LITTLE LEAGUE SHOULDER IN SCHOOL CRICKETERS

A budding bowler playing cricket can come and tell his mom that his shoulder hurts when he throws the ball.  Questions race through mom’s head.  What is it?  What is the reason for it?  What should I do to get him out this trouble?  Is this going to end his cricketing career?  Little league shoulder problem in cricketers is on the rise.  Unfortunately, in many cases timely diagnosis is not made.

Little league shoulder injury is quite prevalent in the west as it mainly happens when the pitcher (in baseball) throws the ball.  That is why it is also known as pitcher’s shoulder or throwing shoulder.  This condition is usually found in adolescent baseball pitchers.

Coming to cricket, as you may be aware, extensive throwing of the ball is involved in cricket while bowling and when the fielder is on the ground.  If after every game your young one complains of pain in the shoulder and this is not abating, then you should see your pediatrician, a sports medicine specialist or an orthopedic surgeon.

According to a statistical study in cricket, prevalence of little league shoulder is highest among pace bowlers (14%), whereas only 4% for spin bowlers, 4% for batsmen, and 2% for wicket keepers.  The most common injuries were hamstring strains, side strains, groin injuries, wrist and hand injuries, and lumbar soft tissue injuries.

WHAT IS LITTLE LEAGUE SHOULDER INJURY?

Fast bowlers are considered to be more prone to suffer this condition as it involves aggressive shoulder action.  The shoulder is formed by articulation of bones called as humerus and scapula.  The upper end of humerus has a growth plate responsible for lengthening of the bone called the physis.  This physis can be damaged by the whip like throwing action in fast bowlers. The throwing action has a phase called late cocking phase and subsequent deceleration.  This causes eccentric torsional forces on the growth plate resulting in the injury.  In little league shoulder injury the player has persisting pain while throwing/bowling and the internal rotation of the shoulder is significantly reduced.  Little league shoulder is technically osteochondrosis of the proximal humeral epiphysis.

In layman terms, this injury is caused by the broadening of the growth plate where the humerus or upper arm bone meets the scapula to form shoulder. This broadening is caused by repetitive stress that is generally caused by throwing a ball again and again. The broadening causes an inflammatory response, which is what causes the shoulder ache.  Little league shoulder injury is attributed to decreased shoulder flexibility and scapular mobility.  The main reason to have a little league shoulder injury is overuse.

TREATMENT FOR LITTLE LEAGUE SHOULDER INJURY

In order to have a thorough look into the shoulder joint, the physician may ask the patient to undergo an x-ray.  If it is little league shoulder injury x-ray will demonstrate widening of the growth plate (physis) and in some cases fragmentation of the bone in this area can also be seen.  Once the diagnosis is confirmed complete rest of the affected shoulder is of paramount importance and it involves four weeks.  Most doctors will advise the patient not to use the shoulder until at least two months.  After that time period when they return to bowling they must make sure that there is no pain in the shoulder.  In the unlikely event, when the cricketer gets back to playing and experiences pain while throwing or bowling, then more rest is required.  Getting back to the game too early or using the shoulder before it is fully healed will only aggravate and prolong the total recovery time.

With the appropriate medical treatment, the players can engage in bowling/throwing without permanent disability of the shoulder.  If proper medical treatment is not sought, then there can be long-term issues with shoulder pain and it can impact their ability to bowl/throw the ball properly, thereby throwing a spanner into their cricketing career.

CAN WE AVERT LITTLE LEAGUE SHOULDER INJURY?

Many medical experts have conducted studies to determine the cause of little league shoulder injury. It is considered that in cricket number of balls delivered by a fast bowler and the amount of rest between games are the primary things that trigger this problem.  So it would not be a bad idea to give your shoulder proper rest after a gruelling match in which you had to bowl in full swing.

The primary goal of a sports medicine specialist, parents and coach should be to protect cricket players from repetitive injuries like this. Recommendations for protecting young bowlers from shoulder injuries include resistance exercises such as scapular stabilisation and rotator cuff exercises.  Many fast bowlers lack adequate muscular strength to dynamically stabilize the shoulder.

In conclusion, it shows that timely evaluation of shoulder pain in fast bowlers should be a priority.  So play the gentleman’s game with confidence and always take a professional opinion if your shoulder hurts.

For any questions related to Little League Shoulder, drop a message to www.BangaloreShoulderInstitute@gmail.com/contact or use the chat option on the website to talk to shoulder specialist.