Pain > Proximal Humeral Epiphysitis Physiotherapy
Proximal Humeral Epiphysitis Physiotherapy
Also commonly called "little league shoulders" or "little leaguers shoulder", proximal humeral epiphysitis (PHE) refers to a painful shoulder injury of a
throwing athlete who is still maturing physically.
Although the injury
is most commonly seen in young baseball players, the injury can occur in
any child participating in repetitive overhead throwing activities such as
With an increased participation and sports specialization at a very
early age, shoulder and elbow injuries in young athletes are common. In fact, almost 10% of shoulder pain in pediatric patients can be attributed to
athletic activities, such as throwing, and of these injuries, 26% are
related to overuse and are preventable.
As movement experts, our senior physical
therapists are uniquely qualified to
- analyze an athlete’s throwing
- evaluate muscle strength
- evaluate movement patterns and
exercises to return the athlete to pain-free sports participation
Signs and Symptoms
With PHE, an athlete may experience:
- Pain in the shoulder while throwing, or the day after a sporting event
- Swelling in the upper arm
- Increased shoulder pain associated with increased throwing
- Decreased speed, velocity, or ability to control the ball during pitching
- Restricted movement at the shoulder compared to the opposite side
- Difficulty lifting the arm and shoulder
How Is It Diagnosed?
A sports medicine or orthopedic physician makes a proper diagnosis of
PHE by conducting a complete physical exam of the entire shoulder
complex. X-rays of the athlete’s shoulder will show the widening of the
growth plate. If conventional x-rays are negative, a physician might
elect to order additional imaging studies, including an MRI.
If a child sees our senior physiotherapists first, we will ask:
- How are you feeling (signs and symptoms)?
- How long have you been experiencing your current symptoms? When do your symptoms typically occur?
- What sport and position do you play, and how often do you play (practice and games) in a typical week/month/year?
- If you are a pitcher, when is the last time you threw a ball?
types of pitches do you typically throw?
- How much rest do you get
between throwing events?
We will take this information and conducts a thorough
physical exam to determine the root cause of the problem. We then
- examine the athlete’s shoulder and elbow range of motion and
- tests the strength of the muscles around the shoulder blade, trunk,
pelvis, and hip
how our senior physiotherapists can help
The conditions caused by PHE, such as muscle weakness or lack of
endurance, lack of range of motion, or poor throwing mechanics can all
be addressed with shoulder physiotherapy.
We will work with
the young athlete to:
- Improve muscle strength and endurance at the shoulder
- Normalize the shoulder's range of motion
- Increase the athlete’s trunk, pelvis, and hip muscle strength and stability to provide a firm foundation from which to throw
- Observe and correct pitching mechanics to reduce stress through the shoulder
- Establish a schedule for the year with a proper amount of participation and rest
- Establish a plan for a controlled progressive return to throwing,
often called an interval throwing program, for a safe return to play
We will work with the athlete to develop an
individualized treatment plan based on the initial evaluation and goals.
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Phoenix Rehab physio Services
Phoenix Rehab Group works with specialist
physiotherapists and rehab therapists who are highly
trained, qualified, experienced and passionate to provide high level of
expert care to our patients.
PHYSIOTHERAPY & PHYSICAL THERAPY
HAND THERAPY & SPLINTING
Patients who sustained injuries to their elbows, forearms, hands, wrists
(sprains and fractures) and fingers, and requires Hand Therapy to increase the function of their hand
following injuries or post-operations as well as custom made hand splints.
Commonly treated hand pain injuries includes
CLINICAL PILATES & WELLNESS PILATES
Clinical Pilates is a form of physical exercise that focuses on
- core stability
- flexibility and
It is a system of safe and effective exercises, which
meet specific individual needs, to treat a wide range of injuries
You may do Pilates as matwork or with the reformer or both, and every session will be customized 100% to your fitness, injury and tolerance.
TRADITIONAL CHINESE MEDICINE (TCM)
DEEP TISSUE RELEASE & SPORTS MASSAGE THERAPY
Sports and deep tissue release massage helps to increase nutrient-rich blood
flow to tired, tight and tense muscles to
- accelerate recovery and
- shorten downtime / recovery period required
It also prevents
muscles from scar tissue micro-tears (and potential ruptures), and increases muscle
Done regularly, it will keeps your muscles healthy and fit with body/movement-confidence. Read the benefits of regular deep tissue release therapy here.
All our allied health therapists and TCM physicians are fully insured and registered with Allied Health Professions Council (AHPC) and Traditional Chinese Medicine Board (TCMB).
See our entire team here with introductions and their specializations.
At the first session, our specialist physiotherapists will carry out a thorough
assessment, helping them to select the most appropriate treatment to
help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide
expert treatment for your pain as well as prescribing specific
exercises to reduce your risk of re-injury and giving you a long term
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