SPORTS - Across the Lifespan

Question 1

What are the unique factors that can lead to increased risk of injury in kids?

Answer 1

P.I.G.S C.M
G - growth non linear
I - injury response unique
S - spurt of growth
P - psychological issues
C - coordination skills immature/underdeveloped
M - maturity assoc variations

Question 2

Describe growth non linearity in kids as it relates to injury risk

Answer 2

Eg. kids have bigger heads, larger trunk, smaller legs
Growth of epiphyseal growth zones differ depending on the part of the body!
- eg. prox humerus and distal femur grow more than the rest of the body

Question 3

Describe maturity associated variations

Answer 3

• girls on average 2 years ahead in maturity compared with boys
• growth spurts occur at different times - usually around 14 but can be +/- 2 yrs

Question 4

For the following adult injuries, describe the differing equivalent in a child:

1. Skier’s thumb
2. Hyperflexion of distal phalange
3. Boxer’s fracture
4. ACJ inury
5. Dislocation
6. Quads/hams strain
7. Patellar tendinopathy
8. Meniscal/ligament injury
9. Ankle inversion sprain
10. Achilles tendinopathy

Answer 4

1. Fracture of proximal phalange (SH type 2)
2. Fracture of distal phalange (SH 2/3)
3. Fracture of epiphysis (SH 2/3)
4. Clavicle # middle third
5. # proximal humerus
6. Avulsion injury of AIIS or ischial tuberosity
7. Osgoode Schlatters/Sinding Larsen Johanssen
8. # of prox tibia/ distal femur epiphysis
9. # of fibula
10. Sever’s disease (calcaneal apophysitis)

Question 5

How is specialization defined accroding to Myer et al (2015) and what does it increase the risk for?

Answer 5

1. Year round training >8 months
2. Chooses 1 sport
3. Quits all sports to focus on 1 sport

• increase risk for injury/serious overuse injury

Question 6

Why is avoiding specialization beneficial?

Answer 6

• better performance
• less burnout
• less social isolation
• more lifelong enjoyment in sports

Question 7

What are the recommendations by Brennan et al 2016 for training in youths?

Answer 7

1. take 1 month off 3x/year for physical/psycho recovery
2. take 1-2 days off/week to reduce risk of injury
3. play variety of sports and delay specialization until late adolescence

Question 8

What are the 4 different types of fractures seen in kids?

Answer 8

Metaphyseal
Physeal
Diaphyseal
Apophyseal Avulsion fractures

*surgery depends on age/gender/degree of displacement

Question 9

Describe metaphyseal fractures in kids+mx

Answer 9

• most common
• cast immob
• but mx can depend on age/sex/degree of displacement

Question 10

Describe physeal fractures in kids+mx

Answer 10

• involved in 15% of all fractures

- can interfere with growth process via injury to zone of hypertrophy

Question 11

Describe diaphyseal fractures in kids+mx

Answer 11

• common in forearm/leg
• greenstick fracture seen in younger athletes since periosteum thicker
• mx = cast immob/surgery depends on age/gender/degree of displacement

Question 12

Avulsion fractures

Answer 12

Elbow - olecranon/med epicondyle
Hip - AIIS/Ischial tub/ASIS
Knee - tibial tub/tibial plateau (ACL)
Foot - 5th MT

Mx - cast immob

• reduce pain+swelling
• ROM/strengthening
• address biomech abnomalities
• RTS considerations

Question 13

Describe the mx of perthes

Answer 13

• rest from agg activity
• ROM to abd+IR
• brace to avoid direct WB on hip; rest of there’s synovitis
• RESOLVES ITSELF over time
• RTS when symptom free and xrays show improvement