Upper Extremity Overuse Injuries

Child and adolescent participation in organized and recreational sports has steadily increased over the past few decades. With this increase in participation, there has been a concomitant increase in sports-related injuries, especially overuse injuries related to repetitive movements. Pediatric patients are uniquely susceptible to overuse injuries that affect areas of bone growth. For example, medial epicondyle apophysitis (Little League elbow), osteochondritis dissecans of the capitellum, proximal humeral epiphysitis (Little League shoulder), and radial epiphysitis (gymnast's wrist) are upper extremity overuse injuries that occur in skeletally immature athletes. Other upper extremity overuse injuries include multidirectional instability of the shoulder, rotator cuff tendinopathy, trapezius muscle strain, and stress fractures. Most of these injuries can be diagnosed clinically and managed with rest and supportive care including activity modification and rehabilitation.