Lesions of the Pitching Arm in Adolescents

Physeal changes and range-of-motion differences in the dominant shoulders of skeletally immature baseball players

“…Subsequent authors similarly have reported on symptomatic young baseball players with abnormal radiographic findings at the proximal humerus with various visual descriptions such as demineralization, epiphysiolysis, and physeal widening. 1,3,6,21 Previous reports of these humeral physeal changes have been noted in symptomatic throwers. Torg et al 20 obtained shoulder and elbow radiographs on 44 youth baseball players (aged 9-18 years).…”

“…) Several studies suggest that anatomic changes probably occur in skeletally immature throwers as a result of the repetitive throwing motion and that these changes impact concurrent and subsequent shoulder pathology. 1,6,9,10,14,21 Proximal humeral physeal changes associated with shoulder pain in young throwers have been documented in the literature. 1,6,9 Dotter 9 described a "fracture through the epiphyseal cartilage of the proximal humerus" and coined the term Little Leaguer's shoulder to describe these radiographic findings and shoulder pain associated with the act of throwing in a skeletally immature athlete.…”

Anterior Translation at the Glenohumeral Joint

“…Specific to damage occurring at the third portion of the axillary artery, translation of the humeral head with the arm in an overhead throwing position is most commonly implicated. For example, Tullos and King 27 described axillary artery compression resulting from the wind-up or cocking phase of a baseball pitch. Dijkstra and Westra, 5 Reekers et al, 20 and Vlychou et al 28 proposed that inferior or anterior translation of the humeral head in the overhead throwing position is the cause of this compression.…”

“Little league elbow”— acute traction apophysitis in an adolescent badminton player

“…These conditions might be more common than formerly expected (5). Overuse disorders among adolescent atheletes arise typically in high repetitive sports, and the term "little league elbow" has been used to describe various conditions in or near the elbow caused by different kinds of sport (6,7).…”