Week 12 Flashcards
Relevant anatomy- growth plates
- area of new bone growth in kids & teens
- usually located at end of long bones
- made up of cartilaginous tissue
When do growth plates close?
- btwn the ages of 14-15 yrs old for females
- btwn the ages of 16-17 yrs old for males
Pediatric medical conditions/considerations
- juvenile diabetes (type I)
- juvenile arthritis
- asthma
- epilepsy
- allergies
- water safety/CPR for drowning
- choking
Working in youth sport important considerations
- pediatric sized emergency supplies
- pediatric tools
Pediatric sized emergency supplies
- oropharyngeal airway
- neck collar
- splints
- EpiPen
Pediatric tool example
- child SCAT6 (ages 8-12)
Injury prevention in youth sports
- proper warm up
- properly fitted protective equipment
- diversifying their activities
- playing time limits
- max games per day for tournaments
- min hrs btwn games
- rotating positions
- proper nutrition & hydration
- avoid overtraining
- baseline concussion testing
- psychological wellness
- pre-season screenings
- pitch count limits- mandated rest days
What should be included in pre-season screenings?
- identify current pain/injuries
- review medical conditions
- assess functional movement patterns
- concussion baseline testing
- discuss important topics
Which important topics should be discussed in pre-season screening?
- concussions
- nutrition
- hydration
- overtraining
- communicating injury early (emphasis on RTP sooner if caught early)
How to promote psychological wellness of youth athletes?
- support following injury
- healthy competition
- healthy eating habits
- inclusivity
- motivational talks
- encouraging cheers
- promoting teamwork
Growth plate injuries/fractures
- excessive repeat stress on the growth plate of the bone causing widening of the growth plate
- growth plate becomes inflamed
What happens if growth plate injuries are not addressed?
Can affect growth
- deformities
- bone stops growing prematurely
Management of growth plate injuries/fractures
- altered activity
- may require 2-3 months of rest from aggravating sport skill
What is proximal humeral epiphysitis (Little league shoulder)?
- irritation of the growth plate in the proximal humerus
MOI of proximal humeral epiphysitis
- overuse in overhand motions causing excessive strain on growth plate
Signs and symptoms of proximal humeral epiphysitis
- progressive increase in pain in proximal humerus or shoulder
What may proximal humeral epiphysitis lead to?
- stress fractures through growth plate
Who is proximal humeral epiphysitis most common in?
- pitchers & baseball players
- also seen in tennis and vball
Prevention of proximal humeral epiphysitis
- limiting pitch counts
- proper throwing mechanics
Patellar tendonitis (Jumper’s knee) MOI
- excessive traction on patellar tendon
What is patellar tendonitis often associated with?
- growth spurts
Signs and symptoms of patellar tendonitis
- pain
- swelling & heat over patellar tendon
- pain with jumping, running, quick COD or strong quad contraction
- pain with flexion and extension
- can often train through the pain
Special tests for patellar tendonitis
- thomas test
- resisted quads
Acute management of patellar tendonitis
- PIER
- roll/soft tissue mobility for quads
- lower extremity mechanics
- train hamstrings to prevent anterior translation of tib on fem
What is Osgoode Schlatter’s disease?
- irritation of growth plate at the tibial tuberosity
Osgoode Schlatter’s disease MOI
- overuse
- excessive traction of quads via patellar tendon
Signs and symptoms of Osgoode Schlatter’s disease
- pain over tibial tuberosity
- visible bump over tibial tuberosity
- pain with contraction & stretch of quads
- jumping especially painful
Special tests for Osgoode Schlatter’s disease
- thomas test
- resisted quads
Acute management of Osgoode Schlatter’s disease
- PIER
- roll/soft tissue mobility for quads
- lower extremity mechanics
- train hamstrings
Prevention of Osgoode Schlatter’s disease
- diversify activity
What is Sever’s disease?
