An injury to the growth plate in the upper portion of the humerus where the rotator cuff attaches is known as “little league shoulder". This is usually seen in throwing athletes and occasional tennis players. It is caused by repetitive micro trauma at the growth plate. It is caused by hard throwing, bad shoulder mechanics as well as the throwing of curve balls before the growth plates are closed. The younger athlete usually complains of shoulder pain when throwing and after throwing.
Diagnosis is based on the patient’s symptoms and physical examination provided by your physician. Physical examination maneuvers allow for accurate diagnosis, and to help eliminate other sources of shoulder pain. X-rays are obtained to evaluate the growth plates and the joint space, as well as to evaluate any abnormalities or calcific deposits. Occasionally, an MRI may be obtained to further evaluate the rotator cuff, labrum, and physes.
Treatment consists of restriction to all throwing activities, as well as diligent icing, occasional anti-inflammatories, stretching, and physical therapy. Once the patient improves, they will be allowed to slowly return to throwing activities. Sometimes throwing mechanic are evaluated for modification to avoid stress in this area, as well as avoidance of throwing breaking balls in the adolescent athlete until the shoulder reaches full maturity. Surgery is a rare treatment modality