(1) We believe the shoulder pain may be occurring because of superior displacement of the humeral head due to weakness of the external rotator muscles.

(2) The treatment of stable proximal humeral fractures (those displaced less than 1 cm) consists of a shoulder immobilizer to prevent external rotation and abduction.

(3) Repeated stresses from overhead motions like throwing can lead to fatigue of the muscles that stabilize the humeral head and prevent anterior subluxation.

(4) They surmised that the bone formation was caused by repetitive mechanical stress to the proximal humeral epiphysis during growth.

(5) The examiner must check for associated injuries, including proximal humeral fractures, avulsion of the rotator cuff, and injuries to the adjacent neurovascular structures.