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Special Populations > Adolescent Athlete Injuries > Flashcards

Adolescent Athlete Injuries Flashcards

1
Q

List questions you should include with adolescent athletes

A
  1. did the condition start insidiously or did they have a trauma?
  2. how long have they had the symptoms?
  3. where are your symptoms?
  4. how do you describe your symptoms?
  5. do the symptoms radiate?
  6. aggravating/relieving factors?
  7. how irritable is it?
  8. is there anything you can longer do?
  9. has this injury changed anything you do?
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2
Q

Patient History Common Questions?

A
  1. Patient history of common condition
    1. have you had any similar injuries or issues in the past?
    2. how long did the episode last?
    3. have you seen any other medical professional?
    4. are you taking any meds?
  2. Past med/surgery history
    1. how is their general health?
    2. do they have any allergies?
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3
Q

List specific disorders in adolescent athletes

A
  1. Distal Radial Epiphyseal Injuries
  2. Little League Elbow
  3. Medial Epicondyle Apophysitis
  4. Lateral Elbow Pain
    1. Panner’s disease
    2. fratures
  5. Little Leaguer’s Shoulder
  6. Osgood-Schlatter Disease
  7. ACL injuries
  8. Chronic Exertional Compartment Syndrome
  9. Sever’s disease
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4
Q

describe Distal Radial Epiphyseal Injuries

A

gradual onset of wrist pain which is worsened by weight-bearing activities

more common in male and female gymnasts

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5
Q

S/S of Distal Radial Epiphyseal Injuries

A
  1. ROM → WNL
  2. tenderness over dorsal radial growth plate, and possibly the volar radial physis
  3. no tenderness over snuff box
  4. X-ray usually show widening of the epiphysis
    1. could potentially use a tuning fork
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6
Q

describe treatment for distal radial epiphyseal injuries

A
  1. rest
  2. elimination of stressful activities
  3. possibly immobilization
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7
Q

describe little league elbow

A

commonly used to describe pain and injuries to the medial elbow during overhead throwing

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8
Q

little leagues elbow can include what other conditions?

A
  1. Epicondyle apophysitis
  2. Epicondyle Avulsion Fractures
  3. Growth plate disturbances
  4. Ulnar Collateral Ligament Injuries
  5. less likely injuries:
    1. MCL injury
    2. common flexor tendon pathology
    3. ulnar nerve pathology
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9
Q

what is the cause of little league elbow?

A

high levels of torque generated during the last cocking phase and early acceleration phase

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10
Q

list S/S of Medial Epicondyle Apophysitis

A
  1. Medial elbow pain
  2. Medial elbow swelling
  3. Decreased throwing distance
  4. Point tender over medial epicondyle
  5. Medial epicondyle hypertrophy
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11
Q

describe treatment for Medial Epicondyle Apophysitis

A
  1. 4-6 weeks rest
  2. immobilization not commonly required
  3. avoidance of aggravating activities (pitching, throwing, etc.)
  4. correction of biomechanics
  5. ORIF if avulsion injury is present
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12
Q

describe Panner’s disease

A

aka Osteochondrosis Dissecans of the Capitellum

condition in which bone underneath the cartilage of a joint dies due to the lack of blood flow, the bone and cartilage can break loose causing pain and limiting motion

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13
Q

incidence and history of Panner’s disease

A
  1. children under 10
  2. usually dominate arm
  3. History
    1. insidious onset, diffuse lateral elbow pain
    2. can also be due to repetitive trauma
    3. can have “locking” in elbow
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14
Q

other differential diagnoses that can present as lateral elbow pain in children

A

other than Panner’s disease

  1. traumatic fracture
  2. avulsion fracture
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15
Q

what is little leaguer’s shoulder?

A

injury to the proximal humeral epiphysis that occurs due to:

distraction or torsion

  • during ball release a distracting force acts across the physis may reach up to ½ body weight. throwing causes sig rotational stress at proximal humerus
  • fatigue fracture
  • localized inflammatory reaction
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16
Q

describe Little Leaguer’s shoulder

A
  1. usually occurs in 11-14 yo
  2. due to high levels of torque generated during the last cocking phase and early acceleration phase of throwing
17
Q

what can Little Leaguer’s shoulder include?

A
  1. osteochondritis
  2. epiphysiolysis of the proximal humeral epiphysis
  3. physeal widening of the proximal humerus
  4. avulsion fractures
  5. fracture to the glenoid rim
18
Q

the long head of the biceps is a _________ during ball release

A

decelerator

19
Q

treatment for little leaguer’s shoulder

A
  1. cessation of throwing until
    1. patient has pain free ROM
    2. radiographs are normal
  2. pitching mechanics analysis
  3. pt then can begin gradual return to throwing and increased based on return to throwing protocol
20
Q

describe Osgood-Schlatter’s disease

A

aka Tibial Tubercle Apophysitis

boy’s > girls

21
Q

symptoms of Osgood-Schlatter’s disease

A
  1. duration of symptoms can vary and be up to 28 months
  2. gradual onset of pain, tenderness, swelling and prominence of tibial tuberosity
  3. pain worse with jumping and/or running
22
Q

treatment for Osgood-Schlatter’s disease

A
  1. activity modification for 4-6 weeks
    1. modification of overall sports activity
  2. ice
  3. immobilization (less common)
  4. stretching
  5. strengthening
23
Q

treatment algorithm in skeletally immature children

A
  1. surgical reconstruction → may damage growth plate but can protect damage to meniscus
  2. primary active rehab w/o surgical reconstruction
    1. favorable functional outcomes
    2. ⅓ to ½ show changes and impairments with sports activities
  3. Physeal-sparing ACL reconstruction
    1. ACL avulsion can be treated with surgical fixation without disrupting the growth plate
24
Q

incidence of Chronic Exertional Compartment Syndrome

A

83% of those diagnosed are athletes or military

  • 54% athletic, 29% military
  • 1 in 2000 military service members
    • 17% of those military members who undergo surgery will be medically discharged
  • 51% anterior compartment
  • frequently seen in endurance athletes
25
Q

differential diagnosis for Chronic Exertional Compartment Syndrome

A
  1. stress fracture
  2. DVT
  3. peripheral nerve entrapment
26
Q

what is Sever’s Disease?

A

AKA Apophysitis of the posterior calcaneus

heel pain where the Achilles tendon inserts into the posterior calcaneus

  • heel pain associated w/adolescents who have an unfused apophysis
  • males 75% of cases, 61% bilateral
  • pain increases with DF
27
Q

the diagnosis of Sever’s disease is based on what?

A
  1. sport involvement
  2. timing of growth spurt
  3. physical exam
  4. decreased flexibility
  5. radiographs
28
Q

Treatment of Sever’s Disease

A
  1. heel cord stretching
  2. discontinuation of sport
  3. heel cup/lift
  4. orthotics
  5. immobilization (if needed)

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