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Rady Children's Specialists

Little League Shoulder

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.