Shoulder/Elbow Pain in Throwing Athlete

Shoulder or elbow pain in a child athlete is often caused by overuse of the arm. This condition, sometimes called “Little League shoulder or elbow,” is an irritation of the growth plates in the shoulder or elbow. A growth plate is the soft part of a bone that lets it grow as the child grows.

This injury is most common among children ages 11-14 who play sports, especially baseball. Because a child is still growing and developing, the demands of a sport on the child’s body can be too much. This is especially true if the child isn’t given enough rest time between active sessions. It is a painful condition but can be treated with proper care.

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Causes & Risk Factors

Shoulder or elbow pain is caused by excessive overhead movement of the arm, and often occurs while pitching a baseball. Overhead movement causes the muscles in the arm to pull on the growth plates. When this movement is repeated over and over, the space in the growth plates begins to widen. In some cases, the growth plates pull away from the bone.

Symptoms & Types

The most common symptoms of this injury are:

  • Pain or “heaviness” in the arm while throwing
  • Elbow or shoulder pain, especially after throwing
  • Tightness of the elbow or shoulder, causing decreased range of motion (inability to fully extend the elbow or rotate the shoulder) 

Diagnosis & Tests

The doctor will ask about your child’s health history and examine him. The doctor will check your child’s elbow or shoulder for tenderness and pain. An x-ray or MRI may also be performed to establish the diagnosis and rule out other causes of pain.

Treatment & Care

The doctor will talk with you about the best treatment plan for your child. Usually, the doctor will recommend:

  • Rest from pitching or throwing for about 6 weeks.
  • Ice the elbow or shoulder 3-4 times a day for 15-20 minutes at a time. Use an ice pack or bag of frozen peas – something similar — wrapped in a thin towel.
  • Take anti-inflammatory medication, such as ibuprofen, as directed.
  • Learn or practice throwing techniques that are less likely to cause injury.
  • Decrease the amount of activity done with the elbow or shoulder. For example, if your child is a pitcher, the doctor may limit the number of pitches your child should throw.
  • Do exercises at home as instructed by the doctor. Your child may also be referred to a physical therapist (PT) for a supervised program of exercises. Your child’s physical therapist or healthcare provider may also ask your child to do exercises at home.

Living & Managing

If your child’s condition isn’t cared for, he may have trouble using the elbow or shoulder in the future. Left untreated, this injury can lead to permanent damage of the growth plates.  Unfortunately, even with the appropriate rest and proper treatment, the athlete may not be able to resume full participation and a change in position or sport may be recommended. Education of athletes, parents, and coaches is critical to prevent these overuse injuries.

References & Sources

“Elbow Injuries in the Throwing Athlete,” American Academy of Orthopedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00644

“The Young Athlete,” American Academy of Orthopedic Surgeons: http://orthoinfo.aaos.org/topic.cfm?topic=A00239