title: Chronic pain due to Little Leaguer's Shoulder in an adolescent baseball pitcher: a case report.
abstract: OBJECTIVE
  To describe a case of chronic Little Leaguer's Shoulder in reference to pain presentation, physical capabilities, and recovery time.
  
  
  METHODS
  A 17-year-old, junior baseball pitcher presented with shoulder pain when performing high velocity pitching. Conservative treatment for an assumed soft tissue injury failed to resolve the pain, which was regularly aggravated by pitching, and which subsequently prompted further evaluation, and eventual confirmation of Little Leaguer's Shoulder on subsequent computerized tomography (CT) imaging.
  
  
  RESULTS
  Prior to proper diagnosis, conservative treatment had consisted of activity modification, spinal adjusting, laser therapy, shockwave therapy, Active Release Techniques(®), Kinesiotape,(®) and rehabilitation. Later, rehabilitation, consisting of general muscle and core strengthening, continued for a further six months under the supervision of college athletic trainers. The athlete was able to return to normal pitching duties approximately 12 months later.
  
  
  CONCLUSIONS
  In this case, a potentially damaging bone injury masquerading as a simple musculo-tendinous injury created a diagnostic challenge. The patient eventually recovered with rest, time, strengthening, and eventual compliance to prescribed activity modification.
authors.affiliation: Resident, Royal College of Chiropractic Sports Sciences (Canada), Private practice in Surrey, British Columbia, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Wasylynko
keywords: Little leaguers shoulder; chiropractic; humeral epiphyseolysis; overuse injury
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