Elbow disorders in throwing athletes.

Skeletally immature throwing athletes are injured when they throw too frequently or use throwing styles and pitches that overstress their elbows. Despite safety guidelines for throwing that recommend throwing more than 300, but less than 600, pitches per season, compliance is almost impossible to monitor, given multiple opportunities for throwing abuse away from organized, supervised league play. All throwers should avoid the side-arm throwing style. Pitchers should not play in multiple leagues, should not play hard-throwing positions when not pitching, and should not pitch when having elbow or shoulder pain. When the elbow becomes painful, pitching should cease and a thorough evaluation performed. Once the diagnosis is made, appropriate nonoperative treatment is undertaken. Operative intervention in this age group uncommonly is needed. Rehabilitation includes identifying and eliminating causative risk factors. Educating the athlete, coach, and parents results in a longer, pain-free throwing career and enhanced enjoyment of the sport.