Mar 24, 2021 3:00 PM


Peter N. Chalmers, MD, with the Department of Orthopaedic Surgery at University of Utah Health, shares his insight on the signs of little league shoulder and how to treat it.

What is little league shoulder?

Little League shoulder is an overuse injury that affects the upper arm growth plate in the throwing arm of young baseball players, usually ages 11 to 16. This stress causes widening of the growth plate, resulting in swelling and pain at the shoulder.

How do you know if your child has little league shoulder?

Pain in the shoulder or upper arm during throwing is the hallmark sign. In more severe cases, Little League shoulder causes pain with activities of daily living or even at rest. Parents need to also be aware of any reports of pain, fatigue or changes in throwing motions. These are often warning signs that, if ignored, may lead to more serious injury.

If your child has the following symptoms, he should see a doctor:

  • Shoulder pain while throwing
  • Soreness that lasts a few days
  • Slower and less controlled throws than normal
  • Swelling or tenderness near the shoulder

How is it diagnosed?

A doctor will complete a detailed physical exam may order imaging tests. The diagnosis of little league shoulder and how severe it is can be usually be made with X-ray imaging, which is done while your child is in the clinic.  In certain cases, an MRI may be helpful.   

Types of diagnostic tests:

  • X-ray:  the most common test for a shoulder injury. This test can show a widened or irregular growth plate.
  • Magnetic resonance imaging (MRI):  provides a more detailed image of both soft tissues and bone. It can look at tendons and ligaments, which cannot be seen with X-rays alone. It also provides more detail of the growth plate. 

How is it treated?

Little League shoulder is treated with a period of rest, physical therapy, and programs to improve strength and throwing mechanics.  Premature closure and fractures of the growth plate have been reported in association with Little League shoulder but these are extremely rare complications. Most will eventually ‘‘outgrow’’ the condition spontaneously with normal growth plate closure. However, some continue to experience pain during the preadolescent or adolescent years which may considerably limit participation.

How do you prevent it?

It’s important to note that Little League shoulder can be prevented. Talking to a child’s pitching coach about the way they throw, where they release the ball, and how they position their arm and wrist can help improve technique and protect from pain.

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