Little League Shoulder

By Nathan Richardson, MD, a leading orthopedic surgeon at Bingham Memorial’s Orthopedic Institute

If a young athlete in your family—particularly a baseball pitcher or catcher or even a tennis player—has been complaining of shoulder pain or pain between their shoulder and elbow, they might be suffering from a condition called Little League shoulder (LLS).

LLS injuries are on the rise and typically occur from overuse and repetitive rotational stress to the growth plates of the humerus—the long upper arm bone that connects the shoulder to the elbow. The growth plate is located on the upper arm bone near the shoulder, and when that area becomes inflamed or irritated, it could mean that the athlete has Little League shoulder.


LLS is primarily caused by:

  • Too much throwing
  • Repeated overhead throwing
  • Using improper technique
  • Lack of muscle strength and endurance

Researchers worked with 95 patients with LLS who ranged in age from eight to 17 years old. Ninety-seven percent of those affected were baseball players and, of those, 86 percent were pitchers. (It should also be noted that the only other sport that produced this problem was tennis.)

Further examination revealed that 30 percent of those affected had a condition called GIRD that produces a loss of rotational range of motion. Athletes with GIRD were three times more likely to have reoccurring shoulder pain after returning to play.


Treatment of LLS consists mainly of rest from throwing. However, physical therapy is used for severe cases or those with GIRD, weakness, early fatigue, or poor throwing techniques. A percentage of athletes from the study group were instructed to stop pitching and change to a field position when returning to play. On average, the time from injury diagnosis to return to play in this group of athletes was 4.2 months.

Due to the frequent nature of young throwing athletes who develop overuse injuries in their developing bones, Little League Baseball has established guidelines to protect the players. Adherence to these guidelines will help to protect pitchers from injury. However, if pain does arise in a young athlete, getting them evaluated sooner rather than later will help to prevent permanent changes in the growth plates of the shoulder. The appropriate rest from throwing will also help get them back to play sooner with a decreased risk of recurrence.

If your child is experiencing any or all of the symptoms of Little League shoulder, bring them in for an evaluation by one of the experts at the Orthopedic Institute. Our team of professionals will get them treated efficiently and accurately so they can get back in the game.

About Dr. Nathan Richardson
Dr. Richardson is a leading orthopedic surgeon who is fellowship trained in shoulder and elbow surgery. He specializes in total joint replacement and injury of the shoulder and elbow. He sees patients at Bingham Memorial’s Orthopedic Institute in Blackfoot, Pocatello and Soda Springs. To schedule an appointment or consultation, call his office at 239-8000 or 535-3626.

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