, of course, is a pain in the throwing elbow and shoulder. Caused by a series of microtears, such pain is one sign a pitcher may be putting too much stress on his joints.
Throwing form is another sign. If the elbow stays higher than the hand or lower than the shoulder on a throw, the pitcher is at risk of developing an injury.
“These are the trends we see as pitchers try to increase acceleration,” McCann said. “Proper alignment should have the hand above the elbow and the elbow above the shoulder.”
From a physical therapy perspective, strengthening exercises for the shoulder, arm, and core, and strengthening and balance for the legs, build a solid foundation for the act of throwing properly, he said.
“Then we focus on throwing mechanics,” McCann said, describing what he called the “cocking phase” of a throw. “We work on loading up in a circular motion and reaching back before they accelerate and throw. This takes a lot of the torque away from the rotation. We’re using the mechanics in the shoulder to set up the throw and take the load off the elbow.”
Other things to consider, especially for younger players, is having them throw curve balls and more complicated pitches because they can’t accelerate as fast. Also, having them play catch frequently in an easy and uncomplicated way, then have them pitch from a 45-foot distance helps lessen the need for longer acceleration.
“It’s important everyone understands the need to balance velocity with control,” he said. “As they watch, they learn and can monitor more closely.”
If a parent or coach is concerned a young ballplayer is experiencing Little League elbow or is on the path toward Tommy John surgery, McCann recommends the young athlete sees a physical therapist well versed in sports medicine, such as the team at 3Dimensional Physical Therapy, for a professional throwing assessment.