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Trending Pediatric Injuries in the Overhead Athlete: A Narrative Review.

Molony J, Merkel D, McElheny K, Matsuzaki Y, Yang M. ยท HSS journal : the musculoskeletal journal of Hospital for Special Surgery ยท 2026

This narrative review looks at overhead-throwing injuries (like those in baseball, tennis, and volleyball) in kids and teens, whose growth plates, subchondral bone, and immature connective tissue make them prone to injuries adults don't get. The authors summarize how these injuries are diagnosed and treated, note that young athletes need more emphasis on neuromuscular rehab than adults, point out there's no consensus on using functional tests to guide return-to-play, and flag pressure from parents and coaches who may not understand safe workloads.
Takeaway: Cap and monitor throwing workloads in young overhead athletes, and prioritize neuromuscular rehab over rushing back to play after injury.
Abstract (source)

Pediatric overhead athlete injuries are increasing in frequency, many of them unique to the youth musculoskeletal system. Conditions relate not only to growth centers but also to subchondral bone and joint instability linked to immature connective tissue. Diagnosis depends on a thorough patient history, correct examination techniques, and use of imaging. Management of these patients requires a greater focus on neuromuscular rehabilitation principles than is needed for adults. There is a lack of consensus on the role of functional testing in rehabilitation decisions, and further investigation is necessary. In addition, practitioners need to be mindful of the psychosocial dynamics among players, parents, and coaches, who may not understand appropriate workloads for young athletes and feel pressured to accelerate the pace of recovery. This narrative review covers the most current principles of diagnosis, treatment, and return-to-play strategies for pediatric overhead athlete injuries including preventing of recurrent injuries and avoiding long-term sequelae.

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