Whiteside JA, Andrews JR and Fleisig GS.
The Physician and Sportsmedicine
-92, 102.

Skeletally immature athletes who throw repeatedly are at risk for elbow injuries that threaten the growth plate. Prevention and treatment of these injuries must take into account not only the number of pitches or throws and how often the athlete plays, but also velocity, throwing mechanics and the player’s age.

Overhand throwing subjects the elbow to forces of tension, compression, shear and torsion. Typically, these repetitive excessive forces involve the hypertrophic zone of the growth plate, which is particularly vulnerable during peak growth velocity – ages 10 to 12 years for girls and ages 13 to 15 years for boys, according to the authors.

A typical history may reveal the patient has persistent medial elbow soreness, stiffness and discomfort that impair throwing and batting performance.

Physical exam findings may include...

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