Find out more about Little Leaguer's shoulder and how it can be treated.
Dr. Keith Meister, Medical Director of Sports Medicine at Medical Center Arlington and Team Physician for the Texas Rangers, continues to share important tips for parents and athletes here on our blog. Today Dr. Meister discusses a shoulder injury that is common in Little League baseball players.
Appropriately, in addition to the condition that results in discomfort in the elbow in the youth pitcher / throwing athlete, the “little league elbow,” there is a similarly noted condition in the shoulder.
“Little leaguers shoulder,” aptly termed, refers to pain that occurs in the throwing shoulder in the growing athlete. The pain begins as a consequence of a stress fracture that occurs in the growth plate in the upper arm bone, the humerus. Stress fractures occur as a result of repetitive use that outweighs the body’s ability to repair damage that can occur in bone as a consequence of even normal use. The upper arm growth plate, or humeral epiphysis, is often times the weak link in the chain of the throwing shoulder. The growth plate, or epiphysis, is made up of cartilage cells that are softer than normal bone and thus more susceptible to injury. Repetitive throwing can result in a fracture of this cartilage plate.
The young thrower, most commonly ages 13-14, will often complain of dull aching pain in the upper arm / shoulder region either with throwing alone or at rest. It usually begins gradually and slowly worsens, affecting initially only the ability to throw but eventually all baseball activities. It is commonly misdiagnosed initially as “tendonitis.” However, in the interpretation of pain in the upper arm of a young thrower, a stress fracture must always be considered. The shoulder is usually tender over the upper outer aspect of the deltoid muscle. Routine shoulder x-rays will often show widening of the growth plate (see slide A). Opposite shoulder x-rays can be very useful in helping to make the proper diagnosis.
Treatment is first rest and avoidance of the aggravating activity. Oral anti-inflammatory medication (Tylenol, ibuprofen) can help with management of painful symptoms. Immediately upon diagnosis, an evaluation of the athlete’s throwing habits should be made. A good rehabilitation program should also be started that focuses on an overall body baseball conditioning program as well as specific exercises for the throwing arm.
If the athlete is pain free hitting, he/she may continue the season as a DH. When pain is absent and examination is normal, a throwing program may be begun with a gradual progression of increasing throwing distance and intensity. At this time, evaluation of throwing mechanics should be made by a qualified individual to assist in the avoidance of recurrent injury.
Most little leaguer’s shoulders will resolve over an 8- to 10-week period. Complete recovery can take even longer. Symptoms occurring for up to a year are possible. In these cases, repeat x-ray examination can be helpful.
Are you concerned that your child's shoulder may have a sports injury? Medical Center Arlington can help diagnose the injury and treat it before it worsens. Please call 1-855-868-6262 for a physician referral.
Injury Prevention in the Youth Pitcher