Sports Injuries Unique to Young Athletes Flashcards

Question

When does traction stress peak during phases of throwing?

Answer 1

traction stress peaks during late cocking and acceleration

Answer 2

traction stress from flexor-pronator muscles and valgus force on elbow

Answer 3

lots of pitching throwing breaking pitches before skeletal maturity - require more flexor-pronator muscle action and sliders rincrease risk for elbow pain by 86% lack of pitching experience poor conditioning and muscle strength

Answer 4

history of gradual onset of pain with pitching, recent increase in pitching volume, and usually no pain with throwing, batting, or AD:'s tender at medial epicondyle may have pain with valgus stress to elbow may have pain with reisted wrist flexion or pronation may lack full elbow extension

Answer 5

not required for diagnosis may show widening, irregular ossification, and fragmentation

Answer 6

rest from pitching for 2-4 weeks until physis is non-tender rehabilitation for 4-6 weeks - stretch flexor/pronator muscles and strengthen shoulder, core/hip muscles interval throwing program for 6-8 weeks that may begin when athlete has full ROM and strength, start at half distance and power and incrementally increase

Answer 7

most heal with conservative treatment long-term problems are rare indadequate rest/treatment can lead to failure of physeal closure, chornic pain from non-union, and acute avulsion fracture

Answer 8

osteochondrosis of proximal humeral physis due to excessive rotational stress, 35% of pitchers are aged 9-14 seen in other overhand sports such as tennis and volleyball

Answer 9

lots of pitching throwing breaking pitches before skeletal maturity lack of pitching experience poor conditioning and muscle strength

Answer 10

history of shoulder pain with pitching may also have pain with regular throwing and ADLs physical exam is tender at proximal humeral physis may have painful arc of motion weakness and pain with resisted shoulder abduction and external rotation

Answer 11

**rest from pitching (4-6 wks)** - until physis is non-tender and ROM is full and pain-free and strength testing does not generate pain **rehabilitation (4-6 wks)** - stretch and strengthen shoulder, core/hip muscles **interval throwing program (6-8 wks)** - may begin when athlete has full ROM and strength, start at 50% distance and power and incrementally increase

Answer 12

don't pitch through pain or fatigue follow guidelines for pitch count limits

Answer 13

separation of apophysis from main bone pelvis is most common site 90% occur in boys 80-90% are sport-related peak incidence is at 14-18 years of age

Answer 14

sudden, forceful eccentric muscle contraction

Answer 15

sudden forceful contraction of muscle pulls apophysis away from adjacent bone athletes report a painful "pop" commonly unable to bear weight after injury upon physical exam: tender at apophysis, typically no swelling/bruising, muscle usuall ynot tender, pain with passive stretch and resisted muscle test

Answer 16

damage of the ischial tuberosity - 30-50% of pelvic avulsions, due to forceful contraction of hamstrings anterior inferior iliac spine - 20% of pelvic avulsions, due to forceful contraction of rectus femoris iliac crest - 2-11% of pelvic avulsions, due to forceful contraction of abdominal obliques

Answer 17

majority respond to non-operative treatment displacement \> 2cm may require surgical fixation **rest (1-4 weeks)** - goal is to releive tension on injured apophysis, requires crutches until weightbearing is pain-free **stretching (1-3 weeks)** - may begin when apophysis is non-tender, gentle actuve stretching involved muscle group **rehabilitation (2-4 weeks)** - progressive resistance exercises, proprioception training, jogging and sport-specific activities

Answer 18

generally good **ischial tuberosity avulsions**: longest recovery time (3-4 months) up to 68% result in non-union 75% have difficulty returning to sports 25% dropped out of sports altogether

Answer 19

stress freacture at pars interarticularis most common at L4 and L5

Answer 20

when upper vertebra slides forward can occur if spondylolysis is bilateral can also be congenital

Answer 21

symptoms of low back pain with lumber extension, loading pain usually relieved with flexion PE findings reveal positive Stork test - pain with single leg hyperextension tender at affected vertebra

Answer 22

xrays (AP, lateral, obliques) - may see fx (dog collar) or slip, may be normal SPECT scan - 100% sensitive MRI - sensitivity improving with newer techniques (ex. saggital STIR)

Answer 23

custom-fitted rigid brace until pain-free ROM physical therapy - progressive core strengthening, first 4 weeks exercise with neutral spine and then slowly increase ROM if pain-free no sports for at least 3 months and pain-free ROM, adequate core strength

Answer 24

common muscle imbalances in gymnasts increase risk for back pain

Answer 25

touch the knee to the chest measures hip flexor flexibility if thigh lifts off table when opposite hip is maximally flexed, hip flexor is tight

Answer 26

the patient is asked to stand unassisted on each leg in turn, whilst the examiner's fingers are placed on the anterior superior iliac spines. The foot on the contralateral side is elevated from the floor by bending at the knee estimates gluteus medius strength

Answer 27

core/gluteal strengthening stretch hip flexors, erector spinae