Trauma & Sports

Panner's Disease: Elbow Pain in Young Athletes

Elbow pain after gymnastics or throwing: Panner's disease is an osteochondritis typical of ages 5-10.

Updated: March 2026·Medically reviewed by Dr. Daniele Priano

Quick Answers

What is the difference between Panner's and osteochondritis dissecans?
Panner disease more diffusely affects the capitellar ossification centre and is typical of younger children; OCD is more focal and more frequent in older children. Age is a clue, not an absolute diagnostic threshold: examination and imaging define the condition, with MRI when needed.
Does it heal completely?
In most cases yes: the humeral capitellum tends to reconstitute over 1-2 years and the elbow regains a complete or near-complete range of motion. The key element is rest from the causative sport during the active phase, with clinical follow-up until resolution.
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A 7-8 year old gymnast who starts complaining of elbow pain and can no longer fully straighten the arm: this is the typical presentation of Panner's disease.

It's an osteochondritis of the humeral capitellum — the lateral part of the lower end of the humerus that forms the elbow joint. It affects children aged 5 to 10, especially those in sports that repeatedly load the elbow: artistic gymnastics (handstands, parallel bars), throwing sports (baseball, javelin), and sometimes swimming.

The mechanism is similar to Köhler's disease in the foot: a temporary vascular insufficiency of the ossification center, which on X-ray appears fragmented or sclerotic — an image that can worry parents, but one that carries a generally favourable prognosis. In most cases the capitellum reconstitutes over 1-2 years and the elbow regains a complete or near-complete range of motion.

The most important distinction is with osteochondritis dissecans (OCD) of the elbow, which is more typical of older children, although age alone does not distinguish the diagnoses and has a very different prognosis: it can cause detachment of a loose fragment and require surgery. In Panner's disease surgery is rarely needed: treatment is usually rest from the causative activity and gentle maintenance of range of motion.

Assessment and treatment

When to seek evaluation

  • Elbow pain during or after sports
  • Limited full elbow extension
  • Tenderness at the lateral capitellum
  • Elbow swelling
  • Pain in a young gymnast or thrower

What is evaluated

  • Elbow range of motion assessment
  • Capitellum palpation
  • Elbow X-ray (fragmentation/sclerosis of the capitellum)
  • Differential diagnosis with adolescent osteochondritis dissecans (OCD)
  • MRI in selected cases

Treatment options

  • Rest from causative sports activity
  • Elbow brace for comfort if needed
  • Gentle range-of-motion exercises
  • Alternative sports that don't load the elbow
  • Gradual return to sports after symptom resolution

Frequently Asked Questions

What is the difference between Panner's and osteochondritis dissecans?▼
Panner disease more diffusely affects the capitellar ossification centre and is typical of younger children; OCD is more focal and more frequent in older children. Age is a clue, not an absolute diagnostic threshold: examination and imaging define the condition, with MRI when needed.
Does it heal completely?▼
In most cases yes: the humeral capitellum tends to reconstitute over 1-2 years and the elbow regains a complete or near-complete range of motion. The key element is rest from the causative sport during the active phase, with clinical follow-up until resolution.
Will my child be able to continue gymnastics?▼
Return is decided after clinical and radiographic reassessment, considering pain, movement and function. Unapproved elbow loading is avoided during healing; one timetable does not fit everyone. Swimming also loads the upper limb and is not an automatically permitted alternative.
Is surgery ever needed?▼
The typical form of Panner's disease is treated conservatively: rest, maintenance of range of motion and gradual return to sport. If surgery appears necessary, this calls for re-assessment of the diagnosis or of associated lesions — surgery may be needed for adolescent osteochondritis dissecans.

Other Juvenile Osteochondroses

Osteochondroses are a family of growth-related conditions. Learn about the others:

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Osgood-Schlatter(Knee)
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Sever(Heel)
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Sinding-Larsen(Kneecap)
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Köhler(Foot)
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Freiberg(Forefoot)
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Iselin(Outer foot)
Complete guide to juvenile osteochondroses →

Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.