crawford_pres

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By: jckoriginal (46 month(s) ago)

Thank you Dr Crawford for this presentation. It wil be usefull to help me with the children.

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Youth Sport Injuries : 

Youth Sport Injuries Approximately 10% of the 30-35 million American children playing organized sports each year will be injured Sports injuries may be responsible for 20% of Emergency room visits Children who abandon active sports for videogames place themselves at risk for obesity and diabetes Specialization in one sport at an early age places them at tremendous risks for early osteoarthritis from significant repetitive injuries

The youth athlete is different : 

The youth athlete is different Psychological Coordination Forces generated are different Open growth plates Muscle-ligament attachments Training Coaching Youth Sport Injuries

Youth Sport Injuries : 

Youth Sport Injuries Chipped bones Growth plate injuries Little league elbow Knee joint injuries Back injuries Pathologic fractures Overuse injuries increased 4x since 2000 Account for 30-50% of all injuries

Chip Fracture : 

Chip Fracture Elbow injury Chip fracture pull-off of attachment of throwing muscle) Treatment is controversial Surgery vs. Cast

The Growth Plate : 

The Growth Plate 13 y/o 16 y/o 15% of reported injuries Vulnerable 10-12 female, 13-15 male Only 2% of growth plate fractures develop a growth problem

Little League Shoulder : 

Little League Shoulder Repetitive overhead activity Quarterback, Pitcher, Big server in Tennis Widening of growth plate (force pulls it apart)

Gymnast’s Wrist : 

Gymnast’s Wrist Wrist pain and swelling 33% females 22% males Widening of the growth plate May show partial growth closure

Little League Elbow : 

Little League Elbow Result of repetitive muscular contraction of flexor mass Risk related to type and number of pitches Microfracture may injure joint cartilage X-ray, MRI diagnostic

Knee : 

Knee Articular “ball-bearing” Cartilage injury Localized injury.. to blood supply “osteochondritis dissecans” to bone and cartilage Affects joint mechanics May separate as loose body or “joint mouse” with destruction of cartilage ….. degenerate to arthritis

SPONDYLOLYSIS SPONDYLOLISTHESIS“crack in the back” : 

SPONDYLOLYSIS SPONDYLOLISTHESIS“crack in the back” Gymnasts Cheerleaders Weight lifters Middle line backers Wrestlers Crew Hockey Overuse disorder at vulnerable site Stress fracture of the back Common cause of back pain

Herniated disc : 

Herniated disc Difficult to establish diagnosis Sciatica, reactive scoliosis, buttock, thigh and low back pain Result of repetitive back flexion and high impact activity X-rays usually normal MRI positive Early degenerative changes may persist into adulthood

Hallmark of Overuse : 

Hallmark of Overuse “Pain decreases with decreased Activity” Night and rest pain = Badness Continuous pain without activity.. Rule out fracture through tumor

Management of Overuse : 

Management of Overuse Immediate cessation and splinting (Rest 2-6 weeks), NSAID’s Return to everyday use (non-sports) Strengthening, stretching, flexibility (after all pain is gone) Encourage multiple sports involvement What starts out early as a minor injury, if left untreated may become a serious injury by jr high or high school

Goal- Sports Participation : 

Goal- Sports Participation Avoid early specialization Avoid overtraining Avoid Pain Avoid Radar Guns

Upsides far outweigh downside : 

Upsides far outweigh downside Develops leadership Builds social skills, teamwork development and Lifelong friendships Special Olympics instills self-esteem for motor and cognitively challenged Center for Disease Control cites more kids seen for sports injuries than automobile accidents,.. however the majority of injuries in young athletes are minor and self limiting

Our responsibility : 

Our responsibility Assist the athlete to achieve their goals injury free Monitor, modify activities, diminish risks Enrich environmental factors i.e. sports equipment, shoes, training Protection from substance abuse Injury prevention

ACLanterior cruciate ligament : 

ACLanterior cruciate ligament Connects anterior leg to posterior thigh Primary stabilizer of the knee Females > males 2-6x when in same sport Non contact injury 50,000 + high school female injuries Felt to be related to alignment, muscle and ligament difference 3-D biomechanical research

3-D Biomechanical-EpidemiologicalCoupled Research : 

3-D Biomechanical-EpidemiologicalCoupled Research Hypothesis Pre-screened females with subsequent ACL injury: demonstrate decreased neuromuscular control Knee valgus increased joint loading would predict ACL injury risk Method: 205 female athletes: 9 subsequently suffered confirmed ACL tears Prospectively measured neuromuscular control Statistical analysis isolate predictors of risk athletes who subsequently ruptured their ACL Tim E. Hewitt Ph.D. CCHMC Human Performance Laboratory

Components of Predicted Injury Risk : 

Components of Predicted Injury Risk Knee valgus (knock knee) angle and torque (rotational force from ground) were primary predictors With 75% accuracy we were able to predict ACL injury Using statistical models we were able to predict injury with 95% accuracy Clinical Relevance Increased dynamic valgus and abduction loads increased risk of ACL injury DNA

Dynamic Neuromuscular Analysis Training : 

Dynamic Neuromuscular Analysis Training Dynamic Fast paced Neuromuscular Drill optimal patterns Analysis Coaching and feedback Technique perfection Has been shown to increase knee stability Has decreased knee injury rates in female athletes

Youth Sport Injuries : 

Youth Sport Injuries Pre-season Health screening Identify any risk factors i.e. strength/flexibility imbalances, anatomical malalignment Provide protective equipment and playing conditions Sport specific training Avoid specializing too early in single sport or position Don’t allow them to play hurt If hurt allow adequate time for recovery Stop the epidemic