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Medial apophysitis, also called Little League elbow syndrome, is a condition caused by excess stress placed on the inner aspect of the elbow that occurs due to repetitive throwing movements and actions. Apophysitis refers to the inflammation of this growth plate that occurs due to recurrent trauma.
Before discussing medial apophysitis, it is important to know what the medial apophysis is. The medial apophysis refers to a small cartilage-like structure called the growth plate that is seen in the elbow of children. It connects the the bony protuberance on the inner aspect of the elbow joint, called the medial epicondyle, to the humerus bone. The apophysis is the site where a number of muscles and tendons are attached which are actively involved in stretching and rotating the forearm and the wrist.
Medial apophysitis is often seen in children who enjoy playing baseball. Baseball pitchers throw the ball aggressively, which can result in excessive stress being placed on the muscles and ligaments attached to the medial epicondyle apophysis, such as the medial collateral ligament. The stress can include excessive stretching, pulling and even traction. With repetitive throwing movements, continuous stress can be placed on the medial epicondyle growth plate, which eventually weakens it. In addition, there is a great degree of inflammation as well, which eventually causes pain.
The most common symptom that patients experience is pain on the inner aspect of the elbow. This pain is worse on movement, and may be felt when throwing or carrying heavy objects. In addition to the pain, there may be localized redness and swelling as well.
The best way to diagnose medial apophysitis is from the history of the condition. As has already been mentioned, this condition is common in baseball pitchers and similar histories are usually obtained from children affected. In some cases, X-rays may be performed to assess the medial epicondyle growth plate in a bit more detail.
Unfortunately, medial apophysitis can't be completely prevented, but there are certain steps that can be taken that can reduce the chance of it occurring. This can include warm up exercises before throwing, changing the strategy and method of throwing the ball and seeking medical advice early.
There are a number of different treatment options available for children with medial apophysitis. These include: