By Dr. Joshua B. Frank, Coastal Orthopaedics
As fall begins, we all start thinking of the busy school year and what it will bring. Many of us also start thinking of football and other fall sports. While this does cause excitement it also brings with it some trepidation.
Over the years we have learned a tremendous amount about sports, physiology, biomechanics, and technique. This advancement in knowledge has allowed athletes to become faster, stronger, quicker, and more efficient.
Another area that has advanced is that of sports medicine. In particular, the study of young athletes. Whenever we talk about sports injures, it is probably best to divide injuries into acute injuries and sub-acute or chronic injuries.
Acute injuries are often obvious and can cause immediate onset of pain. In some circumstances the initial injury is not quite as dramatic and may not cause play to stop. It is important to recognize and address these injuries in a timely manner, as they can go on to cause permanent disability. We have learned that children can sustain similar injuries as adults. The diagnosis of pediatric anterior cruciate ligament (ACL) and meniscal injuries is on the rise. This may be related to increased awareness and better diagnosis of these injuries. If left untreated, it is possible that these injuries can lead to further damage to the knee and even the onset of early arthritis. Acute knee injuries should be evaluated by a medical professional and may require x-rays or even and MRI.
Sub-acute or chronic injuries can also sideline a young athlete. Over the past years, there has been an increased focus on sports. While sports are great and teach children excellent life skills as well as improve physical condition, there is a point where it can get to be too much. That point may be different amongst athletes and may change as a child grows.
In an effort to improve athletic ability, children and adolescents are often specializing in one sport and participating in that sport year-round. Whether it be on a team, in camp, or even in the backyard, year-round sports can lead to fatigue and injury. Overuse injuries can occur all over the body. Thee are even names to associate injuries with certain sports. For example, a chronic, over-use injury to the growth plate of the proximal humerus (shoulder) is known as “Little Leaguer’s Shoulder.”
Obviously, these types of injuries are not limited to baseball. We do not yet know how much time is too much time in gymnastics practice, or ice-skating or even playing basketball outside. We do believe that performing multiple sports over the course of a year allows for different muscles to be used and rested. Also, period of rest and time without any major sports participation is also beneficial.
Another important recommendation is to prepare for the upcoming season well in advance. A period of limited activity followed by a sudden onset of intense training can easily lead to aggravation of growth plates, tendons, and apophyses. In general, a graduated schedule of increased activity with appropriate stretching may help prevent these conditions. Even though training camp begins in August, young athletes should be preparing on their own well in advance of these intense training periods.
Sports are great. With the increased prevalence of childhood obesity it has become even more evident that many children are not nearly active enough. With appropriate training, rest, and conditioning we hope to prevent many injuries and keep our young athletes safer.