If you’re a baseball fan, you undoubtedly noticed the abundance of elbow injuries afflicting pitchers this season, many of whom ended up on the bench recovering from Tommy John surgery. A new study presented in Chicago at the November annual meeting of the Radiological Society of North America (RSNA) may shed some light on how these injuries develop in a player’s youth.
The repetitive motion and force involved in throwing a baseball place significant stress on the growing bones, joints, and muscles of the elbow. However, little research has been done on what the repetitive motion means for growth plates, areas of bone composed of cartilage in skeletally immature children, which is what led researchers from the Children’s Hospital of Philadelphia to search for answers.
“We conducted this study in order to better understand the patterns of injuries that can occur among youth baseball players with elbow pain,” senior author Jie Chen Nguyen, MD, from Children’s Hospital of Philadelphia, said in a statement. “Tissue vulnerability and, thus, sites at risk for injury, change with growth and maturation. A younger player injures differently than an older player. It is our hope that this data will help us continue to improve and individualize the care of current and future generations of youth baseball players.”
According to the researchers, estimates indicate that 20% to 40% of youth baseball players age 9 to 12 experience elbow pain at least once every season. Skeletal maturity, marked by the closure of growth plates and the cessation of bone growth, typically occurs around ages 13 to 15 for girls and 15 to 17 for boys.
“When we look at the forces that baseball players, even Little League baseball players, deal with during routine practice and games, it becomes apparent why elbow injuries are so common amongst this group,” study co-author Vandan Patel, from Children’s Hospital of Philadelphia, said in the same statement.
The study, a retrospective analysis of elbow MRI exams from 130 players age 18 and younger experiencing elbow pain, aimed to identify injury patterns based on skeletal maturity. Among skeletally immature players, common MRI findings included fluid buildup around the joint, stress injuries near the growth plate, fractures, and osteochondritis dissecans (OCD) lesions.
“In terms of the skeletally immature children, 9 patients (11%) had intra-articular bodies, and 19 patients (22%) had OCD lesions,” Patel added.
Conversely, skeletally mature players exhibited injuries shifting from growth plates to soft tissue, with triceps tendinosis and fluid buildup in the bony area of the elbow. Surgical interventions were required for certain injuries, such as intra-articular bodies and unstable OCD.
While a link between injury prevalence and prolonged play was observed, further research is needed to understand which injuries occur as a result of continued use, as well as the role rest and proper care have in mitigating any permanent damage.
The researchers were careful to add that their findings should not scare children and parents away from baseball. Instead, they hope a better understanding of how common elbow injuries occur and change over time will lead to more science-driven coaching and practice, the times when the elbow joint is being used most often.
“[Our research] does not mean that elbow injuries are inevitable in baseball,” Patel noted. “With proper technique and proper rest, these injuries could potentially be avoided.”
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.