- irritation of calcaneal tuberosity growth plate (attachment for achilles tendon)
Sever’s disease MOI
- overuse
- excessive traction of achilles
Signs and symptoms of Sever’s disease
- pain over achilles insertion into calcaneus
- pain with forceful achilles contraction (jumping, sprinting, starts/stops)
Special test for Sever’s disease
- single leg calf raise
Acute care for Sever’s disease
- stretch gastrocs & soleus
- NSAIDs
- heel lift
Little league elbow MOI
- chronic valgus overload to medial elbow from throwing
What else can little league elbow lead to?
- medial epicondylitis
- medial epicondylar apophysitis (growth plate injury)
- avulsion fracture
- MCL sprain
Signs and symptoms of little league elbow
- pain & inflammation over medial elbow
- pain & weakness with throwing
- medial instability
Special tests for little league elbow
- wrist flexor muscle testing
- valgus stress
- x-rays
Acute care for little league elbow
- PIER
Prevention of little league elbow
- limited pitch counts
- proper throwing mechanics
Other growth plate irritation sites
- distal radius (gymnastics from repeat load)
- anterior inferior iliac spine (tumbling sports such as gymnastics or cheer)
Treatment for growth plate fractures
- rest, cast, splint
- surgical repair
Principles of splinting
- include the joint above & below the injury
- pad the splint for comfort & added support
- check distal pulse before & after splinting
Stages of heat illness
- Heat cramps
- Heat exhaustion
- Heat stroke
What are heat cramps?
- muscle cramping during/after activity in the heat
What are heat cramps thought to be caused by?
- fluid & salt loss from sweating
Who are heat cramps common in?
- runners
Signs and symptoms of heat cramps
- pain
- spasm
Acute care for heat cramps
- rest in cool area
- water/sports drink
- gentle stretching & massage
Prevention of heat cramps
- sufficient hydration & electrolytes
- avoid/minimize activity in high temps
How does heat exhaustion result?
- activity in hot temps
- body’s ability to regulate temp becomes stressed
Signs and symptoms of heat exhaustion
- normal or slightly elevated body temp
- cool, moist, pale skin
- headache
- nausea
- vomiting
- dizziness
- weakness
- exhaustion
- level of consciousness starts to decline in later stages
Acute care for heat exhaustion
- rest in cool place
- cold cloths in armpits, groin, back of neck, drink cool water
What might heat exhaustion progress to if left untreated?
- heat stroke
- body unable to cool itself
Signs and symptoms of heat stroke
- dry, red, hot skin
- progressive loss of consciousness
- rapid & weak pulse
- rapid and shallow breathing
- high body temp
Acute care for heat stroke
- cool the body
- give fluids
- minimize shock
- call EMS
Cold- related emergencies
- frostbite
- hypothermia
What is frostbite?
- when body tissues freeze following prolonged exposure to cold
- water within & surrounding cells freeze & swell which damages the cells
What can frostbite result in?
- loss of digits or limbs
Superficial frostbite
- skin only
Deep frostbite
- skin & underlying tissues freeze
Signs and symptoms of frostbite
- decreased sensation
- skin is cold and waxy
- discolouration
- tingling
- swelling
- pain with rewarming
- blisters within 24hrs
Repeatability of frostbite
- once an area gets frostbite, subsequent exposure can result in frostbite more easily in area
Acute care for frostbite
- gentle rewarming by soaking in warm water
- apply dry sterile dressing
- gauze btwn fingers/toes
- warm drink
- blanket
**do not rub area
What sports is frostbite common in?
- snowboarding
- skiing
- hockey
- skating
- fall sports that go late in to season (football, field hockey, rugby, soccer)
When to refer to doctor for frostbite
- signs of infection
- red streaks
- blisters
- drainage
- no return of sensation or normal skin tone
Prevention of frostbite
- dressing in layers
- removing wet clothing/gear
- avoid extended time during extreme cold weather
What is hypothermia?
- a dangerous drop in body temp below 95 degrees celcius following extended exposure to cold
Signs and symptoms of hypothermia
- shivering
- slow irregular pulse
- slow breathing rate
- numbness
- confusion
- drowsiness
- pale cold skin
- loss of coordination
What can hypothermia lead to?
- shock
- coma
- cardiac arrest
Acute care for hypothermia
- ABCs
- gradual rewarming with dry clothes
- blankets
- warm environment
- heating pads
- warm drinks if alert
