Posts Tagged ‘sport specialization’

Elbow Pain? What Parents Should Know

Posted on: September 1st, 2021

Jason Determann, MD (September, 2021) Fall baseball is back in swing along with elbow aches and pains for young throwers. The throwing motion creates repetitive stress that often leads to a variety of both simple and complex conditions. Understanding the disorders that lead to elbow pain in children may help explain why your little guy or girl starts holding their elbow.

First of all, don’t think you’re alone. Nearly 30% of 8-12 year old baseball players will have elbow pain. That number jumps to 45% by age 14. While tendons and ligaments may be strong, they’re still growing. Growth plates around the elbow are called a physis: cartilaginous connection of immature bone often making up the weakest link that can lead to throwing problems

Little League Elbow

Little League Elbow is one of the most common conditions that affects the pediatric growth plates. Also called medial apophysitis, the inflammatory condition stems from repetitive traction or pull from the muscles and ligaments on the inside growth plate.  The inside bump on the elbow will likely be sore to the touch, but should improve with a period of rest, ice, and over the counter NSAIDs such as ibuprofen or naproxen.

Another condition is known as Osteochondritis Dissecans : fragmentation of elbow cartilage and bone due to a repetitious compressive load.  Loss of motion and symptoms such as locking or catching in the elbow are usually involved. X-rays are needed to confirm the diagnosis and often MRI is used to determine the severity of cartilage injury.

As children continue to grow, the concern of ulnar collateral ligament injury (UCL) comes into play. This ligament is the primary stabilizer of the inside of the elbow and is needed in overhead athletes. This ligament can get strained, develop partial tearing, or even complete tearing in severe cases. Due to sport specialization at a young age and year-round competition, the incidence of UCL problems in pediatric throwers is rising.

Elbow Injury Prevention

Regardless of the problem, the first step is a simple one: stop throwing!  Most elbow pain in children we encounter stems from overuse: the body is telling our child it needs a short break. This break can range anywhere from 2 to 6 weeks, and is often shortened with NSAIDS and physical therapy. Continuing to play or throw through the pain should be avoided to prevent even more serious injury.

In sum, the key treatment to elbow pain in children is prevention. We all share this responsibility. Emphasis should be placed on an adequate warm up and cool down. Additionally, proper throwing mechanics should be taught at a relatively early age and constantly re-evaluated. Most youth leagues, including ours here on the Eastern Shore, have pitch counts per game, week, and season. Adhering to these guidelines is critical to maximizing the health of your child’s arm.

Sport Specialization: Is it Safe? Is it Necessary?

Posted on: December 29th, 2019

Albert Jay Savage IV, MD

(June 2020) Youth sports have surged across the country, and a weekend drive around Eastern Shore ballparks proves we’re part of that trend.  By all accounts, the physical, mental and emotional benefits of individual and team sports are well documented.  From a sports medicine perspective however, this boom in youth sports has raised some alarm:   increasing “sport specialization” at a young age means an increase in youth sports overuse injuries, too.

Doesn’t My Child Need to Focus on One Sport?

Sport specialization has been defined as “year-round intensive training in a single sport, at the expense of other sports.”  Some parents reading this may be skeptical , as conventional wisdom suggests young athletes determined to “up their game” as they age will fall behind if not working consistently on their skills.    However, a quick dive into current research reveals some surprises:  (1) most players in Division 1 athletics did not pursue early specialization, (2) baseball pitchers from colder climates that do not throw year-round tend to excel over those from warmer climates, and (3) early specialization may actually decrease the likelihood that an athlete will reach an elite level.

Furthermore, studies find overuse injuries consistently linked with the following risk factors: (1) a high level of sports specialization, (2) playing their sport for more than 8 months of the year, and (3) playing their sport for more hours per week than their age. 

child throwing baseball

Tips to Prevent Youth Sports Overuse Injuries

Most overuse injuries can be prevented with proper training and common sense.

  • Learn to listen to your body and listen to what kids are telling you.
  • Remember that “no pain, no gain” does not apply here. 
  • These young athletes are not just little adults.  They have growing bones and soft tissues and are susceptible to different types of injuries.
  • Follow the 10 percent rule. In general, you should not increase your training program or activity more than 10 percent per week. This allows your body adequate time for recovery and response.

From a parent’s perspective I want my kids to enjoy playing sports –and to soak up the character traits and teamwork skills that healthy competition offers.  From my former athlete perspective, I know the value of hard work in reaching their greatest potential.    But all of us as parents can agree in the goal of safety first and foremost. Nothing is achieved when our children are sidelined with preventable injuries. 

The debate over single sport injuries is likely to grow along with the options and enthusiasm for youth sports overall.  I encourage parents and coaches to learn more – some great resources can be found at the American Orthopedic Society for Sports Medicine website,

Dr. Savage received his MD from the University of Alabama at Birmingham, followed by residency at the UAB Department of Orthopaedic Surgery. He is Board Certified and Fellowship Trained in Sports Medicine.