Inner Elbow pain 9yr old

Long time reader first time poster. I am coaching a 9-10 yr. fall ball team that my 9 yr old playing 10u in the spring is playing on. He is very small for his age about 4’ 2 or 3" and weighs 52 - 54 lbs. We have taken him to an Endocrinoligist about his size and they have done xrays and state he is a late bloomer. His bone and growth plate age is 2.5 yrs. behind his physical age. Despite being so small he has a very strong arm especially for his size. Prob throwing 50 - 55 mph (never had a gun on it) and has the second highest velocity on the team despite being the smallest player. He had never pitched before so I thought I would give him a few innings in fall ball. He had a few lessons last fall and has decent form. Overall he probably threw 8 innings in a 12 - 14 game schedule. Never more than 2 innings in a row even though they do at times get long. His longest plate appearance has been prob less than 50 pitches.

So he tells me the other day warming up that when he throws he has a slight pain on the inside of his elbow. I remember having this pain growing up but it eventually went away. I did not pitch him that game. Yesterday playing catch in the yard he says it is still there and it doesnt hurt bad but does hurt with every throw. My thoughts are he probably needs some rest and downtime. We typically take 2 - 3 months off in the winter and dont even pick up a baseball but play allot in the Spring, Summer and Fall. He throws allot but pitches very little. He will typically throw a baseball for at least 45 minutes 4 days a week but doesnt spend but about 10 - 15 minutes 2 times a week practicing pitching. I am not in a hurry to put him on the mound full time.

So I told him he would not be pitching in our remaining 4 games and we will be limiting his throwing so that he can rest his arm. He will play 2nd all the time and will not see any more time at short or third.

Reading the boards I see allot about elbow pain and rest but can you guys give me some feedback? He states his arm feels fine, no pain at all, until he throws and then it is a slight pain. Thanks for the help!

I wouldn’t let him throw at all until after an orthopedic doctor sees him, and then only as directed by the doctor.

Two concerns come to mind. First is that you didn’t say how long he’s been playing which makes me wonder about overuse. Second, having a strong arm and, at the same time, a “bone age” that is 2.5 years behind means he can put a lot of stress on those soft growth plates.

I would have him checked out by a good sports doc and consider having him x-rayed in both arms to compare growth plate width to check for a growth plate separation in his throwing arm.

Hes played baseball since 4. Played Spring, Summer and Fall the last 2 years. The only difference this fall has been the pitching. This is his first time to pitch any at all. So that is probably the cause. We worked him up to it starting with short 20 -30 pitch practice sessions and worked up. Ive also noticed a substantial increase in velocity in the past 2 months so he may have gone through a growth spurt.

I’ll take him to see a doc and next spring may not allow him to pitch. I have to remember he is a 10 yr. old (in a couple weeks) in a 7.5 yr. olds body. He loves playing middle IF so we will concentrate on that for a couple years. No rush on the pitching he is a late bloomer with very good velocity. I am going to protect his arm.

Pitching is just throwing while utilizing as much body momentum as possible and should be LESS stressful on the arm… I find that most kids who injure themselves pitching are attempting to do something different than just throw properly. However, now that your son feels something every time he throws the ball, he most likely has some “structural shift” somewhere along the kinetic chain in his arm/body that is causing the discomfort. Easy to fix for a doc who focuses on correcting structure - also, you might want to post a video of him pitching and/or throwing the ball; sometimes it’s something simple like he’s not keeping his fingers on top of the ball throughout the delivery.

Those growth plates are even more vulnerable during growth spurts. Since your son’s “bone age” is behind his actual age, it might be worthwhile to track your son’s height on a monthly basis and when you detect an increased rate of growth then you back off on his throwing workload.

Some place on this planet, I want to say it’s some country in Europe, they monitor growth of kids and when a growth spurt is detected in a kid, the kid is removed from competition for something like 6 months to help avoid injury. So, what I am suggesting is very resonable.

