Little League Schulter

Little league shoulder is thought to occur due to overuse damage of the proximal humeral epiphysis/metaphysis, seen typically in young baseball players, especially pitchers.

Epidemiology

Although it is most commonly seen in baseball players particularly in pitchers, it also presents in adolescents playing cricket and volleyball, swimmers and gymnasts.

Clinical presentation

Clinical presentation is most commonly manifested as shoulder pain.

Pathology

Little league shoulder patients commonly demonstrate delayed epiphyseal closure and physeal broadening leading to an acute transphyseal break in the bone. The pathogenic process is exacerbated by repetitive overhead ball throwing.

Radiological features

Plain radiograph
  • widening of the proximal humeral physis
  • sclerosis and fragmentation of adjacent bone
  • demineralization of bones

Treatment and prognosis

Treatment consists of counseling, rest and physiotherapy.

It seldom requires surgical intervention.

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