Topic 6a: Conditions in Specific Populations; Young Athletes

Question 1

what are some risk factors that are particular to the young athlete?

Answer 1

• body is still developing
• overuse injuries
• new athletes
• don’t know their boundaries
• anatomical malignments (muscle growing faster than bone)
• training errors

Question 2

where is our primary ossification centre?

Answer 2

at diaphysis

Question 3

where is our secondary ossification centre?

Answer 3

at epiphysesw

Question 4

what is the anatomy of the growth plate?

Answer 4

• plate of cartilage
• 1/5 of the joint capsule and surrounding ligaments support it meaning it is more prone to injury
• top of plate is articular cartilage
• under articular is secondary ossification centre
• below that is epiphyseal plate (this is the zone that grows)
• below that is metaphysis (alot of blood supply is located here so if its injured, blood supply is limited)
• below that is diaphysis

Question 5

what does the epiphyseal plate contain?

Answer 5

reserve zone, proliferation zone, maturation zone, calcification zone

Question 6

what is mismatched growth?

Answer 6

a growth related problem that happens when there is muscle-tendon tightness due to longitudinal bone growth out pacing soft tissue growth.
- this creates susceptibility to overuse injuries
- can take up to a year for muscle to catch up to bone

Question 7

how are ligaments and tendons affected by growth related problems?

Answer 7

youth are less likely to damage a ligament or tendon, but because they are stronger than the growing bones, they are more likely to rip off a piece of that bone instead.
- ligaments and tendons insert into fibrous and fibrocartilaginous periosteal perichondral regions of metaphysis

Question 8

common fractures in younger athletes

Answer 8

1. epiphyseal fractures
2. apophyseal injuries
3. various osteochondroses
4. stress fractures (spondylolytis, spondylolythesis)
5. patellofemoral pain syndrome (PFPS)

Question 9

what age is epiphyseal injuries most common in?

Answer 9

ages 10-16

Question 10

What are the salter-harris classifications?

Answer 10

type I: separation of the physis
type II: fracture-separation of growth plate and small part of metaphysis
type III: fracture- part of the physis
type IV: fracture- physis and metaphysis
type V: crushing of physis with no displacement- may cause premature closure (stunt growth)

Question 11

when can an apophyseal injury happen?

Answer 11

when there is an extensive tension or a force that tugs and pulls away at the cartilage part of the bone
- most commonly happens in knee

Question 12

what is osteochondrosis?

Answer 12

degenerative changes to epiphyses of bone during rapid child growth

Question 13

3 types of osteochondroses

Answer 13

1. articular (relating to joints)
2. non-articular
3. physeal

Question 14

what is spondylolysis?

Answer 14

a stress fracture of the pars interarticularis
- tends to happen before the age of eight, but symptoms develop in 10-15 age group

Question 15

what is spondylolisthesis?

Answer 15

a bilateral fracture of the pars interarticularis accompanied by anterior slippage of the involved vertebra
- more common in males and diagnosis happens in 10-15 age group
- when it happens its usually worse in females

Question 16

what is the most common fracture in children?

Answer 16

greenstick

Question 17

what is patellofemoral pain syndrome (PFPS)?

Answer 17

a general term that is used to describe pain around the knee cap.
- also describes general growing pains

Question 18

how do we communicate with injured young athletes?

Answer 18

• we don’t want to intimidate them
• distractions
• being reassuring
• standing on their level
• using words they understand
• listen to how they are describing things