Little League Shoulder: Causes and Solutions case presentation A healthy 12-year-old male baseball player presents to your office with left upper arm pain that has been ongoing for 2 to 3 months.
Little League Shoulder: Causes and Solutions case presentation A healthy 12-year-old male baseball player presents to your office with left upper arm pain that has been ongoing for 2 to 3 months. He is left hand dominant. The pain has been progressive and worse whenever he pitches.
His coaches have been trying to limit his pitch counts, but he continues to have pain when throwing. He has tenderness over his proximal upper arm region to palpation, but otherwise a normal examination. His x-rays show widening of the proximal humerus when compared to the opposite side.
What is the most likely diagnosis? Proximal humeral epiphysiolysis C. Kohler's disease introduction Proximal humeral epiphysiolysis, or Little League shoulder , is common in adolescent players and is characterized by throwing related pain over the proximal humerus.
Pain related to throwing accounts for 10 percent of all shoulder pain in pediatric patients. Little league shoulder is most commonly seen in youth throwing athletes between 11 and 16 years of age with the peak age at 13. Since growth plate closure occurs between 18 and 21 years old, injuries can theoretically occur until that age.
While most common in male baseball pitchers, the condition can occur in females, youth catchers, other baseball positions players, and tennis players. Repetitive loading of the humerus with the torque and distraction forces of throwing can cause microtrauma and irritation of the proximal humeral physis, which is substantially weaker than the surrounding bone. According to high speed motion analysis studies, youth pitchers can generate substantial forces at the shoulder.
If you are experiencing symptoms that may be related to little league shoulder, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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