Had a similar situation with my boy at 9. The big problem at that age is a seperation of the growth plates – they give more than the ligaments at that age. Go to an ortho and have them look at it. They’ll x-ray to make sure the plate is ok. If it is, then it is likely some swelling in the ligament. Get some physical therapy on it so it heals as well as gets stronger. They should give some exercises (throwers ten) to strenghten the arm. Let us know how it turns out. Good luck.

Went to the Ortho/Sports Med DR. about a week ago. She asked many good questions and reall ytried to understand his history. I was impressed with her baseball knowledge. After bending and stretching him in many different ways she stated that his throwing shoulder had much less flexibility than is non throwing shoulder and recommended the “sleeper stretch” 3 times a day. I can already see drastic improvements in his flexibility from this stretch. She stated that this lack of flexibility caused undo stress on his elbow and that it was very common to see this in pitchers. She did an xray on both arms and saw no growth plate or bone damage and stated it was probably an overuse injury.

She recommended downtime of 2 - 4 weeks then a gradual throwing program to get him back to normal (or better than normal with increased flexibility and strength). One thing that concerned me was she suggested starting the throwing program with a tennis ball. Just tossing to begin with but the build up to almost full speed with it before moving to a baseball. Wouldnt a light tennis ball hurt his arm more than help?

She also mentioned the Throwers Ten and stated she would email it to me… Havent gotten it yet but I will just Google it… Im sure it is somewhere out there.

Just got some very good pics of him from a side shot with a burst camera. Probably around 10 - 12 or so shots for each pitch. This was very helpful and even as a novice I could pick out a couple things to work on. His glove hand sometimes would tuck nicely into his shoulder and on other pitches would become lazy and end down around his waist (could be some of the accuracy issues) also I noticed on most of his pitches he released very high (needs to release out front more) but after release his hand would rotate palm out. Shouldnt he work on completeing the throwing motion keeping his hand palm down so that the arm is not rotating?

I only have these pics in a slide show but as soon as I get the single pics I will post for some advise. Thanks for all the help so far.

Spring, Summer, and Fall baseball…Wow, for a 9 year old, hope you don’t burn him out.

Yeah I understand that and have concerns about burn out. I do not force him to play fall ball and the only reason he played summer baseball is because he made Allstars. As a 9 it is districts and out. I have purposely not pursued travel ball this year. he played a few tournys last fall but we have gotten away from it. He plays with his friends.

Here’s a link to something I wrote at least 6 or 7 years ago and I still stand behind it.

That isn’t to say anyone in this thread is abusing or overusing any young player, but rather to make the point that kids aren’t miniature adults and have to be watched very closely. The main thing to remember is, there’s just no reason to take a chance with a kid who isn’t physically mature! No one is running around with a contract or a scholarship until they’re at least Jrs in HS, so there’s no reason to hurry things along.

"That isn’t to say anyone in this thread is abusing or overusing any young player, but rather to make the point that kids aren’t miniature adults and have to be watched very closely. "

I understand what you are saying here but to just set the record straight. My son has never pitched before this fall. This fall his longest outing was 2 1/3 innings in which he pitched roughly 40 - 50 pitches. This was by far his longest outing. In a total of 12 games he pitched 12 innings of baseball. Typically this was 1 inning in relief at a time and maybe one or two starts of no more than 2 innings. He did not pitch every game.

My oldest and most mature player has carried the work load at pitching. NEVER pitching more than 3 innings and at the most 50 - 60 pitches. He has pitched most games as long as there have been at least 3 - 4 days rest in between. Again he is a VERy mature 11 year old and could probably go much longer than I have used him.

I make it a point not to abuse my arms and my son has had a very light load. The overuse could be attributed to all of the throwing he does at practice, before games and playing with his friends. When he is not at a practice or a game he is constantly playing sandlot ball in the neighborhood. Much better than playing video games but he needs to learn that he needs to rest his arm from time to time and all of the throwing counts not just pitching.