Little League Elbow


Throwing a baseball or softball can put significant strain on the elbow—and for children, whose bones are still growing, this can lead to an overuse injury known as Little League elbow.

Before puberty, the elbow contains a growth plate made of cartilage that is soft and less durable than hard bone, and which hasn’t yet reached its full length. The growth plate is attached to the muscles that allow you to rotate the lower arm towards the ground and flex the wrist. Repeatedly throwing a ball, and not allowing enough recovery time between training sessions, can cause tiny cracks in cartilage that may eventually separate the plate from the bone. This damage can occur over time, or from just one pitch.

If you suspect your child has Little League elbow, he or she should stop pitching immediately, apply ice for 15 to 20 minutes, and support the affected elbow by wrapping it in an elastic bandage.

Your doctor may want to take an X-ray to diagnose a suspected case of Little League elbow, and to see how extensive the damage is to the growth plate. If the condition is caught early, permanent damage is rare, and the elbow generally will heal with time, rest, icing and compression. Less often, your doctor will need to put your child’s arm in a cast to let the growth plate heal, and if damage is very severe, surgery may be necessary to pin the plate to the elbow.

Once the elbow has healed, prevent a recurrence by making sure your child’s coach supervises his or her pitching for proper form. Limiting pitching time, along with holding off on pitching curve balls until the pitcher has reached puberty, also can keep the elbow healthy—and keep your child on the field.

Chronic Compartment Syndrome

In your arms and legs, the muscles, blood vessels and nerves are grouped into compartments by tough tissue called fascia, which is designed to keep these groupings in place. The fascia’s stiffness can become a problem, however, if your muscle swells. That’s because the fascia cannot stretch, and the swelling can put intense pressure on the vessels, nerves and muscles of the affected limbs.

There are two types of compartment syndrome: acute and chronic. Acute compartment syndrome is considered a medical emergency. It causes tingling, intense pain, and a feeling of fullness in the affected muscle, and it is usually caused by trauma to your limb, such as from a car accident or being rammed in the leg by a football player’s helmet. If you think you have acute compartment syndrome, it’s important that you seek emergency treatment as soon as possible, since the condition can result in permanent muscle damage.

Compartment syndrome in its chronic form, however, stems from exercise that entails repetitive motions, such as running, tennis, swimming and biking. Symptoms include a visibly bulging muscle, difficulty moving the limb and numbness. This condition generally clears up on its own if you rest from the activity that caused it; other conservative treatments, that may be effective include rest, anti-inflammatory medications and physical therapy. Still, you should consult a doctor to rule out other possible causes of your limb pain, such as a stress fracture or tendinitis. In addition, these non-surgical methods sometimes are unsuccessful in treating chronic compartment syndrome; therefore, surgery may be necessary to make more room for the enlarged muscle by opening up the fascia surrounding the affected muscle.

To prevent chronic compartment syndrome, make sure you warm up appropriately when exercising and cool down afterward, and that you stay well-hydrated while you’re being active. Participating in a variety of athletic activities can give certain muscles a chance to rest between workouts, cutting down on your risk of chronic compartment syndrome.


There are many injuries that can cause back pain. When it occurs in children or adolescents, however, one of the most common culprits is spondylolysis, or a stress fracture on the bones of the lower back. In fact, the condition is most commonly diagnosed in adolescents aged 15 and 16, and the risk of spondylolysis increases during the growth spurts that occur during puberty.

The tiny cracks in the bone that form in this stress fracture can cause the bones of the spine to slip. In severe cases, these bones can put pressure on nerves and may require surgery to correct.

To some people with spondylolysis, the condition feels like a strained muscle in the lower back. You may also feel as though your hamstring muscles are tight or that you’re having back spasms.

Athletes most at risk of this injury include those in sports that put repeated pressure on the bones of the lower back and may stretch it too far, such as gymnastics, football and weight lifting. The condition may result from weakness in parts of the spine, and although some experts suspect this weakness is due to genetics, the cause is not definitively known.

Your doctor may diagnose you with spondylolysis after taking an X-ray. Or if the fracture is minor and therefore harder to see, using other imaging tests such as magnetic resonance imaging, or MRI, which uses a magnetic field to create an image of the soft tissues of your body.

The first step to treat spondylolysis is taking a break from athletic activities; anti-inflammatory medication such as ibuprofen can also help your back heal. In about three-fourths of cases, these measures are enough to treat spondylolysis. If these measures don’t halt the pain, however, your doctor may recommend physical therapy or, in severe cases, surgery to correct any slippage that has occurred due to damaged backbone.

