Shoulder and Elbow Conditions, Sports Medicine at Johns Hopkins All Children's

Little league shoulder and elbow are bone-related overuse injuries caused by improper throwing mechanics. While often seen in throwing sports such as baseball, these injuries may also occur in athletes in overhead sports such as racquet sports, swimming, gymnastics and volleyball.


Little league shoulder symptoms include a gradual onset of pain in the upper part of the arm bone during throwing and overhead activities. Athletes may notice a decrease in velocity and control of throwing or arm swing. Any shoulder pain that persists in a young athlete is a sign of injury and needs physician evaluation.

Little league elbow is indicated by pain that is located on the inner side of the elbow. Repetitive throwing may stress the ligaments and growth plates in the elbow causing irritation, inflammation and in some cases separation from the rest of the elbow.


Our physicians here at the Johns Hopkins All Children's Sports Medicine clinic will ask about symptoms, examine the shoulder or elbow and order x-rays to evaluate the area.


Since Little League Shoulder and Elbow are bone-related overuse injuries, it is important to rest the affected growth plate, bone, and muscles attached which will allow healing to occur. After the initial period of rest, treatment for these conditions occurs in three phases: 

  • Phase One: Physical therapy focuses on decreasing the pain and inflammation of the affected joint. Biomechanical analysis addresses core, spine and/or leg weakness or tightness allowing the athlete to maintain strength and endurance in unaffected areas. This also allows the physical therapist to correct the mechanical faults causing stress to the shoulder or elbow.
  • Phase Two: Muscles in the shoulder, elbow, shoulder blades, and upper back are strengthened to provide stability and absorb stress during throwing or overhead movements.
  • Phase Three: After clearance from the athlete’s doctor, the physical therapist will design a return-to-sport program. When this final phase is complete, the athlete will have re-trained his or her body to move more efficiently, gaining strength, accuracy, and speed.

Request a Consultation

If you’re concerned your child may have little league shoulder or elbow, call 727-76SPORT to schedule an appointment or request an appointment online with our Sports Medicine physicians, who will determine a diagnosis and recommend further treatment.

Meet Our Team

Sarah Irani, MD

Dr. Irani practices in the Sports Medicine program at Johns Hopkins All Children’s Hospital. During her fellowship, she served as part of the physician team providing coverage for athletic teams at the University of South Florida and Eckerd College as well as youth and NCAA events.

View Sarah Irani’s Bio

Sarah Irani, MD

Patrick Mularoni, MD

Dr. Mularoni is a sports medicine physician at Johns Hopkins All Children’s Hospital. His current research interests include concussion management and prognosis in patients with mild traumatic brain injuries. He is the chairman of the Medical Emergency Committee and lectures internationally on pediatric emergency and sports related topics.

View Patrick Mularoni’s Bio

Patrick Mularoni, MD

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For more information about the Sports Medicine program, give us a call at the phone number below. We serve families in the greater Tampa Bay area and beyond.

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