Shanley Ellen, Thigpen Chuck
Int J Sports Phys Ther. 2013 Oct;8(5):630-40.
Adolescents ranging in age from 11-15 (early-mid adolescence) comprise the largest percentage of baseball and softball athletes in the United States. Shoulder and elbow injuries are commonly experienced by these athletes with baseball pitchers and softball position players most likely to be injured.
Physeal injury often termed "Little League" shoulder or elbow is common and should be differentiated from soft tissue injuries such as biceps, rotator cuff, or UCL injuries. Regardless of diagnosis, rehabilitation of these athletes' shoulder and elbow injuries provide a unique challenge given their rapidly changing physical status.
Common impairments include alterations in shoulder range of motion, decreased muscle performance, and poor neuromuscular control of the scapula, core, and lower extremity. A criterion based, progressive rehabilitation program is presented. Discharge from formal rehabilitation should occur only when the athlete has demonstrated a resolution of symptoms, acceptable ROM, muscle performance, and neuromuscular control while progressing through a symptom free return to sport.
Reintegration into the desired level of sport participation should be guided by the sports medicine professional with a focus on long-term durability in sport performance as well as injury prevention. A prevention program which includes parent, coach, and athlete education, regular screening to identify those athletes at the highest risk, and monitoring athletes for the development of risk factors or warning signs of injury over the course of participation is indicated.
年龄在11至15岁之间的青少年（青春期早期至中期）占美国棒球和垒球运动员的最大比例。这些运动员常见肩部和肘部损伤，棒球投手和垒球位置球员最易受伤。
骨骺损伤常被称为“小联盟”肩部或肘部损伤很常见，应与诸如肱二头肌、肩袖或尺侧副韧带损伤等软组织损伤相区分。无论诊断结果如何，鉴于这些运动员身体状况快速变化，对其肩部和肘部损伤进行康复治疗都面临独特挑战。
常见功能障碍包括肩部活动范围改变、肌肉表现下降以及肩胛骨、核心部位和下肢神经肌肉控制不佳。本文介绍了一个基于标准的渐进式康复计划。只有当运动员在无疼痛恢复运动过程中症状消失、活动范围可接受、肌肉表现和神经肌肉控制良好时，才能从正式康复中出院。
重新融入期望的运动参与水平应由运动医学专业人员指导，重点是运动表现的长期耐久性以及预防损伤。建议实施一项预防计划，包括对家长、教练和运动员进行教育，定期筛查以确定风险最高的运动员，并在参与过程中监测运动员是否出现风险因素或损伤警告信号。
5级。
