Little League Elbow Is Overuse Injury

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DEAR DR. DONOHUE: My 12-year-old son is something of a phenomenon when it comes to baseball, and he loves playing the game. I haven’t pushed him into it. He’s a particularly awesome pitcher, and his coaches are amazed at what he can do.

I practice with him every day. He now has a sore elbow in his pitching arm. I think it might be Little League elbow. My wife blames me, because, she says I overwork him. I need some guidelines on how much throwing is too much. Thanks. — R.C.

ANSWER: The elbow is a site that’s a potential calamity for the immature skeleton. Children have vulnerable spots in their bones called growth plates. These bone parts haven’t yet become bone. They permit elongation of bones. One of those sites is the elbow.

To make sure we’re talking about the same thing, let the boy’s throwing arm hang down with his palm facing forward. Feel the area of the elbow next to the body. That’s where Little League elbow makes itself known.

It’s an overuse injury, meaning the boy is throwing too many pitches with too little rest. The incidence of elbow pain in young baseball players is quite high — 20 percent to 40 percent. It can be avoided with a sensible program that limits the number of throws per day.

First, your son should not throw until the pain leaves. Then he can resume throwing, but gradually do so. Eventually he can work up to the Little League’s standards for pitching for 12-year-olds. If a boy or girl of this age throws 66 pitches in one game, the child needs four days of rest — no throwing; if it’s 51 to 65 pitches, three days of rest are required; 30 to 50 pitches, two rest days; 21 to 35 pitches, one rest day. In practice, he should be limited to 20 pitches if he throws daily. It he throws more, he should follow the schedule for the number of pitches thrown in a game.

If your boy’s pain lasts a week, have the family doctor examine him. If he really has Little League elbow, healing can take six to 12 weeks.

DEAR DR. DONOHUE: Will you kindly tell me what is the appropriate time interval for a repeat colonoscopy? I have different information from doctors. I had my first colonoscopy when I was 51. The doctor who performed it said I didn’t need another until I was 61. A different doctor says I need a repeat at 56. Which is it? — E.P.

ANSWER: If no polyps were found on your first exam and if you have no close relatives who have had colon cancer, then the usual time for the next exam is 10 years. Otherwise, it is five years.

The booklet on colon cancer explains its detection and treatment. Readers can order a copy by writing: Dr. Donohue — No. 505W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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