Injury Prevention for Children

When I was a young gymnast, my mother had trouble watching me compete on the balance beam.  She said the beam just looked so big and I looked so small, and a fall from that height seemed dangerous.  Fortunately, I grew and the beam remained the same height. Yet, as I got older the injuries were much more frequent due typically because of overuse.  These injuries included sprains, pulled muscles and strains and were an everyday struggle.

Recognizing and preventing possible sports injuries in your children can be challenging.  A good beginning is to understand the common injuries within your children sport.  Parents, coaches, former athletes, and sports medicine practitioners will be able to provide this information.  Some of the most common across many sports are:  sprained ankle, pulled groin and  pulled hamstring. There are also excellent resources online including a website named Youth Sport Parent, which addresses many issues in youth sport beyond injury.

A very popular concern for youth sport injuries today is the overuse injuries that can be caused by chronic play without adequate rest and recovery.  This is a particular concern with some youth sports becoming more specialized encouraging participation in the same sport (and the same sport specific movements) year-round. One of the best things a parent can do is listen to their children talk about how they feel, both physically and mentally.  Furthermore, a parent can follow up with more questions to clarify something their child said.  This can be a simple, but very useful, way to get a better understanding of when rest is needed.

Parents can also talk to their children about both hydration and stretching in and out of their sport training and review muscle pull prevention tips.  Experts on youth sports medicine have encouraged more dynamic, rather than static, stretching during warm up in order to loosen muscles and increase heart rate before vigorous exercise.

Understanding injury prevention in sport will be different for each athlete.  The factors in which an athlete becomes injured can include various physical, emotional, and mental elements.  For parents, it isn’t necessarily only a concern for that one big fall, but a process of understanding the risk and assessing the needs for rest.  Lastly, and most importantly, a parent can help young athletes to begin to understand themselves better especially in terms of a possible risk and the need for recovery.

Stress Fracture

Sometimes, gravity can be an athlete’s worst enemy—especially in the case of stress fractures.

This overuse injury occurs most commonly among athletes who run and jump a lot, repeatedly putting a significant amount of weight on the legs and feet. That’s why most stress fractures occur in the bones of the foot and lower leg (they can also occur in the spine in a condition known as spondylolysis).

In a stress fracture, the bone does not completely break in half; instead, tiny cracks form, and these grow into stress fractures. The condition can cause intense pain when you put weight on the bone and when you touch the fractured area. Swelling also can accompany the pain, and you may find the pain worsens with each workout.

If you have lower leg pain, and taking some time off from weight-bearing activities doesn’t relieve it, you may have a stress fracture—and because a stress fracture that heals improperly can cause chronic pain, it’s crucial to treat the condition.

Sports that most often cause stress fractures are those in which the legs and feet pound the ground repeatedly, such as in gymnastics, running, ballet dancing, basketball and soccer. However, anyone who has suddenly increased his or her activity level can develop a stress fracture.

There are a number of tests your doctor can perform to diagnose a stress fracture. These tests include magnetic resonance imaging, or MRI, on the affected bone, along with taking an X-ray or a bone scan, in which a radioactive tracer is tracked through the bone.

To help your stress fracture heal, it’s important to minimize the weight you put on the affected bone. To do this, you may need to use crutches, a splint, or, if the fracture is in your foot, a supportive boot. In very serious cases, surgery may be necessary to heal a stress fracture.

Goal Setting For Sports Injury Recovery

The concept of injury recovery can seem depressing to all athletes, whether injured or not. I can remember the sports medicine room at my university and the collection of injured athletes from all different sports.  We were the “broken” and some of the healthy athletes avoided the room all together in fear of injury being contagious.  However, we all know that injury is a part of sport and the recovery process can be a very informative experience in understanding yourself better as an athlete.  Though sometimes unpleasant, injury allows a great deal of time for reflection. In injury your body provides a clear message that the pace of your life and sport needs to slow down and begin to heal.

Recovery can be a very frustrating process because athletes quickly go from being very active to doing nothing.  However, it is recommended to think of recovery as an active process rather than a passive one.  One of the most effective ways to become active in the process of recovery is to engage in the process of goal setting.  Goal setting is a part of athletes’ and coaches’ every-day training and should be included in the training regimen for injured athletes as well.

Following Smith’s (1994) SMART Goals create goals that follow guidelines to set you up for success.  SMART is an acronym for specific, measurable, action oriented, realistic, and time-based.  So, an example of a smart goal would be to complete rehabilitation exercises every day for two weeks.  This goal is specific because the exercises would be specifically assigned, measurable because the exercises are numbered or timed, it is action oriented, realistic, and time-based.

Remember these three things when using goal setting in injury recovery:

  1. Write it down. Write your goals down in a journal or a calendar.  This can help you keep track of your progress and represent your commitment to yourself.
  2. Be flexible.  Allow yourself to return to a goal to re-evaluate how realistic it is for you.
  3. Find support.  Goal setting is a much more effective and fun process when you know that you have additional support to give you encouragement or just listen when you need to talk about your experience.

