The first line treatment for a sports-related shoulder injury is RICE: rest, ice, compression, elevation. If the pain, swelling, and difficulty using the arm persists, then an evaluation by an orthopedic specialist is warranted. During this evaluation, a physical exam will be performed as well as x-rays. In skeletally immature children, acute injuries may occur at the area of growth in the bone known as the growth plate. The growth plate is more commonly injured because it is weaker than the surrounding shoulder ligaments. Most growth plate fractures heal without complications, but they require special attention to avoid future problems with growth. Other acute injuries to the shoulder may include a shoulder dislocation, a shoulder separation, AC joint sprain, and labral tear. Chronic shoulder injuries, ones that occur over time because of repetitive activity, are known as overuse injuries. For example, Little League Shoulder, also known as proximal humeral epiphysiolysis occurs from throwing and presents as inflammation around the growth plate of the humerus bone. Rotator cuff tendinitis and impingement syndrome are also chronic injuries. Obtaining an MRI of the shoulder will be very useful in helping diagnose these conditions. After your child is seen, evaluated, and diagnosed, the appropriate treatment will be implemented. Usually treatment will consist of nonsteroidal anti-inflammatory medications, application of ice, rest and then a good physical therapy program.