Posts Tagged ‘overuse injuries’

Youth Sports? Best to Mix it Up

Posted on: April 6th, 2021

Joey F. Carter, MD

(April, 2021) Need a sure sign of spring? You’ll find it on Saturday mornings at the ballpark and soccer fields these days.   Some of these young athletes may be playing not just during a traditional season but year-round, with club travel leagues starting as early as 7.  But is sports specialization in children a healthy choice?

What is Sports Specialization?

The past twenty years have brought a significant shift from unstructured free play and school-based sports to what’s called “sport specialization.” The numbers are astounding:  close to 30 million children between the ages of 6 and 18 and close to 60 million in organized programs are participating in year-round sports.   

Conventional wisdom may lead us to think kids will fall behind their peers if not putting in the “10,000 hour rule” of practice making perfect.  But the growing intensity of this early specialization may lead to more harm than good. The American Orthopaedic Society for Sports Medicine * has found the trend alarming enough to define a list of risk factors associated with overuse injuries in young athletes.

Know the Risk Factors for Overuse Injuries

  1. Participation in intense training and/or competition in their sport more than eight months per year.
  2. Participation in one sport to the exclusion of others or free play.
  3. Playing their sport for more hours per week than their age.

Do any of these hit close to home?   Overuse injuries we see in young athletes include knee disorders with soccer, basketball, and volleyball players. Shoulder injuries include “Little League Shoulder” due to repetitive pitch counts for pitchers and the intensity of throws catchers must make during a game.  “Little League Elbow” often results from high-throwing volume.  Racket sports and gymnastics also fall into the year-round sport specialization/overuse injury loop. 

Mix it Up – and Don’t Forget Free Time Too

Finding the right balance in training and competition is a tough topic for coaches and parents, who may feel pressured to keep up… and keep their child’s spot on the team.    Clearly, our children find enormous benefit from individual and team sports – with physical development, socialization, teamwork, and a strong work ethic.  But too much of a good thing also leads to psychological burnout and loss of motivation. What’s the answer? Limit practice, ensure plenty of rest, and keep it fun! Mix up other sports, and find time for free play, too.   We all want our children to succeed on the field of play – without preventable injuries. 

*www.sportsmed.org.

The Limping Child

Posted on: March 29th, 2020

Gregg Terral, MD

(May 2019) Limping is a common complaint that prompts parents to seek medical attention for their child. Usually the limp is caused by minor injury that will get better by itself. However, limping that last longer than a week and that is not improving may indicate a more serious condition requiring medical evaluation. The challenge for both the parent and the physician involve the difficulty in young children at describing their symptoms as well as with older children trying to play through their pain even when it is not safe.  As a parent, it’s important to understand a limping child.

What is Causing My Child to Limp?

Injury:

Minor injuries such as contusions, low-grade sprains and strains will resolve quickly. Pain and limping related to more serious ligament sprains and muscle strains as well as traumatic and stress fractures will however persist.

Overuse injuries:

Overuse injuries to various sites of growth can also occur – typically the heel, mid foot, leg, kneecap, as well as the pelvis. These causes of pain fall under the general diagnosis of apophysitis. Patella maltracking as well as patella tendinitis or jumpers knee may also be a concern.

Infection and inflammatory disease:

Viral and bacterial infections can settle in growing bones and adjacent joints causing significant pain at times. Several types of inflammatory disease such as juvenile arthritis can also be a cause.

More Serious Issues Behind a Limp

Other less common causes of leg pain or limping can be related to congenital abnormalities such as a congenital hip dislocation or congenital foot deformities

Legg-Perthes disease is caused by insufficient blood supply to the hip, leading to a flattening of the ball within the ball and socket joint of the hip. This condition usually occurs between the ages of 4 and 10 in otherwise healthy children.

Slipped capital femoral epiphysis occurs just before puberty and is a slippage of the growth plate within the hip socket.

Diskitis is an inflammation of the disc spaces within the spine which can also cause painful limping.

Nervous system disorders create a problem with the nerve signals that control walking. Disorders of the nervous system can cause weakness or tightness in the muscles which can also cause a child to walk differently.

Tumors of various types can grow into bone and soft tissue and cause pain locally.

A thorough history and physical exam by your physician accompanied by appropriate imaging which may include studies such as x-rays, ultrasound, bone scans, MRI, or CT scan can readily provide a diagnosis. Occasionally bloodwork will also be needed to make the appropriate diagnosis and develop a treatment plan.

If your child has an issue lasting more than a few days, we’re here to help.

https://orthoinfo.aaos.org/en/diseases–conditions/the-limping-child/

Dr. Terral received his MD from Louisiana State University Medical Center in New Orleans, followed by residency in the Department of Orthopaedic Surgery at the University of Mississippi Medical Center in Jackson, MS.  He is Board Certified and Fellowship Trained in joint reconstruction.

Sport Specialization: Is it Safe? Is it Necessary?

