Sports Medicine: Little League Shoulder

What is little league shoulder?

Little league shoulder (proximal humeral epiphysitis) is an overuse injury of the shoulder. This condition is an inflammation of the growth plate at a part of the arm bone (humerus) that is closest to the shoulder. Little league shoulder affects young athletes that are still growing.

What causes little league shoulder?

Little league shoulder is caused by repetitive stress to the shoulder from overhead throwing, causing inflammation to the growth plate. This injury is most often seen in baseball, but it can also be seen in other sports with a lot of overhead motion such as tennis and volleyball.

What are the symptoms of little league shoulder?

The primary symptom of little league shoulder is pain while throwing. This pain usually gets worse with an increased number of throws or when trying to throw with more velocity. Pain afterwards can last for several days. The athlete may indicate that they feel like their shoulder is weak and that they have less control over their throws. In severe cases, the shoulder may be visibly swollen.

How is little league shoulder diagnosed?

A physician will use a thorough history and physical examination to determine if an athlete has little league shoulder. Often x-rays and a MRI will be ordered to rule out other types of injuries that may mimic this condition. The physician may also order x-rays of the uninjured shoulder to compare to the injured shoulder looking for changes in the growth plate.

What is the treatment for little league shoulder?

Rest is the most effective treatment for little league shoulder; how much rest depends on the severity of the injury. Physical therapy will be used to strengthen the shoulder muscles for a return to throwing. Once an athlete is released to begin throwing, a throwing progression should be used in order to slowly build up the shoulder’s endurance.

What is the long term outlook for an athlete with little league shoulder?

With proper rest and rehabilitation, full return to activity is expected. The earlier little league shoulder is diagnosed, the shorter the recovery time. If left untreated, pain may escalate and in rare cases, a displaced fracture through the growth plate may occur.

It is important to follow pitch count guidelines for young athletes to help prevent little league shoulder. Pitch count guidelines can be found on www.littleleague.org under the “rules and regulation changes” tab.