Shoulder pain in adolescent athletes

We’ve previously discussed the high prevalence of shoulder pain in older adults, but it is also a common phenomenon in adolescent athletes. Kids are not only starting sports earlier and playing longer seasons but also choosing to specialize sometimes before high school. More of the same overhead activities cause increased stress on shoulders. Softball, volleyball, baseball, swimming, tennis, and gymnastics are common sports in which athletes may experience shoulder pain. Other sports with high-speed impacts, like hockey and football, also result in frequent shoulder injuries. Even though shoulder pain is common in these sports, it’s important to remember that it is not normal. Your physical therapist is competent and experienced in diagnosing and treating shoulder pain, which in turn will help your child return to sports quickly and safely.

Below is a shortlist of some common shoulder injuries that are seen in younger athletes and ways your physical therapist can help.
  • Shoulder instability: Typically, shoulder (or glenohumeral) instability is caused by weakness of the muscles and other structures surrounding the shoulder. If your child is very flexible or hypermobile, it is likely that he or she may have some shoulder instability. Strengthening the muscles around the shoulders and in the upper back can be very helpful in preventing further injury or dislocation.
  • Shoulder subluxations or dislocation: A shoulder dislocation occurs when your upper arm bone pops out of its cup-shaped socket. This usually occurs with significant stress on the shoulder, such as a fall or getting tackled, and it accounts for approximately 25% of shoulder injuries in high school athletes. Once an athlete dislocates his or her shoulder, it is more likely to occur again. Physical therapy plays a crucial role in returning strength and stability to this area to prevent further injury and allow for full participation in sport activities.
  • Collarbone fractures: Fractures here also typically require a lot of force, and are common in football, hockey, and soccer players. Even if the bone doesn’t break all the way through, it can still result in deformity, pain, and limited mobility of the shoulder. Usually, it will take time to heal, which may require a sling. After your child is out of his or her sling, PT can be helpful in improving mobility and strength in the shoulder.
  • Little Leaguer’s shoulder: This injury typically occurs in younger children who participate in baseball, softball, or other activities that require repetitive shoulder motion. Kids typically will experience pain on the outside of their shoulder that worsens as they throw more frequently. A physical therapist can assist your child in returning to sports slowly to protect the arm, as well as making adjustments in throwing mechanics to decrease stress on the shoulder.
Not sure where to start?

Your physical therapist can determine the likely cause of your child’s pain and help you determine if further imaging may be necessary. Because the growth plates in children’s bones are open, you don’t want to risk injury at these sites. Don’t just chalk the soreness up to growing pains, as prolonging treatment could make matters worse in the long run. Instead, let us help your child return to activities that he or she loves, without pain.

Bre Nedden, PT DPT, DN Cert. March 11th, 2021