Symptoms of little league shoulder include:

• Pain in the shoulder with pitching or throwing.

• Pain with the shoulder at rest or with lifting the arm

• Decreased throwing speed and/or accuracy

A doctor will complete a detailed physical exam may order imaging tests. The diagnosis of little league shoulder and how severe it is can be usually be made with X-ray imaging, which is done while your child is in the clinic.  In certain cases, an MRI may be helpful.   

Types of diagnostic tests:

• X-ray:  the most common test for a shoulder injury. This test can show a widened or irregular growth plate.

• Magnetic resonance imaging (MRI):  provides a more detailed image of both soft tissues and bone. It can look at tendons and ligaments, which cannot be seen with X-rays alone. It also provides more detail of the growth plate. 

Once the diagnosis of little league shoulder is made, your doctor will decide the best possible treatment.

Conservative management:

• Rest – your doctor may suggest you avoid throwing activities for a period of time.

• Ice – this helps to decrease swelling, bleeding, and pain in the shoulder.

• Physical therapy – under the guidance of a certified physical therapist, your child will undergo a strengthening and stretching regimen that will focus on strengthening of the shoulder and arm  muscles.  Strength of the core, legs and hip are emphasized to enhance stability and overall ability to throw.

• Video throwing analysis – at Cincinnati Children’s, we are able to perform two-dimensional video analysis of throwing motion. Trained therapists are able to break down the phases of throwing to look for deficiencies.

• Return-to-throwing program – once cleared to return to throwing, the athlete will undergo a progressive throwing program that slowly

increases the forces and demands through the arm and shoulder, which are necessary for full return to competitive play.

While no injury can be completely prevented, proper mechanics, rest and strength can reduce the risk of injury. USA Baseball has developed guidelines for young pitchers to help reduce the risk of injury.

Recommended pitch counts by age and associated rest periods:

(Courtesy of Little League Baseball)

Parents need to also be aware of any reports of pain, fatigue or changes in throwing motions.  These are often warning signs that, if ignored, may lead to more serious injury.

• USA Baseball
• Little League Baseball & Softball