pain

As a state, Arizona is beginning to see a decrease in numbers of people who are diagnosed with the Corona Virus. There are beginning to be less restrictions and people are cautiously returning to activities. One activity my children participate in is youth baseball. They are between the age of 10 and 13, and children in these ages are normally pretty healthy. There have been several instances that have come up with my children’s friends and teammates which can be extremely painful and reduce their ability to participate in athletics. These are problems in the growth plate. I have witnessed this mostly in one body part: the elbow.

What is it?

The issue at the elbow almost exclusively occurs due to the repetitive action of throwing. This is why this is commonly called Little Leaguer’s Elbow. The medical term for this is Medial Epophysitis. This is basically an irritation on the inside of your elbow joint caused by repetitive motions. Excessive throwing causes a lot of stress on the inside part of the elbow which can be sometimes too much for growing bones and muscles. In extreme cases, part of the bone can actually break off. This typically happens in youth athletes between the ages of 8-17, when bone and muscle growth is most likely to occur.

Does my kid have it?

Typically, there is no specific incident that leads to this injury, but there can be. Usually, the young athlete will begin feeling pain on the inside of the throwing elbow where the bump is. This is where several muscles attach. The pain will worsen with the activity and if it gets bad enough, they will not be able to throw anymore. It will be fairly tender to the touch and you may notice swelling.  Pain when extending their elbow or wrist flexion is also a common occurrence.

What do we do about it?

If you notice your child has this, there are two things to immediately do.

1. STOP THROWING!!! With repetitive stress injuries, the very first thing is to stop doing what is causing the pain. In this case, throwing. It is very important to not push through and play with this injury as it can lead to a much more serious condition.
2. ICE: Ice at the initial stages can reduce swelling and irritation.

With all injuries that deal with soft tissues (muscle, tendon, ligament) there are several stretches and exercises which can be done. Almost always, the muscles on the palm side of your athlete’s forearm will be very stiff, and most times weak. These muscles should be stretched lightly and strengthened. The two stretches which are important are these:

With your elbow extended, gently extend your wrist to where you feel a gentle stretch on the palm side of your forearm. Hold for about 30 seconds and repeat 3 times.

Now, do the exact opposite. Hold for the same amount of time about 3 times.

Strengthening the forearm, wrist, and shoulder muscles of your throwing arm is extremely important. These should be prescribed specifically for the individual athlete.

How long does it take to heal?

The answer to this question really depends on the severity. It can be anywhere from a few weeks, to 1-3 months.  Coaches and leagues take special care with pitch counts depending on ages and this is an excellent thing to do, however any position player who throws often can be at risk. If you want to prevent this, a doctor or a physical therapist can identify the most important activities to do in order to prevent.

Concussion

A concussion is defined as rapid acceleration and deceleration of the brain tissue within the skull. This type of injury occurs most often in a car accident or sports related injury. A concussion  is estimated by the CDC to happen over 3.8 million times per year. Unlike many issues, this injury can be difficult to manage and treat on your own since it is an injury that you can often not see.

What are the Symptoms?

Common symptoms following concussions can include dizziness, headaches, light and noise sensitivity, vision changes, difficulty with focusing on tasks, and difficulty thinking. Another common symptom following a concussion is difficulty in sleeping.This is related to the trauma and your brain working harder than it normally does for routine tasks.

Treatment

Immediately following this injury, rest for the body and brain is effective. If symptoms persist longer, physical therapy intervention can be extremely effective. The treatment includes balance testing and progression, memory recall, vestibular rehabilitation, and cervical spine treatment. The goal is to restore normal mobility and decrease headaches present caused by tension in the surrounding tissues. Treatment techniques are slow and progressive in nature. We start out with low demand on the body, both physically and mentally.

The goals of concussion treatments include allowing the patient to return to full activity performance, whether that be playing sports or returning to a full work shift. Ultimately, your individual brain’s reaction to treatment will determine how quickly you will progress.

As with most efficient therapeutic experiences, communication between the therapist and referring physician is crucial.  This is true for returning to sports or to work activity. Making sure the patient is progressing at the right pace, not too fast or slow, is important. The doctor can help with these progressions based on imaging results following an injury. If you feel that you are suffering from concussion-like symptoms, or have recently had a head injury, please feel free to contact our office for consultation.

Written by Casey Badder PT