Little league shoulder

Last revised by Daniel J Bell on 26 Jun 2020

Little league shoulder is thought to occur due to overuse damage of the proximal humeral epiphysis/metaphysis, seen typically in young baseball players, especially pitchers.

Although it is most commonly seen in baseball players particularly in pitchers, it also presents in adolescents playing cricket and volleyball, swimmers and gymnasts.

Clinical presentation is most commonly manifested as shoulder pain.

Little league shoulder patients commonly demonstrate delayed epiphyseal closure and physeal broadening leading to an acute transphyseal break in the bone. The pathogenic process is exacerbated by repetitive overhead ball throwing.

  • widening of the proximal humeral physis
  • sclerosis and fragmentation of adjacent bone
  • demineralization of bones

Treatment consists of counseling, rest and physiotherapy.

It seldom requires surgical intervention.

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Cases and figures

  • Case 1
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