HELP! My child has little league shoulder: What should I do?

Little league shoulder is an overuse injury that involves the growth plate.  It can occur due to excessive pitching, poor mechanics, or doing a combination of several overhead activities. With winter upon us, many baseball players use this time period for strength and conditioning, while giving their arms a rest. For young baseball players, this is an ideal time to engage in a program designed to treat or prevent growth plate injuries to the shoulder.

What is a growth plate?

• A growth plate, also known as the epiphyseal plate, is the area of growing tissue at the end of long bones.

What types of injuries occur at growth plates?

• Because the growth plate is the weakest area of the bone in children and adolescents, injuries to this region are common
• Growth plate injuries are due to direct trauma or overuse and are classified into 5 different categories
• Little league shoulder is a separation of the growth plate (classified as a Type I growth plate injury) and is the most common injury seen with overuse, while the remaining 4 classifications are typically caused by trauma and involve a fracture.

How can I tell if my child has little league shoulder?

• Pain with throwing is the first indicator and is usually accompanied by an altered throwing motion and decreased velocity.
• X-rays and sometimes an MRI, in conjunction with a physical examination, are used to confirm the diagnosis by comparing the space at the growth plate from one side to the other.

What should I do if my child is diagnosed with little league shoulder?

• The best treatment is discontinuing throwing or any activities that hurt, for 4-8 weeks depending on the severity. However, while “shutting them down” is the first step, it does NOT necessarily mean your child has to rest.
• Your child can continue cardiovascular exercise, strengthen the uninvolved arm, and work on core strengthening, provided there is no shoulder pain.
• As the symptoms subside, physical therapy is a key component in preventing this condition from advancing. The focus of physical therapy should go beyond strengthening and range of motion of the shoulder joint and should include core, back, and lower extremity strengthening and flexibility as well.

How can I reduce the risk of my child getting little league shoulder?

• Avoid throwing with arm fatigue
• Avoid throwing with arm pain
• Limit pitch counts, provide 2-3 days of rest between games pitched, and pitch no more that 8 months out of the year with less than 100 innings.
• Stay involved with a strength, flexibility, and conditioning program

If you would like additional information on the prevention and treatment of throwing injuries, please contact The Sports Rehabilitation Center.