Medial Epicondyle Apophysitis – or Little League Elbow, as it is more colloquially known – occurs when the tendons and ligaments of the elbow are stressed by repetitive throwing motions that exceed the forces that the growth plate on the medial (inside) side of the elbow can tolerate. With overhand baseball pitches, the highest amounts of force are placed on the elbow during the “late cocking” and “early acceleration” phases and can be exacerbated when throwing curveballs and breaking pitches. Compressive forces exerted on the medial aspect of the elbow during these pitches lead to inflammation and pain characteristic of little league elbow in young athletes, similar to ulnar collateral ligament injuries in adults.