Posted on: December 29th, 2019

Albert Jay Savage IV, MD

(June 2020) Youth sports have surged across the country, and a weekend drive around Eastern Shore ballparks proves we’re part of that trend.  By all accounts, the physical, mental and emotional benefits of individual and team sports are well documented.  From a sports medicine perspective however, this boom in youth sports has raised some alarm:   increasing “sport specialization” at a young age means an increase in youth sports overuse injuries, too.

Doesn’t My Child Need to Focus on One Sport?

Sport specialization has been defined as “year-round intensive training in a single sport, at the expense of other sports.”  Some parents reading this may be skeptical , as conventional wisdom suggests young athletes determined to “up their game” as they age will fall behind if not working consistently on their skills.    However, a quick dive into current research reveals some surprises:  (1) most players in Division 1 athletics did not pursue early specialization, (2) baseball pitchers from colder climates that do not throw year-round tend to excel over those from warmer climates, and (3) early specialization may actually decrease the likelihood that an athlete will reach an elite level.

Furthermore, studies find overuse injuries consistently linked with the following risk factors: (1) a high level of sports specialization, (2) playing their sport for more than 8 months of the year, and (3) playing their sport for more hours per week than their age. 

child throwing baseball

Tips to Prevent Youth Sports Overuse Injuries

Most overuse injuries can be prevented with proper training and common sense.

  • Learn to listen to your body and listen to what kids are telling you.
  • Remember that “no pain, no gain” does not apply here. 
  • These young athletes are not just little adults.  They have growing bones and soft tissues and are susceptible to different types of injuries.
  • Follow the 10 percent rule. In general, you should not increase your training program or activity more than 10 percent per week. This allows your body adequate time for recovery and response.

From a parent’s perspective I want my kids to enjoy playing sports –and to soak up the character traits and teamwork skills that healthy competition offers.  From my former athlete perspective, I know the value of hard work in reaching their greatest potential.    But all of us as parents can agree in the goal of safety first and foremost. Nothing is achieved when our children are sidelined with preventable injuries. 

The debate over single sport injuries is likely to grow along with the options and enthusiasm for youth sports overall.  I encourage parents and coaches to learn more – some great resources can be found at the American Orthopedic Society for Sports Medicine website, www.sportsmed.org.

Dr. Savage received his MD from the University of Alabama at Birmingham, followed by residency at the UAB Department of Orthopaedic Surgery. He is Board Certified and Fellowship Trained in Sports Medicine.

A Repetitive Problem – The One Sport Injury

Posted on: October 29th, 2019

Gregg Terral, MD

( August 2019) Summer break is over, kids are back in school and fall sports are in full swing from elementary to high school. With more and more young athletes under 12 focusing on just one sport and training year-round, we’ve seen a growing number of our younger patients with what’s called a “one sport injury” caused by repetitive movements.  The condition is called apophysitis.   

What Causes the One Sport Injury?

The apophysis is a growth plate that provides an attachment site for a muscle to attach to bone via a tendon. Apophysitis occurs due to repetitive or chronic traction at either the origin or insertion site. This is because the growth cartilage present in this younger age group is the weak link in the muscle-tendon unit and is prone to injury. Continuous stress can lead to injury with pain and swelling.

The knee is the most commonly seen site of apophysitis where the patellar tendon attaches to the upper tibia. Other common sites are the Achilles tendon at the heel, the lower part of the kneecap, the outer side of the foot), the inner elbow (Little League elbow), and shoulder (Little League shoulder). Runners, sprinters, and soccer players are especially prone to locations in the pelvis causing hip or groin pain.

child throwing baseball

Among athletes between the ages of 5 to 14, overuse injuries impact:

  • 27% of football players
  • 25% of baseball players
  • 22% of soccer players
  • 15% of basketball players
  • 12% of softball players *                                   
  • *American Academy of Orthopaedic Surgeons

How Can We Treat Overuse Injuries?

We treat all types of apophysitis with a period of rest, ice, activity modification, and potentially physical therapy depending on the condition severity. Depending on the location, a variety of straps, braces, and orthotics can aid in providing comfort, protection and stabilization of the involved site. Healing time varies from a few days to weeks or months depending on a patient’s willingness to rest and avoid contributing activities.

What Parents and Coaches Can Do

  • Have a pre-season wellness check to determine any health concerns that could lead to injury
  • Warm-up and cool-down before and after athletic activities
  • Use correct sport specific equipment
  • Train in proper techniques like throwing or running
  • Hydrate!  Drinking plenty of water maintains health and minimizes cramps
  • Play different positions or sports throughout the year to minimize overuse injury risk
  • Don’t  play with pain – allow time to rest and heal

Keeping those growing bones, joints and muscles healthy ensure the ultimate goal: a healthy lifetime love of sports, too.

Dr. Terral received his MD from Louisiana State University Medical Center in New Orleans, followed by residency in the Department of Orthopaedic Surgery at the University of Mississippi Medical Center in Jackson, MS.  He is Board Certified and Fellowship Trained in numerous specialties including trauma-related musculoskeletal injuries and joint reconstruction.