ACL Graft Choice Risk Factors ACL-RSI Calculator (Return to Sport Readiness)AHA Pre-Participation Screening AOFAS Ankle-Hindfoot Scale ASES Elbow Score ASES Shoulder Score Acute:Chronic Workload Ratio (ACWR)Altitude Gain Guidelines Ankle Syndesmosis (High Ankle Sprain)Athlete's Heart vs HCM Beighton Score (Joint Hypermobility)Borg CR-10 Scale Borg RPE Scale (6–20)Brighton Criteria (BJHS)Buffalo Concussion Treadmill Test (BCTT)Child SCAT6 (Age 8–12)Commotio Cordis Protocol Cumberland Ankle Instability Tool (CAIT)DASH (UE Disability Index)Doha Groin Agreement ESC HCM SCD Risk Score ESC Pre-Participation Screening Energy Availability Calculator FAI Syndrome (Warwick)FAOS (Foot and Ankle Outcome Score)Fear-Avoidance Beliefs Questionnaire (FABQ)Female Athlete Triad Risk Foot Posture Index (FPI-6)Foot and Ankle Ability Measure (FAAM)Functional Movement Screen (FMS)Graduated Return-to-Play (GRTP) Protocol HAGOS (Hip and Groin Outcome Score)Hamstring Asymmetry Index Heat Index (Apparent Temp)Hip Outcome Score (HOS)Hooper Index (Athlete Wellness)I-PRRS (Psychological Readiness)IKDC (Objective Examination)IKDC (Subjective Knee Evaluation)Injury Severity KJOC Shoulder & Elbow Score KOOS (Knee Outcome Score)KOOS-PS (Physical Function Short Form)Kujala (Anterior Knee Pain Scale)LEAF-Q (LEA Screening)Lake Louise AMS Score Limb Symmetry Index (LSI)Little League Elbow Grading Lysholm Knee Score Marx Activity Rating Scale (MARS)Mayo Elbow Performance Score (MEPS)Modified Schober Test NEXUS C-Spine Criteria Neck Disability Index (NDI)One-Rep Max Estimator Osgood-Schlatter Severity Oswestry Disability Index (ODI)Ottawa Knee Rules Oxford Elbow Score Oxford Shoulder Score PAR-Q+ Readiness Questionnaire PARS-3 Youth Readiness Patellar Instability Severity Score Pitch Smart Guidelines (USA Baseball)Pittsburgh Knee Rules Post-Concussion Symptom Scale (PCSS)QuickDASH (Shoulder & UE)RED-S CAT (Clinical Assessment)Re-injury Anxiety Inventory (RIAI)Relative Age Effect (RAE)Return-to-Play Battery SANE Score (Single Assessment)SCAT6 (Sport Concussion Assessment Tool 6)SCOAT6 (Sub-acute and Office Follow-up)SEAQ-I Appetite Questionnaire STarT Back Screening Tool Session RPE (Internal Load)Sever's Disease Activity Single-Leg Hop Test Battery Standardized Assessment of Concussion (SAC)Steroid Equivalence Calculator Stinger / Burner Grading Sweat Rate and Rehydration TSK-11 (Tampa Scale for Kinesiophobia)TUE Criteria Checklist Tanner Stage Assessment Tegner Activity Scale (TAS)Training Monotony and Strain UCL Injury Risk (Medial Elbow)VISA-A (Achilles Tendinopathy)VISA-P Scale (Patellar Tendinopathy)VO2 Max VOMS (Vestibular/Ocular-Motor Screening)WADA Prohibited List Checker WBGT (Wet Bulb Globe Temp)WORC (Rotator Cuff Index)WOSI (Shoulder Instability Index)Wilks Score (Relative Strength)Wind Chill Index hEDS Diagnostic Criteria (2017)iHOT-33 (International Hip Outcome Tool)

Recent Journal Updates

British J Clinical PharmacologyJun 26, 2026

Effect of carbamazepine on the pharmacokinetics of vepdegestrant, a PROteolysis TArgeting Chimera estrogen receptor degrader, in healthy adults

Clinical Context

We think this has broad domain relevance to Little League Elbow Grading.

WHO NewsJun 15, 2026

Open letter to leaders of G7, G20, BRICS and all nations on finalizing the WHO Pandemic Agreement’s Pathogen Access and Benefit Sharing annex

Clinical Context

We think this might be relevant to the clinical guidance for Little League Elbow Grading.

