young athlete Flashcards
importance of youth sports
- Leadership skills
- Self-esteem
- Healthy lifestyle habits (active)
- Reduced depression
young athletes
ncludes both children and adolescents
* Girls: Child (11 and under) adolescent (12-18)
* Boys: Child (13 and under) adolescent (14-18)
* Immature skeletal anatomy
* Immature emotional development
* Development (maturation)
* Timing, rate, and magnitude vary
* Not consistent between body systems
skeletal differences in young athletes
Bones less dense, more elastic (especially during growth spurt= transient mineral shortage)
Greenstick Fx
open physis
weakened area. saltar harris fx
apophysis
Insertional point for tendon/ligament
Apophysitis and avulsion common
Secondary growth center: opens ~ 9, closes ~ 22yo
fastest growth rate
During a growth spurt, bones can grow faster than the soft tissues can adapt = increased injury risk
sampling age and goal
6-12, develop fundmental skills
Running, Jumping, Throwing, Catching
Physical Literacy Across Sports
Rotate Through Sports and Positions
Example: Learn to throw
specialization of youth
age 13-15
goal: sport and position specific skill acquisition
Proficiency of Movement
Fine Tune Technique
Example: Learn to Pitch (how to throw a curveball
investment of youth developement
Age: 16-18
Goal: Skill Mastery
Proficiency of Movement
Increase Pitch Velocity
Improve Shooting Accuracy
Example: Throw a curveball with accuracy
definition of sport specialization
Original Definition (Hill 1987):
“Participation in a single sport to the exclusion of other sports”
Expanded Definition (Hill 1987, Hill 1989, Jayanthi 2013):
Participation in a single sport >8 months per year
High intensity training and competition within that sport
Participation in multiple leagues throughout the year
problem with early specialization
$2 Billion in Healthcare expenditures & growing
Increased Injury Risk (Bell 2018)
Burnout (Myer 2015)
Impaired physical/social development (Myer 2015)
surgical sport injury cases < 13 yo
2004-2009: 117 ± 32
2010-2014: 212 ± 70
impact
70% participate in some type of organized sport
Average age of specialization is 8 yo (<12 = early)
Encouraged to have a primary sport by 2nd grade
The average child today plays fewer than 2 sports
Questions:
Why is early specialization occurring?
why? follow the money
Youth sports is now a $15 Billion industry
Year round availability of:
Sport specific lessons/training
Competitive travel teams
Competitive club teams
Showcase tournaments
causes of early specialization
Be cautious of interpretation
Some concern for injury risk, pt education is working
Parents Unaware of Recommendations
Coaches Unaware of Recommendations
does early specialization lead to sport success
Unrealistic Expectations: 0.5% of HS athletes make it to the Pro level
early sspecialization injury risk summary
Limited Evidence Suggests
High Sport Specialization is Associated with Higher Risk of Overuse Injury
81% more likely ~ Double the risk
No evidence to support early specialization in most sports
Multi-sport may even reduce risk
injury prevention programs
Education is the best we have right now
Less than 10% studies include under 18
90% of athletes are under 18
Children are not small adults
recommendations: AOSSM
Monitor closely if:
participate more hours per week than their age
>16 hours per week of intense training
Single sport athletes should have break periods involving diverse neuromuscular training
Promote multisport participation
Patient education
recommendations AMSSM
Prior injury
High-risk injury
Menstral dysfunction
Diversify sports
apophysitis
Traction injury to the apophysis in growing individuals
Cartilaginous that ossify during skeletal maturation (injury does not impact longitudinal bone growth)
Overuse
Repetitive explosive movements: running, jumping, throwing
apophsitic common locations
Common locations:
Tibial Tubercle: Osgood-Schlatter’s
Inferior Patellar Pole: Sinding-Larsen-Johansson
Calcaneus: Sever’s
Medial Epicondyle: Little league elbow
Little league Shoulder: traction injury to the proximal humeral growth plate
apophysitis treatment
Activity to tolerance (modify if needed)
Unless growth plate involved
Muscle length
Muscle strength
Symptom management
Chopat strap
It will go away with rest and as the apophysis matures
avulsion fx
Traction injury resulting in fracture
Childrens ligaments/tendons are stronger than their pliable bones
Ligament/tendon tears rare in children, more likely to avulse
Same mechanism as acute tendon ruptures in adults
Sudden pop with pain, localized over bony insertion
+/- laxity
