Prevent Little League Elbow with These Essential Arm Care Checklists

Little League elbow is a common injury that affects young baseball players, often cutting promising careers short if not addressed properly. However, with the right approach to arm care, you can not only prevent this injury but also enhance your performance on the field. As someone who has been both a college baseball player and a Doctor of Physical Therapy specializing in sports and orthopedics, I’ve helped over 300 athletes recover from Little League elbow. My experience on the field and in the clinic gives me a unique understanding of both the mechanics that lead to this injury and how to effectively treat it.

In this blog post, I’ll share with you the essential checklists that I recommend to all my athletes: a Pre-Throwing Warm-Up Checklist and a Post-Throwing Recovery Checklist. Following these routines will help protect your arm, prevent injuries, and keep you performing at your best. Plus, I’ll explain how you can get a customized checklist tailored specifically to your needs.

The Importance of Pre-Throwing Warm-Up and Post-Throwing Recovery

Why is it so crucial to properly warm up before throwing and recover after? Simply put, your arm is a complex system of muscles, tendons, and joints that require careful preparation and recovery to handle the stresses of throwing a baseball. Without the proper warm-up, your muscles and joints aren’t ready for the intense activity, increasing the risk of injuries like Little League elbow. Similarly, failing to cool down properly after throwing can lead to overuse injuries, inflammation, and long-term damage.

By incorporating a structured warm-up and recovery routine into your training, you not only reduce the risk of injury but also improve your throwing performance and longevity. Let’s dive into the checklists that can make all the difference.

Pre-Throwing Warm-Up Checklist

Purpose:
The goal of the pre-throwing warm-up is to loosen up your arm and shoulder, preparing them for the intense activity of throwing. This warm-up routine enhances your performance and significantly reduces the risk of injury by ensuring your muscles, joints, and nervous system are all firing on all cylinders.

Steps:

1. Y + Reverse Lunge (2 x 15 reps):
   Why is this important?
   This exercise focuses on scapular strength and lower body stability, both of which are crucial for throwing. It ensures that your shoulder blade can tilt backward when you cock your arm and that your legs provide a stable foundation for powerful throws. Common mistakes:
   Avoid excessive low back extension and ensure proper engagement of the lower trap muscle. If you’re not feeling the muscle work, you’re not getting the gains you need.

2. T + RDL (2 x 15 reps):
   Why is this important?
   This exercise targets your mid-back, lower back, glutes, and hamstrings—key areas for maintaining posture and balance during throws. It strengthens the muscles used in the deceleration phase, reducing injury risk. Common mistakes:
   Ensure adequate hip flexion and scapular retraction. Control is key; activate the right muscles in a balanced position.

3. Pushup Plus + Alternating Toe Reach (2 x 20 reps):
   Why is this important?
   Core stability and shoulder strength are essential for a strong follow-through. This exercise improves your shoulder blades’ ability to protract and reduces fatigue. Common mistakes:
   Make sure you push through the ground effectively, fully engaging in the pushup plus for maximum benefit.

4. Side Plank + External Rotation Isometric + Reach (2 x 10 reps):
   Why is this important?
   This exercise strengthens your shoulders and obliques, which are crucial for throwing mechanics and rotational power. Common mistakes:
   Ensure a solid foundation by pushing through the floor adequately, avoiding undue stress on the shoulder.

5. Split Stance Internal Rotation (2 x 25 reps):
   Why is this important?
   Enhancing internal rotation is vital for preventing overuse injuries related to repetitive throwing motions. Common mistakes:
   Keep your shoulder blades stable during the rotation, avoiding excessive protraction.

6. Split Stance Reverse Throw (2 x 20 reps):
   Why is this important?
   This exercise mimics throwing mechanics and enhances rotational power, crucial for generating force. Common mistakes:
   Ensure full trunk rotation to avoid stressing the front of your shoulder.

