Still the #1 injury in kids, ankle sprains commonly occur during sports. The ankle “twists,” (usually inward) and the bottom of the foot faces the other ankle. Pain occurs rather immediately
Injuries of the elbow are not rare in throwing sports. In particular, injuries along the inner aspect (the side that your pinky finger is on) of the elbow are rather common in young throwers. And if one were to isolate a particular injury, Little League Elbow comes to mind. This injury occurs for several reasons but the two that stand out are throwing too much, or throwing incorrectly. Investigation into this malady has brought much attention to sports, especially Little League baseball. Although not isolated to baseball, it is this sport that youngsters are seemingly placed in harms way. Either they are asked to pitch too much, or with mechanics that put the elbow into a vulnerable state. The injury results from both overuse and biomechanical challenges. The specifics of the injury include damage of the supporting structures holding the elbow together as well as to the muscles that dynamically support the region. The Ulnar Collateral Ligament, a very strong ligament on the inner side of the elbow, is challenged when one uses the upper limb for the throwing motion. Since ligaments are rather strong in the young population, the injury, in its minor form may be a simple sprain of this ligament. However, in more severe cases, the ligament may exert excessive pressure onto the bone in which it attaches and in fact can cause a traction effect on the bone. What results is the possibility that this area of bone, called the epicondyle, gets injured. It may even pull the bone apart and result in a very serious injury. It’s medical name, medial epicondylitis, is a traction apophysitis, but known to most as Little League Elbow. The player who suffers with this condition will note local soreness in the region of the “funny bone.” There will likely be increased pain when the child throws, the area may be swollen and mild erythema (redness) may ensue.
It is essential that this injury be reported to the child’s parent (s) and coach. If left unattended, it may lead to life long morbidity and even affect growth of the local bone in that region. The reason, the injured area is also the region where bone grows. Treatment is essential. The child MUST rest the area. This means NO throwing until the elbow is pain free. Applying ice through a towel to the area, five minutes on and five minutes off several times/day may help. It will take approximately 2-3 weeks on the short side for healing to occur. If the injury is more significant, healing may take several months. Once the pain is persistent for greater than 2-3 weeks, a visit to the physician is warranted. An x-ray may be taken. The purpose is to assess the area and more specifically visualize the bony epicondyle and make sure it is attached. If it isn’t, healing will take months and not weeks. Fortunately, there is a trend in Little League baseball to track both the number and type of pitches a child throws. Hopefully, through heightened awareness and prompt medical attention, this malady will not cause significant long term damage to our young population.
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