Little League Shoulder

14 y/o M with presents with insidious-onset lateral shoulder pain. Pt plays baseball, tennis, and volleyball. Primarily throws breaking pitches, e.g. sliders, curveballs. Tenderness with palpation of proximal/lateral humerus on exam.

• Bilateral AP shoulder x-ray in internal/external rotation show unilateral widening of the proximal humeral physis

• Tylenol/NSAIDs for pain

• Abstain from throwing/overhead sports for 3 months

• Begin strengthening exercises when comfortable, interval throwing program when pain free

• Parents advised that injury is generally self limited

• Consider adequate rest periods, icing to prevent future episodes

Notes

• Pathophysiology: Overuse injury resulting in epiphysiolysis of the proximal humerus

• See OrthoBullets for more information