Health Answers

Health Answers: What is ‘Little League shoulder’?

Q. What is “Little League shoulder” and how is it treated?

A. Little League shoulder is a type of injury seen almost exclusively in young baseball players. Benton Heyworth, a pediatric orthopedic and sports medicine surgeon at Boston Children’s Hospital, explains that it’s “an overuse injury that affects the growth plate in the top of the arm bone, very close to the shoulder joint.” Growth plates are soft areas at the ends of long bones where new bone forms. They disappear during the teenage years but are present in most adolescent and preadolescent pitchers.

When kids over-stress their shoulders, Heyworth says, “the vulnerable area in the system is the growth plate.” The resulting injury, which causes shoulder and upper arm pain, is different from adult shoulder injuries. Heyworth and his colleagues recently analyzed 95 cases of Little League shoulder at one clinical center over a 15-year period. Almost all cases were boys, with an average age of 13; almost all played baseball, and 86 percent were pitchers. The analysis also suggests the incidence may be growing.


Treatment consists of at least three months of rest. Physical therapy can improve throwing technique, strength, and flexibility for getting back into play. Treatment is successful more than 90 percent of the time, Heyworth says, with no long-term problems if properly treated.

“It’s really a problem of pitchers throwing too much,” Heyworth says. Parents should pay attention to Little League Baseball’s daily pitch count limits and rest recommendations, particularly for kids who play on multiple teams.

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