Little League shoulder is pain in the upper arm or shoulder that occurs only in a growing child. More specifically, it occurs in the humerus (arm bone) at the location where the bone is growing called a growth plate. The growth plate is made up of cartilage and therefore is softer and more vulnerable to injury than the bone part of bones.
In Little League shoulder, the growth plate becomes irritated or inflamed usually from overuse. It usually gets better if properly treated, but if ignored, can limit a young athlete’s throwing career and cause the humerus to stop growing resulting in a limb length difference between the two arms.
Most frequently, it is caused by lots of throwing. It occurs most often in pitchers but can occur in other baseball players (especially catchers) and other athletes who do repetitive overhead movements with their arms, such as tennis and volleyball
Symptoms seen in this problem include:
- Shoulder pain when throwing.
- Soreness for a few days after overhead activities.
- Slower or less controlled throwing.
- Swelling or tenderness around the upper arm or shoulder.
An exam of the shoulder and arm will demonstrate tenderness along the growth plate, and X-rays may show widening or a break in the growth plate. It is important to X-ray the normal arm for a comparison. An MRI is rarely indicated.
Treatment for Little League shoulder is rest from throwing so that the growth plate can heal. Physical therapy is rarely indicated, unless your child demonstrates poor overhead mechanics related to muscle weakness or joint looseness and tightness. If your child returns to play too early or plays with pain, he is at risk for stopping growth of the arm.
Once your child is pain-free, he should be able to return to play. However, he should refrain from pitching for a year from when the injury occurred. Your child should never experience pain when throwing. Returning to throwing should be done in a controlled fashion. Slowly increase the number, speed and distance of throws under the guidance of a qualified professional such as a physical therapist or athletic trainer. Your child should stop throwing if the shoulder becomes painful.