Treatment and Prevention of Injuries in Skeletally Immature Throwing Athletes

Increased participation in youth sports has led to a corresponding increase in throwing-related injuries among skeletally immature athletes. These injuries often stem from overuse and can in part be attributed to sport specialization leading to year-round sport participation without adequate rest and an increase in volume of practices and games during the season. Injuries that occur in skeletally immature athletes can be unique to this population due to the vulnerability of the open growth plates. Common injuries include Little League shoulder (proximal humeral epiphysiolysis), internal impingement of the shoulder, Little League elbow, medial ulnar collateral ligament injuries, and capitellar osteochondral defects. Diagnosis and management of these injuries requires a high index of suspicion from the treating physician. In addition, prevention strategies and pitching guidelines have been introduced to decrease the burden of injury on this population. Proper treatment, appropriate intervention, and a thorough understanding of injury prevention guidelines can allow these young athletes to undergo a timely recovery and return to sport participation with minimal long-term effect.