# Shoulder Pain in a Pediatric Throwing Athlete

## TL;DR

A 12-year-old softball player experienced shoulder pain due to a rare avulsion fracture, linked to improper throwing mechanics and stress from repetitive movements.

## Contribution

This case report highlights an unusual injury location and emphasizes the role of throwing mechanics in pediatric shoulder injuries.

## Key findings

- A 12-year-old athlete had an avulsion fracture at the distal acromion linked to improper throwing mechanics.
- Conservative treatment led to successful healing and gradual return to activity.
- The case underscores the importance of proper mechanics in preventing pediatric shoulder injuries.

## Abstract

Pediatric avulsion fractures most commonly occur at sites of secondary ossification and are often associated with chronic stress from repetitive movements. Because of a variety of risk factors, youth athletes place higher stress on ossification centers, and their activities may predispose them to injury. This case report describes a 12-year-old female softball player who presented with pain at the distal acromion, worsened by her overhead throwing motion. Further questioning revealed improper throwing mechanics placing extenuated stress on the shoulder. Plain radiograph imaging showed an avulsion fracture of the distal acromion; conservative management with decreased mobilization and cessation of activity was recommended. Reimaging four weeks later revealed a bone-on-bone healing, and the patient was gradually allowed to return to function. This report’s discussion details the unusual location for a common injury, the mechanism of injury, an association of throwing mechanics with a shoulder injury, and recommended treatment strategies for pediatric avulsion fractures.