Tennis Elbow

Perhaps one of the best-known sports injuries is tennis elbow, an overuse injury of a tendon in the elbow. Despite the name of the condition, it can actually be caused by any activity in which you flex and lift your wrist and hand repeatedly.

The most obvious symptoms of tennis elbow are, perhaps not surprisingly, elbow pain. This discomfort may radiate from the outside of the elbow, down to the wrist and hand, worsen over time and be accompanied by weakness in the lower arm.

Golfer’s elbow, another well-known condition, differs from tennis elbow because tennis elbow affects the outside of the elbow, whereas golfer’s elbow causes pain on the inside of the joint

Resting the injured arm, icing it, compressing it and taking over-the-counter anti-inflammatory pain killers may help your elbow heal on its own. But if your elbow feels hot and inflamed, you think you might have broken a bone, or you can’t move your arm, see your doctor.  He or she may suggest you see a physical therapist to learn exercises that will lengthen and strengthen the muscles of your arms. You may also need to use a brace or strap to support the elbow and reduce stress on it. Finally, in about 10 percent of tennis elbow, surgery is necessary to either sever and then reattach the tendon, or trim the part of it that’s become inflamed.

Once you’ve recovered from tennis elbow, you can prevent it from coming back by continuing with the physical therapy exercises that helped your elbow heal, along with altering the movements that may have caused the injury, such as your tennis swing. This can help minimize reduce stress and strain on the elbow. In fact, by learning to protect your elbow, you may actually end up improving your tennis game!

Acute Compartment Syndrome

The nerves, blood vessels and muscles in your arms and legs are grouped into compartments by tough tissue called fascia that keeps these groups in place. Although the fascia’s stiffness is what helps hold tissue in place, the rigidity of the fascia can become a problem if your muscle swells, since the fascia cannot stretch. For this reason, swelling can put intense pressure on the vessels, nerves and muscles of the affected limbs. There are four compartments in your lower leg, and this part of the body is the most common site of compartment syndrome.

There are two types of compartment syndrome: acute and chronic.  One type of compartment syndrome, chronic compartment syndrome, is caused by exertion or exercise and generally is not dangerous. On the other hand, acute compartment syndrome is considered a medical emergency. It causes tingling, intense pain, and a feeling of fullness in the affected muscle, and it is usually caused by trauma to your limb, such as from a car accident or being rammed in the leg by a football player’s helmet. If you think you have acute compartment syndrome, it’s important that you seek emergency treatment as soon as possible, since the condition can result in permanent muscle damage.

Specifically, acute compartment syndrome can be triggered a fracture, crush injury (for example, getting hit in the leg by a football player wearing a helmet), by wearing bandages that are too tight, or even when bloodflow is reestablished after surgery. The pain caused by acute compartment syndrome may seem more intense than what the injury itself would cause.

Acute compartment syndrome is a very serious condition, because loss of blood flow to a muscle can irreparably damage it. Therefore, it’s important that you visit an emergency room as soon as possible if you suspect you may have the syndrome. Once in a clinical setting, a doctor can measure the pressure in the affected compartment to determine if you have acute compartment syndrome.

There is no nonsurgical treatment for acute compartment syndrome; it requires opening the fascia to relieve the pressure that is being placed on the muscle and other tissue in the compartment. This incision is sewn shut once the pressure has returned to normal.

Bruised Heel Injury

Pounding the pavement (or a similarly hard surface) is often a sizable part of an athlete’s training, and as a result, the heels of the feet take plenty of abuse, bearing the weight of the entire body. Unfortunately, the heel is protected only by a small pad of fat, and repetitively landing on the heels can cause this pad to ride up on the side of the heel bone, leaving it unprotected.

Not surprisingly, this causes pain in the heel. You might also notice bruising or dark spots on the bottom of your heel; those are due to capillaries that have ruptured because they are no longer protected by the fat pad that is normally on the underside of your heel.

Athletes most at risk of a bruised heel are those who put repeated strain on their heels, such as from high-impact activities like martial arts, basketball, football and running. A bruised heel likely will heal on its own; you should rest until your heel no longer feels painful. Also, if you’ve run more than about 400 miles in your running or athletic shoes, replace them to make sure your heels are getting the cushioning you need. If your shoes aren’t old enough to warrant replacement, add heel cushions to your shoes to pad your heels.

If the pain doesn’t dissipate after a few days, or if you think your heel pain might be due to another condition, such as plantar fasciitis, see a doctor. He or she can diagnose the cause of your heel pain and help you get back on your feet as soon as possible.