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Little League Shoulder: Don’t Get Benched All Season

by Tyler Triggs MS, LAT, ATC

Key Points

  • Overuse injury of the humerus

  • Pain & swelling at the shoulder

  • Early treatment is key for limiting the severity

  • Must stop throwing

  • Early strengthening and rehab is very important


Little league shoulder also called pitcher’s shoulder (proximal humeral epiphysitis) is an overuse shoulder injury usually seen in baseball players or throwers, ages 10-18.The growth plate at the shoulder joint thickens due to a variety of reasons including muscle weakness, excessive throwing and poor mechanics. This causes inflammation and pain while throwing and if allowed to worsen even during daily activity.


  • Pain in the upper arm/shoulder

  • Pain in the throwing arm

  • Increased pain while throwing

  • Shoulder weakness

  • Decreased throwing velocity

Athletic Trainer’s Take:

Little league shoulder shows up gradually or without a specific play that caused an injury. Many times the athlete has recently thrown a high number or pitches, increased throwing velocity or added a new pitch.

I commonly see athletes for this injury after they initially had pain then rested for a short period of time before returning to pitch again because they felt “good” after resting. The best time to treat this is as soon as pain appears the first time to prevent excessive thickening of the growth plate.

If the pain has become severe or persistent, finding a qualified professional to direct you to a doctor who is going to treat this correctly is very important. Resting from pitching completely is almost always a must, but making sure to start rehab and strengthening as soon as possible is the most important piece of treatment.

To fix the problem long-term, completing a thorough movement & pitching evaluation, followed by a strengthening and mechanics correction plan with a healthcare professional that understands your sport is the only solution. If you just rest and return to activity, the injury is very likely to return.

What you can do for prevention:

  1. Closely monitor pitch counts and total pitch volume

  2. Complete a movement assessment with a qualified healthcare provider

  3. Take three months off throwing (minimum) per year

  4. Participate in well structured strength & conditioning

What to do when pain appears:

  1. Stop throwing

  2. Contact you local Athletic Trainer

  3. Try mobility & strengthening programs

  4. Visit a qualified doctor for imaging

  5. Start early rehabilitation plan

  6. Review pitching mechanics

When to contact an Athletic Trainer:

  • If you need help and advice on properly modifying your activity, an AT can provide you with ongoing support.

  • If you need direction with proper stretching and strengthening exercises, an AT can get you started on effective exercise progression and regressions.

  • If the pain is getting worse or now become persistent, an AT can advise you on the right steps to take next.

*Contacting an ATC first can prevent unnecessary imaging or doctor visits. This will save you time, money and ensure the right steps are taken to get back to throwing pain free.

Disclaimer: These statements are a reflection of my education and experience. The suggested treatment options are not intended to diagnose an injury and have not been researched.

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