Little leaguers shoulder

BACKGROUND: Differences in range of motion and rotational motion between the dominant and nondominant shoulders in throwing athletes are well documented, although the age at which these changes begin to occur is not known. HYPOTHESIS: Changes in glenohumeral rotational motion in the shoulder of the Little League/adolescent baseball player occur during the most formative years of physical development. STUDY DESIGN: Cross-sectional study. METHODS: Elevation, internal rotation at 90 degrees of abduction, and external rotation at 90 degrees of abduction were measured in the dominant and nondominant shoulders of 294 baseball players, aged 8 to 16 years...

When compared with adults, children have unique injury patterns secondary to their anatomical differences. The susceptibility of the growth plate to injury is well-documented. "Little Leaguer's shoulder" is the term used for injury to the open proximal humeral epiphysis in the Little League pitcher. We present a case report and literary review. Discussed are the possible etiologies, patient presentation, physical exam, radiographic findings, and treatment recommendations.

A case of Little Leaguer's shoulder in a skeletally immature patient is described with a review of the English literature. This entity manifests as widening of the proximal humeral physis and is well known to our orthopedic colleagues. To our knowledge, however, there is little in the current radiologic literature describing Little Leaguer's shoulder. We describe such a case.

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Over 25 million children participate in school-sponsored sports, and an additional 20 million participate in extracurricular organized sports. Over the past decade, increased intensity of training, more pressure for success, new opportunities for structured play, and more organized advanced leagues and traveling teams have led to a corresponding increase in overuse injuries in the skeletally immature athlete. Perhaps the classic sports model for overuse injuries of the upper extremity is baseball. Throwing sports contribute to an increased incidence of elbow and shoulder injuries that might be related to intensity of training, throwing mechanics, and poor conditioning, including core strength...

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Twenty-three cases of Little Leaguer's shoulder were reviewed including the history and physical examination findings, as well as bilateral internal and external rotation anteroposterior comparison radiographs of the proximal humerus. The average follow-up was 9.6 months (range, 1.5 to 54), and all patients were observed until they had either returned to baseball or their symptoms had resolved. The average age of the patients in this series was 14 years. The chief complaint in all patients was pain localizing to the proximal humerus during the act of throwing...

The case of an adolescent Olympic-level gymnast with insidious onset shoulder pain is presented. Radiographic evaluation revealed bilateral physeal irregularities of the proximal humerus similar to those seen in Little Leaguer's shoulder. Roentgenograms of the involved shoulder also demonstrated Salter-Harris type I displacement at this physis and a slipped capital humeral epiphysis was diagnosed. A discussion reviewing proximal humeral physeal injury follows the case presentation.

Soft tissue aspects of skeletal trauma are discussed according to two categories: (1) those injuries in which the significance of the soft tissue in the pathophysiology of the skeletal lesion is indicated by the characteristics of the skeletal injury (such as extension teardrop fracture, little leaguer's elbow, "baseball fracture," and Bennett's fracture); and (2) those injuries in which the associated soft tissue injury, or complication, may be reasonably inferred by the location and nature of the skeletal injury (such as major facial fractures, posterior sternoclavicular dislocations, fractures of the lower rib and lumbar transverse processes, and pelvic disruptions)...

Roentgenographic changes consistent with osteochondrosis of the proximal humeral epiphysis were observed in five young baseball pitchers complaining of shoulder pain in the throwing arm. The symptoms and findings were quite similar to the previously reported involvement of the medial epicondylar epiphysis or "Little Leaguer's elbow."The act of throwing a baseball hard is an abnormal whip-like action which places a forceful repetitious traction strain on the shoulder joint. Shoulder pain in youngsters engaged in organized competitive swimming programs can also be explained in this way...