Day 4 Lectures Flashcards
Long bone growth plates close at ages
M: 15-17
F: 13-15
___ lags behind osseous development
musculotendinous system
Strategies to reduce injuries injury in youth atheltes
- use needs analysis
- monitor rapid growth changes
- optimize dose response
- use effective training modes in combo
- start early during childhood
- use risk stratification to individualize and protect
- enhance adherence
Risks for developing injury as youth athlete
- training hours per week is more than their numerical age
- playing 1 sport > 8 mo a year
- previous injuries not addressed
- burnout
How to long to return to sport after ACLR in Level 1
9-18 months
Stress + Recovery =
Adaptation
Fitness - Fatigue =
Performance
lack of sleep for youth
poor decisions about food
decreased mental sharpness
reduced tissue healing
Sleep for youth
- single greatest, cheapest, proven recovery tool
- Teenagers need 8-10 hrs/night
- when they sleep well, release growth hormone, rebuild tissues, decrease anxiety
- less than necessary increases risk for injury by 1.7
RF for Injuries include
- concussions
- football
- males
- 14-18 yo
Common overuse injuries
- little league elbow and shoulder
- tibial and calcaneal apophysitis
- bone stress injuries
Pediatric Fractures
- proximity to growth plate may require extra imaging for tracking of proper growth
- vascular or neural compromise might delay healing
- immobilization may be hard dependent on age
- faster healing times due to thicker periosteum and high metabolism
RF for Osgood-SChlatter
- high training loads
- quads strong/tight, hammies weak
- COM behind support leg
- higher arches
ankle DF < 10° - vitamin d deficiency
Prognosis for OS
- without treatment, 2 years of healing
- with PT, 3-6 mo
Management for OS
- activity.load mods
- ankle mobility
- hamstring motor control
- quad motor control
- NO NSAID
OS Overview
- apophysitis at tibial tuberoisty
- repetitive load at immature growth plate
- often in boys age 14
- soccer is most common, in plant leg
Calcaneal Apophysitis/Sever’s Disease Overview
- heel pain in adolescents
- repeptitive stress
- more common in 12 yo boys
RF for Sever’s Disease
- obesity
- history of OSD
- rapid growth
- high frequency of high speed/high impact sports like track, football, ballet, basketball, tennis
- limited ankle DF
- pronated foot posture
- toe walking is NOT a RF
Mgmt for Sever’s Disease
- stretching is painful
- address mid and forefoot vs calf
- lack of motion in foot
- heel lifts early on, orthotics later on
- heel raise/eccesntric
- typically 4012 weeks for RTS
Summary for Sever’s Disease
- manage load
- limit/avoid NSAIDs
- build up rest of system
- address form faults
- eccentric training
Golf Swing biomehcanics
- lower COG and wider BOS for stability
- ball displacement due to angular velocity and long/rigid lever
- sequential summation of forces
- stretch-shortening cycle
- transfer of body weight
more stability in golf allows for
less deviation in club path
improved force transfers
Golf Swing phases
- backswing
- forward swing
- acceleartion
- early follow-through
- late follow through
Dowswing
- summation and transfer of forces in sequence
- rotation sequence initiated by hips, spine, shoulder, elbow, wrist
Golf injuries
- males 2x more likely
- ages >60 or 10-19
- LBP most common
Most common reason for gold injuries
overuse
other reasons are golf cart, falling, swing mechanics
Excessive slide in gold may be due to
weak lead leg hip abductors
Late knee buckle in gold may be caused by
weak quadriceps
Baseball pitch is initiated from
stable single limb position
Javelin throw is from an
extended plant leg after an approach
Volleyball UE power comes
without direct ground reaction forces
Tennis UE power occurs
with longer external moment arm
Phases of baseball pitch
- windup
- stride
- arm cocking
- arm acceleration
- arm deceleration
- follow-through
RF for baseball injuries
- fatigued
- inadequate rest
- single sport specialization
- GIRD vs total arc of motion
- excessive use of weighted balls
- poor throwing mechanics
Common actions with injuries for elbow baseball
valgus load demand
increased thoracic kyphosis
decreased elbow extension
Cocking Phase for Baseball
- from foot contact to max ER ROm
- need 20°of horizontal abduction
- concentric ER force with eccentri IR force
- watch for leading elbow or improper trunk rotation
Stride phase of baseball
- initiated forward momentum towards plate
- stride should be 85% of their height
- slight toe-in foot position to affect pelvic rotation
Arm Acceleration Phase in Baseball
- from max shoulder ER to ball release
- watch for excessive contralateral trunk lean
- watch for shoulder adducted < 90°
- watch for insufficient knee extension
Management for baseball injury
- load management
- stretch/joint mobs
- joint proprioception
- perturbation drills
- strengthening LE
Weighted ball for baseball can cause
- higher torque and force at shoulder
- increased shoulder ER
- increased injury rate
Volleyball Injuries
- shoulders are most common with greatest amount of loss of playing time
- excessive horizontal adduction may predispose to impingement
Cocking phase variations
- straight
- bow+arrow low/high
- circular
- snap
Arm Acceleration phase volleyball
- high velocity
- variable based on type of attack and position
- highest EMG for subscap, teres major, lats, pec major
Management for volleyball
- adjusting types of ball contacts
- adjust workload
- address mobility and strength deficits
- optimizing body mechanics
Tennis Serve Phases
- wind-up
- cocking
- acceleration (ball impact)
- Deceleration
- Follow-up through
Tennis Considerations
- racket grip size
- racket head size
- starting stance
- types of serves
- long lever arm
Tennis Injuries
- longer lever arm creates more torque
- subacromial impingement syndrome
- high velocity with max ER to max IR
- GIRD due to humeral retroversion
What is common across overhead athletes?
- shoulder ER ROM
- scapular dyskinesia during abduction
- shoulder IR/ER strength
- injury prevention program
- mobility, stability, motor control as treatment goals