7. Single Leg Stance + Eccentric External Rotation (2 x 8 reps, 4 seconds down):
   Why is this important?
   This exercise focuses on scapular control and strength, essential for increasing velocity. Common mistakes:
   Maintain controlled shoulder blade movement to prevent increased anterior tilt.

8. Median Nerve + Forearm Flexor Stretch (2 x 1 minute, rotate back and forth):
   Why is this important?
   This stretch is great for nerve and forearm mobility, preventing nerve-related issues and tightness from repetitive throwing. Common mistakes:
   Keep the shoulder aligned during rotation to ensure optimal nerve and forearm stretch.

These exercises are designed to prepare your arm for the rigors of throwing, making sure you’re not only ready to perform but also protected from injury.

Post-Throwing Recovery Checklist

Purpose:
After a game or practice, your arm needs to recover. The post-throwing recovery checklist helps reduce inflammation, prevent overuse injuries like Little League elbow, and restore your arm’s strength and flexibility.

Steps:

1. Scapular T Eccentrics (2 x 12 reps):
   Why is this important?
   This exercise targets the posterior shoulder muscles, crucial for controlled deceleration after throwing. Common mistakes:
   Avoid skipping the eccentric (lowering) phase. Slow, controlled movement is essential for full muscle engagement.

2. External Rotation at 90° Abduction (2 x 12 reps):
   Why is this important?
   Strengthening the rotator cuff at this angle protects your shoulder from strain after high-velocity throws. Common mistakes:
   Keep your elbow at shoulder height and maintain a stable core to maximize activation.

3. Prone Scapular Angels (2 x 15 reps):
   Why is this important?
   This exercise improves scapular mobility and control, ensuring smooth shoulder coordination during recovery. Common mistakes:
   Fully extend your arms during each repetition to activate the muscles effectively.

4. Quadruped Supinated Lat Stretch with External Rotation (2 x 60 seconds):
   Why is this important?
   This stretch relieves post-throw tightness, maintaining shoulder mobility and range of motion. Common mistakes:
   Maintain external rotation throughout the stretch for optimal effectiveness.

5. Posterior Cuff Stretch (2 x 60 seconds):
   Why is this important?
   Keeping the posterior shoulder flexible prevents dysfunction and enhances recovery. Common mistakes:
   Keep your elbow aligned with your shoulder to maximize the stretch’s impact.

6. Waiter Walks (2 x 30 seconds):
   Why is this important?
   This exercise improves shoulder stability, supporting overall arm health. Common mistakes:
   Keep the arm in a slightly forward position to avoid anterior shoulder discomfort.

7. Advanced Scaption on Swiss Ball (2 x 10, 10, 10 reps):
   Why is this important?
   This exercise builds shoulder strength and stability while challenging your core, promoting recovery. Common mistakes:
   Avoid using momentum; focus on slow, controlled movements.

8. Tubing Forearm Work (Wrist Flexion, Extension, Supination, Pronation, Ulnar, and Radial Deviation) (2 x 20 reps each direction):
   Why is this important?
   Strengthening your forearms enhances grip control and overall arm function, preventing injuries like tendinitis. Common mistakes:
   Slow down each motion to fully engage the forearm muscles.

These recovery exercises are just as important as the warm-up. They help your arm bounce back from the strain of throwing and keep you ready for the next game or practice.

Get Your Customized Checklist

Want a checklist that’s tailored specifically to your needs? Head over to Pre-Game Arm Care Routine or Post-Throwing Arm Care Routine to get a personalized routine designed for your arm. Whether you’re dealing with Little League elbow or just want to protect your arm for the long haul, I’ve got you covered.

Conclusion

Taking care of your arm before and after throwing is essential for preventing injuries like Little League elbow and keeping you on the field. By following these checklists, you’re not only protecting your arm but also enhancing your performance. If you’re experiencing pain or want more specific help, don’t hesitate to reach out. You can book a call with me on my website for a consultation where we’ll discuss how to get you healthy and back in the game.

And before you go, check out my next video where I dive deeper into the top five exercises to heal Little League elbow. Stay healthy and keep throwing hard!