What’s the Key to Preventing Elbow Injuries in Young Athletes?

This episode of the OrthoInfo podcast is brought to you by the American Academy of Orthopaedic Surgeons (AAOS) and American Shoulder and Elbow Surgeons (ASES).

In this episode, shoulder & elbow surgeons William R. Aibinder, MD, FAAOS, and Julia Lee, MD, FAAOS, address a growing concern: the rise in elbow injuries among children and teens who play overhead sports such as baseball, softball, volleyball, gymnastics, and cheer.

Drs. Aibinder and Lee explain how to tell normal soreness from warning signs, which remedies families can try at home to relieve symptoms, and when it’s time to see a doctor. They also walk listeners through the course of care, from the physical exam and testing to pinpoint the issue, to conservative treatments like physical therapy, to surgery for more serious issues. They emphasize that the treatment approach may depend on the nature of the injury (acute vs. overuse) and that treatment decisions should always be made with the athlete’s best interests and long-term goals in mind.

Throughout the conversation, both surgeons stress the importance of honest communication between athletes, parents, coaches, and trainers, and the need to look at the whole athlete, not just the elbow.

Key topics covered in this episode:

• Common elbow injuries in young athletes, including UCL (“Tommy John” ligament) injuries, ulnar nerve irritation, tendinitis, and osteochondral defects (OCD lesions)

• Sports that put the elbow at the greatest risk, especially those involving overhead motion, heavy upper extremity force, or weightbearing on the arms

• The difference between normal soreness and mechanical pain that returns with the same motion or lasts longer than a week or two

• Home care basics such as rest, stretching, and short-term anti-inflammatories, plus whether to use heat or ice

• When to see a specialist and what the first visit looks like for overuse injuries compared with acute injuries

• How X-rays, CT scans, MRI, and ultrasound each serve a different purpose in diagnosing the problem

• Why honesty from athletes, parents, and coaches leads to better care and more realistic expectations

• Non-operative treatment, including physical therapy as “prehab” to get the elbow to a stronger starting point if surgery is ultimately needed

• Timing surgery around seasons, school, and long-term athletic goals

• Return to throwing programs and the role of mechanics, the kinetic chain, core strength, and patience

• Prevention strategies, including pitch counts, playing multiple sports (not specializing), adequate sleep, good nutrition, and rest

As Dr. Lee points out, keeping young athletes healthy means putting the athlete at the center and making sure everyone involved is on the same page. Addressing mechanics and making sure that the injury is completely healed before the athlete returns to play can help prevent elbow injuries from happening again.

Host: William R. Aibinder, MD, FAAOS, Associate Professor, University of Michigan; OrthoInfo Shoulder & Elbow Section Editor; member, American Academy of Orthopaedic Surgeons (AAOS) and American Shoulder & Elbow Surgeons (ASES)

Guest: Julia Lee, MD, FAAOS, shoulder & elbow surgeon, Sierra Pacific Orthopaedics; member, American Academy of Orthopaedic Surgeons (AAOS) and American Shoulder & Elbow Surgeons (ASES)