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Little League Shoulder, Sports Medicine

Mike LaGrange, MD, FAAFP, CAQSM and Tracy Ray, MD, FACSM, CAQSM Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Also known as thrower’s shoulder

  • Remodeling and deformation of the proximal humeral physis

  • Overuse injury from recurrent, excessive torque placed on the growth plate

  • Typically seen in o...

DIAGNOSIS

Diagnosis based on history, physical, and classic radiographic findings 

HISTORY

  • Patients typically complain of pain while throwing or with overhead activity.

  • Pain with throwing is typically co...

TREATMENT

GENERAL MEASURES

  • Treatment consists of rest from throwing and limited use of over-the-counter (OTC) pain medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) as ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • After 3- to 12-mo rest/physical therapy to reassess exam and give guidance on starting an interval throwing program

  • Repeat x-rays are not necessary because it can ...

REFERENCES

1
Little League. Regular season pitching rules—baseball and softball. https://www.littleleague.org/playing-rules/pitch-count/. Accessed October 17, 2018.
2
Shanley E, Thigpen C. Throwing injur...

ADDITIONAL READING

DiFiori JP, Benjamin HJ, Brenner JS, et al. Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med...

CLINICAL PEARLS

  • An adolescent should never throw with shoulder pain or fatigue.

  • Loss of velocity or pitch control during an outing are signs of shoulder fatigue.

  • Pain with external rotation and pain alo...

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