Glenohumeral internal rotation deficit is risk factor for little league shoulder

SEATTLE — In a study of young athletes with little league shoulder researchers found that almost one-third had glenohumeral internal rotation deficits, according to data presented at the American Orthopaedic Society for Sports Medicine Annual Meeting, here.

The study by Benton E. Heyworth, MD, and colleagues at the Children’s Hospital Boston, analyzed 95 patients with a mean age of 13 years who were diagnosed with little league shoulder (LLS) at a single pediatric referral center between 1999 and 2013. The majority of patients were baseball players, however, 3% of the athletes in the study were tennis players. The researchers evaluated age, gender, physical examination and radiologic findings for indications of glenohumeral internal rotation deficit (GIRD), as well as the treatment trends and rates of recurrence.

The researchers observed GIRD in 30% of the young athletes. Symptoms of LLS resolved in an average of 2.6 months while full return to play occurred at an average of 4.2 months. Recurrence of symptoms was observed in 7.4% of patients at an average of 7.5 months after the resolution of symptoms and was significantly higher for patients with GIRD (14.3%) than without GIRD (4.5%). Patients also reported elbow pain (13%), shoulder fatigue/weakness (10%) and clicking or other mechanical symptoms (8%).

While rest and physical therapy were the most common treatment methods, 25% of the patients were advised to change positions upon their return to play.

“We feel consideration toward longer follow-up in this population is warranted, particularly with the tension toward underlying biomechanical factors,” Heyworth said. —by Christian Ingram

Reference:

Heyworth BE. Paper #10. American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.

Disclosure: Heyworth has no relevant financial disclosures