WHO NewsMay 28, 2026

Message by the WHO Director-General to the people of the Democratic Republic of the Congo

Clinical Context

We think this might be relevant to the clinical guidance for Little League Elbow Grading.

Little League Elbow Grading

Stage 1

Medial Epicondylar Apophysitis

Strict adherence to Pitch Smart volume guidelines is the most effective prevention. Stage 3 injuries often require orthopedic consultation and prolonged cessation of throwing (3–6 months).

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Evaluation of elbow pain in youth baseball pitchers (ages 8–16) with repetitive overhead throwing.

Pre-participation screening for adolescent athletes with high training volume (>80 pitches per game, >8 months per year).

Monitoring of known medial elbow stress injuries (e.g., medial epicondyle apophysitis) to guide return-to-play decisions.

Differential diagnosis of medial elbow pain versus lateral or posterior elbow pathology in throwing athletes.

Serial assessment during rehabilitation to track healing and readiness for progressive throwing programs.

Key Indication - Medial Epicondyle Apophysitis Grading

The Little League Elbow Grading system is primarily indicated for classifying the severity of medial epicondyle apophysitis (MEE) in skeletally immature throwers. It integrates clinical findings (pain location, swelling, range of motion) with radiographic or ultrasound evidence of physeal widening, fragmentation, or avulsion. Grade I (mild) involves pain with throwing only; Grade II (moderate) includes pain with daily activities and radiographic changes; Grade III (severe) involves acute avulsion fracture or chronic nonunion. This grading guides activity modification, immobilization, and surgical referral.

When Not to Use / Contraindications

Acute elbow dislocation or fracture requiring emergency reduction or surgical fixation.

Skeletally mature athletes (closed physes) – alternative diagnoses like ulnar collateral ligament (UCL) injury should be considered.

Isolated posterior elbow pain (e.g., olecranon apophysitis or stress fracture) – use specific grading for those conditions.

Systemic inflammatory arthropathy or infection (septic arthritis) – requires urgent rheumatologic or infectious disease workup.

Inability to cooperate with physical examination (e.g., severe pain, cognitive impairment) – imaging may be prioritized.

Last Comprehensive Review: 2026

Recent Journal Updates

British J Clinical PharmacologyJun 26, 2026

Effect of carbamazepine on the pharmacokinetics of vepdegestrant, a PROteolysis TArgeting Chimera estrogen receptor degrader, in healthy adults

Clinical Context

We think this has broad domain relevance to Little League Elbow Grading.

WHO NewsJun 15, 2026

Open letter to leaders of G7, G20, BRICS and all nations on finalizing the WHO Pandemic Agreement’s Pathogen Access and Benefit Sharing annex

Clinical Context

We think this might be relevant to the clinical guidance for Little League Elbow Grading.

WHO NewsMay 28, 2026

Message by the WHO Director-General to the people of the Democratic Republic of the Congo

Clinical Context

We think this might be relevant to the clinical guidance for Little League Elbow Grading.

Little League Elbow Grading

Stage 1

Medial Epicondylar Apophysitis

Strict adherence to Pitch Smart volume guidelines is the most effective prevention. Stage 3 injuries often require orthopedic consultation and prolonged cessation of throwing (3–6 months).

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Evaluation of elbow pain in youth baseball pitchers (ages 8–16) with repetitive overhead throwing.

Pre-participation screening for adolescent athletes with high training volume (>80 pitches per game, >8 months per year).

Monitoring of known medial elbow stress injuries (e.g., medial epicondyle apophysitis) to guide return-to-play decisions.

Differential diagnosis of medial elbow pain versus lateral or posterior elbow pathology in throwing athletes.

Serial assessment during rehabilitation to track healing and readiness for progressive throwing programs.

Key Indication - Medial Epicondyle Apophysitis Grading

When Not to Use / Contraindications

Acute elbow dislocation or fracture requiring emergency reduction or surgical fixation.

Skeletally mature athletes (closed physes) – alternative diagnoses like ulnar collateral ligament (UCL) injury should be considered.

Isolated posterior elbow pain (e.g., olecranon apophysitis or stress fracture) – use specific grading for those conditions.

Systemic inflammatory arthropathy or infection (septic arthritis) – requires urgent rheumatologic or infectious disease workup.

Inability to cooperate with physical examination (e.g., severe pain, cognitive impairment) – imaging may be prioritized.

Last Comprehensive Review: 2026