Topics Discussed: cumulative trauma disorders; humerus head juvenile osteochondritis; knee injuries; throwing.
Sections: Shoulder Impingement Syndrome, Glenohumeral Joint Instability, Disorders of Long Head of Biceps Brachii, Atraumatic Osteolysis of the Distal Clavicle (AODC), Long Thoracic Nerve Neuropathy, Suprascapular Neuropathy, Scapular Dyskinesis, Scapulothoracic Bursitis and Crepitus, References.
Excerpt:"Although epiphysiolysis of the proximal humerus occurs primarily in young baseball players, it has also been reported in cricket (fast bowlers), volleyball, swimming, gymnastics, and racquet sports.1,2 The proximal humeral physis accounts for 80% of the longitudinal growth of the humerus. In sports involving overhead throwing, the physis is subjected to significant amount of stress, leading to microtrauma, throwing-related pain, and characteristic changes seen on the radiographs. This is classically described as the "little leaguer's shoulder," because of its original description in little league pitchers.Proximal humeral osteochondrosis is a rare problem in children of unknown etiology, exacerbated by overuse in a throwing athlete with a genetic predisposition. These athletes will present similarly to little leaguer's shoulder. Imaging studies reveal fragmentation of the proximal humeral epiphysis. Treatment of nondisplaced fragments is rest and a reduction of stresses about the shoulder. Throwers should refrain from throwing until completely asymptomatic, and then should undergo appropriate conditioning before return to full time play...."
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