Medicine: The Dangerous Arm

Little League baseball is tough enough on the psyche of anxious parents who are determined that their kids win—or else.

The kids themselves take a different beating. Across the U.S., pediatricians have come to recognize that young pitchers frequently suffer injuries that are painfully reminiscent of big-league headlines.

The diagnosis: "Little League elbow" and "Little League shoulder." Both troubles result from the fact that bone and cartilage in youngsters have not hardened to the point where they can sustain the stress of continued hard pitching. In Little League elbow, the piece of bone that rests at the end of the elbow (the medial epicondylar epiphysis) is pulled out of position by tendons and muscles and is sometimes fractured. In Little League shoulder, the cartilage near the end of the upper arm bone (humerus) is torn loose. Both injuries require immobilization with a cast, splint, or sling. But all too often, cases are treated at home as "pulled muscles." Many of the injuries could be avoided if young pitchers were warmed up properly before going into a game. Says the University of Florida's Dr. Byron G. Brogdon, who has been compiling case histories for the past three years: "The findings suggest that Little Leaguers (ages nine to twelve) and Pony Leaguers (ages 13 to 14) are placed on a pitcher's mound, inspired to maximum efforts by the adulation of their contemporaries and the exhortations of their often vicariously ambitious parents, at the worst possible time in their lives."