young boy at risk for little league shoulder symptoms

An Overview of Little League Shoulder

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young boy at risk for little league shoulder symptomsLittle league shoulder is a type of overuse injury that typically affects children and adolescents up until their mid-teens. It can affect both boys and girls, and most commonly occurs in kids who play sports involving overhead throwing. Most cases occur in softball and baseball players, but little league shoulder symptoms can also affect other young athletes including tennis players.


Here’s an overview of little league shoulder symptoms, causes and treatment options from Dr. Francis Mendoza, NYC-based orthopaedic surgeon specializing in the treatment of sports-related shoulder injuries.


How Do Overuse Injuries Differ Between Children and Adults?

While overuse injuries in adults commonly affect tendons and ligaments, overuse injuries in children can affect the bones themselves. Children’s bones are still growing, and repeated stress on the growing portion of the bone can injure it. In little league shoulder, the injury occurs in the humerus, the long bone of the arm.


The long bones of the body, the humerus (upper arm bone) as well as the femur (thigh bone) grow from an area on each end called the growth platethe weakest part of a child’s still-growing skeleton. The growth plates build new bone throughout childhood and adolescence then solidify into hard bone when adult growth is achieved. Unfortunately, while a child is still growing, the growth plate areas are much more susceptible to injury than the rest of the skeleton, which is one of the reasons why little league shoulder is such a common injury among young athletes.


What Does Little League Shoulder Involve?

In little league shoulder, repeated stress to the humerus causes the growth plate to widen. This leads to inflammation, swelling, and pain in the shoulder. The condition can worsen if left untreated, and eventually may even lead to bone damage. There is also a small chance that the growth plate could close before growth is complete.


What are the Common Little League Shoulder Symptoms and Causes?

Little league shoulder is caused by repetitive overhead motion combined with lack of muscular strength, especially weakness in the shoulder and upper back.  Repeated overhead throwing without proper rest makes the condition more likely, as does poor throwing technique or poor body mechanics.


There has been a sharp uptick in the incidence of little league shoulder in recent years due to the fact that more children are playing sports year-round without sufficient rest in between.


Common little league shoulder symptoms include:

  • Pain in the shoulder during pitching or throwing
  • Pain when the shoulder is at rest, or when lifting the arm
  • Swelling
  • Impaired mobility
  • Reduced range of motion
  • Decreased throwing speed when playing sports, or decreased accuracy

Less commonly, little league shoulder symptoms can include elbow pain.


How is Little League Shoulder Treated?

As with other overuse injuries, resting the affected area is the most important aspect of treatment. Your child will probably be restricted from throwing activities for a period of time, typically a span of a few months.


A typical treatment program for little league shoulder includes:

  • Rest and refraining from throwing or other forceful overhead motions
  • Icing the affected shoulder if there is swelling and inflammation
  • A stretching and strengthening program
  • A return-to-throwing program in which the child gradually increases the demands on the shoulder and arm


Rest alone may be sufficient to reduce little league shoulder symptoms, but strengthening the muscles that support the area is also important to reduce the likelihood of re-injury. Physical therapy, which can include strengthening exercises and flexibility training, may also be recommended. Most young athletes experience relief from little league shoulder symptoms within two to three months with conservative treatment, and are typically able to return to play after four months.


If your child is experiencing shoulder pain or other little league shoulder symptoms, prompt treatment is important. Schedule your consultation today, and don’t let little league shoulder keep your child out of the game.

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