{
  "abstract": "Background\n\nPhyseal stress injuries involving the shoulder epiphyseal growth plate complex, known as Little League Shoulder (LLS), occur primarily in skeletally immature overhead athletes.Sources of data\n\nThis systematic review included research on LLS published within the last 10 years, from 1 January 2015 through 23 September 2025, from four electronic databases (Embase, PubMed, SPORTDiscus, Cochrane Library) focusing on diagnosis, management, imaging, and criteria for return-to-sport.Areas of agreement\n\nLLS is mainly described in male, skeletally immature overhead athletes aged 11-15. Early specialization, multi-team participation, and inadequate rest are reported risk factors. LLS commonly presents with throwing-related shoulder pain, proximal humeral physis tenderness, posterior capsule tightness, and scapular dyskinesia. X-rays remain first-line imaging, demonstrating lateral physeal widening and irregularity. Throwing cessation for 2-4 months, followed by rehabilitation and gradual return-to-throwing yields excellent short-term outcomes, with low rates of growth disturbance. Prevention strategies include pitch-counts, rest, proper throwing mechanics, and delayed specialization.Areas of controversy\n\nThe prevalence of LLS remains unknown due to variable diagnostic criteria, imaging use, and underreporting. Recurrence and long-term sequelae are inconsistent across studies, and the reasons athletes discontinue baseball remain uncertain. Evidence is conflicting regarding the benefits of formal rehabilitation compared with rest alone.Growing points\n\nAdvanced imaging demonstrates structural remodeling of the shoulder, suggesting that repetitive loading during skeletal immaturity impacts long-term morphology and mechanics.Areas timely for developing research\n\nProspective studies using clinical and imaging criteria may help define the incidence, severity, risk factors, sport-specific patterns, and to clarify symptom resolution, humeral remodeling, and factors influencing attrition. Longitudinal studies should compare rest versus structured rehabilitation and varying return-to-throwing protocols.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, United States.",
    "Department of Physical Medicine and Rehabilitation, University of Utah, 85 N. Medical Drive, Salt Lake City, UT 84132, United States.",
    "Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT 84108, United States."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Annika Lenz",
      "orcid": "0000-0002-1483-3711"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Luke Johnson",
      "orcid": "0009-0000-6901-8362"
    },
    {
      "affs": [
        0
      ],
      "name": "Mark Riederer",
      "orcid": "0009-0002-7049-1063"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Aaron Provance",
      "orcid": "0009-0003-3959-6446"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0prqa8xsgyp1x.bib",
  "cited_by": 0,
  "doi": "10.1093/bmb/ldag044",
  "fulltext_url": "https://europepmc.org/articles/PMC13725757",
  "id": "0prqa8xsgyp1x",
  "issns": [
    "0007-1420",
    "1471-8391"
  ],
  "landing_url": "https://europepmc.org/article/MED/42969580",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "AcademicSubjects/MED00010"
    ],
    [
      "heading",
      "Invited Review"
    ],
    [
      "heading",
      "Physeal Stress Injury and Osteochondrosis"
    ],
    [
      "openalex",
      "2746|Shoulder Injury and Treatment"
    ]
  ],
  "openalex": "W7225094858",
  "pdf_url": "https://europepmc.org/articles/PMC13725757?pdf=render",
  "pmcid": "PMC13725757",
  "pmid": "42969580",
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/0prqa8xsgyp1x.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:53Z",
      "native_id": "MED:42969580",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42969580"
    },
    {
      "first_seen": "2026-11-05T12:22:14Z",
      "native_id": "PMC13725757",
      "source": "pmc",
      "url": "https://doi.org/10.1093/bmb/ldag044"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Shoulder Injury and Treatment",
      "subfield": "surgery"
    }
  ],
  "title": "Little league shoulder revisited: a systematic review of the last decade.",
  "title_text": "Little league shoulder revisited: a systematic review of the last decade.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:21:52Z",
  "url": "https://research.draconitic.com/paper/0prqa8xsgyp1x",
  "venue": "British medical bulletin",
  "versions": []
}