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Pytiak AV, Stearns P, Bastrom TP, et al. Are the Current Little League Pitching Guidelines Adequate? A Single-Season Prospective MRI Study. Orthop J Sports Med. 2017;5(5):2325967117704851doi: 10.1177/2325967117704851.
Pytiak, A. V., Stearns, P., Bastrom, T. P., Dwek, J., Kruk, P., Roocroft, J. H., & Pennock, A. T. (2017). Are the Current Little League Pitching Guidelines Adequate? A Single-Season Prospective MRI Study. Orthopaedic journal of sports medicine, 5(5), 2325967117704851. https://doi.org/10.1177/2325967117704851
Pytiak, Andrew V, et al. "Are the Current Little League Pitching Guidelines Adequate? A Single-Season Prospective MRI Study." Orthopaedic journal of sports medicine vol. 5,5 (2017): 2325967117704851. doi: https://doi.org/10.1177/2325967117704851
Pytiak AV, Stearns P, Bastrom TP, Dwek J, Kruk P, Roocroft JH, Pennock AT. Are the Current Little League Pitching Guidelines Adequate? A Single-Season Prospective MRI Study. Orthop J Sports Med. 2017 May 19;5(5):2325967117704851. doi: 10.1177/2325967117704851. eCollection 2017 May. PMID: 28567429; PMCID: PMC5439649.
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Orthop J Sports Med. 2017 May 19;5(5):2325967117704851. doi: 10.1177/2325967117704851. eCollection 2017 May.

Are the Current Little League Pitching Guidelines Adequate? A Single-Season Prospective MRI Study.

Orthopaedic journal of sports medicine

Andrew V Pytiak, Phillip Stearns, Tracey P Bastrom, Jerry Dwek, Peter Kruk, Joanna H Roocroft, Andrew T Pennock

Affiliations

  1. Orthopedics & Scoliosis Division, Rady Children's Hospital, San Diego, California, USA.
  2. Department of Orthopedic Surgery, University of California, San Diego, California, USA.
  3. Department of Radiology, Rady Children's Hospital, San Diego, California, USA.

PMID: 28567429 PMCID: PMC5439649 DOI: 10.1177/2325967117704851

Abstract

BACKGROUND: Little League throwing guidelines have recently been implemented in an attempt to lessen the growing number of elbow injuries occurring in youth baseball players.

HYPOTHESIS/PURPOSE: The purpose of this study was to examine pre- and postseason changes seen on magnetic resonance imaging (MRI) in youth baseball players' elbows in an attempt to identify risk factors for pain and MRI abnormalities, with a particular focus on the current Little League guidelines. We hypothesized that MRI abnormalities would be common in pitchers with high pitch counts and poor guideline compliance.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: A prospective study of Little League players aged 10 to 13 years was performed. Players were recruited prior to the start of the season and underwent bilateral elbow MRI as well as a physical examination and completed a questionnaire addressing their playing history and arm pain. At the end of the season, a repeat MRI and physical examination were performed. MRIs were read by blinded radiologists. During the season, player statistics including innings played, pitch counts, and guideline compliance were recorded. Physical examination findings and player statistics were compared between subjects with and without MRI changes utilizing chi-square and analysis of variance techniques.

RESULTS: Twenty-six players were enrolled. Despite 100% compliance with pitching guidelines, 12 players (48%) had abnormal MRI findings, and 28% experienced pain during the season. There was a significant difference in distal humeral physeal width measured pre- to postseason (1.54 vs 2.31 mm,

CONCLUSION: Arm pain and MRI abnormalities of the medial elbow are common in Little League baseball players who comply with the Little League throwing guidelines, especially those playing year-round.

Keywords: Little League elbow; magnetic resonance imaging; medial epicondylitis; youth baseball

Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

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