Don’t let Little League Shoulder keep your All-Star out of the game

Baseball-Pitcher-2As baseball’s All-Stars gather at Target Field in Minneapolis, some young players (and aspiring All-stars) are being sidelined by Little League Shoulder. This overuse injury most commonly strikes pitchers between the ages of 12 and 14 years and may take them off the field for three months or longer, depending on the severity of the injury. Benton Heyworth, MD, from Boston Children’s Hospital’s Sports Medicine Division, explains the condition and offers some strategies for prevention. Heyworth presented research about risk factors, treatment options and return to play for children diagnosed with Little League Shoulder at the American Orthopaedic Society for Sports Medicine annual meeting in July.

“Little League Shoulder is an overuse injury that can be prevented,” says Heyworth. The primary prevention strategy is to set limits—on pitch counts and the playing season.

  • Players aged 11 to 12 years should be limited to 100 pitches per week, and a maximum of 3,000 pitches per year.
  • Players age 13 to 14 years should be limited to 125 pitches per week, and a maximum of 3,000 pitches per year.
  • Players of all ages should avoid year-round baseball, limiting participation to eight months a year.

What are the symptoms of Little League Shoulder?

“Pain is the hallmark of Little League Shoulder. Young kids should not be experiencing a pattern of pain with throwing,” explains Heyworth.

Sometimes players or parents may try to cope with pain before consulting a physician. That’s a mistake, says Heyworth.  The sooner a child sees a specialist who treats throwing injuries, the sooner treatment can begin.

The specialist, typically an orthopedic surgeon or sports medicine physician, can diagnose Little League Shoulder by history, physical exam and x-rays. The standard prescription is physical therapy and three months of rest from pitching. The physical therapist will focus on stretching and proper warm-ups and address any biomechanical issues, like subtle restricted range of motion in the throwing motion, which may be related to Little League Shoulder.

It’s important to address issues that may have contributed to Little League Shoulder, says Heyworth. Most children outgrow the injury, but if underlying issues aren’t addressed, players may have recurrence of the condition as they return to play.

To learn more about preventing common baseball injuries, download Boston Children’s Injury Prevention guide.