Overuse Injuries in Youth Athletes: What Clinicians Need To Know

1. Overuse Injuries in Youth Athletes: What Clinicians Need To Know Northeastern University

2. Contents Objectives Introduction Risk Factors Common Injuries Prevention Treatment Recommendations What Clinicians Can DO References

3. Objectives To educate clinicians on the causes and effects of overuse injuries. To raise awareness about risk factors associated with overuse conditions. To provide information regarding the most common overuse injuries. To make recommendations for treatment options. To guide clinicians on ways to minimize overuse injuries.

4. Introduction What Are Overuse Injuries? Overuse Injuries are subtle injuries that occur overtime as a result of repetitive microtrauma to tendons, bones, and joints. These conditions are most often seen in young athletes.

5. Introduction (cont.) Why Do Overuse Injuries Occur? When a healthy amount of stress is put on the body’s bones, muscles, ligaments, and tendons, the body undergoes the remodeling process. This process involves both the breakdown and buildup of tissue in order to make the body stronger and more functional. If breakdown occurs at a rate at which buildup cannot keep up, an overuse injury occurs.

6. Introduction (cont.) How Common Are Overuse Injuries and Why? 50% of pediatric sports injuries are related to overuse. That number is increasing due to increased participation in youth sports. 30 to 45 million children from ages 6 to 18 participate in athletics.

7. Risk Factors • Anatomical: • Imbalances between strength and flexibility • Body alignment • Knock-knees, bowlegs, unequal leg lengths, etc. • Development • Children are still developing, therefore their bones cannot handle as much stress as adult bones. • The growth plates are immature so remodeling is always occurring.

8. Risk Factors (cont.) • Environmental: • Training Factors • Single-sport intensive training • Weekend tournaments • Parental Pressure

9. Common Injuries • Tennis Elbow • Cause: Inflammation of the lateral epicondyle • Symptom:Typically pain on the lateral epicondyle. Condition often leads to weakness in the wrist and difficulty performing everyday tasks. • Treatment: PRICE, manual therapy, stretching, exercises • Swimmer’s Shoulder • Cause:When tendons of the rotator cuff become impinged as they pass through the shoulder joint. • Symptoms:Gradual pain at the front and side of the shoulder, especially during overhead movement. • Treatment: Rest, ice, gradual rehabilitation exercises

10. Common Injuries (cont.) • Little Leaguer’s Elbow • Cause: Inflammation of the growth plate inside the end of the elbow. Often caused by repetitive throwing of a baseball. • Symptoms:Pain on the inside of the medial elbow. • Treatment: Rest, strengthening exercises, ice massage • Runner’s Knee • Cause: Any patellofemoral condition of the knee; most common are patellar tendonitis and patellofemoral syndrome. • Symptoms: Patellofemoralpain in the front of the knee • Treatment: PRICE, stretching of hamstrings and quadriceps, iliotibial band

11. Common Injuries (cont.) • Achilles Tendinitis • Cause: Repetitive strain on the Achilles tendon • Symptoms: Pain, inflammation and degeneration of the Achilles tendon. • Can be acute (most painful) or chronic. • Ankle feels stiff and painful at the start of exercise and first thing in the morning. • Treatment: Rest, ice, heel pad, ultrasound therapy, exercises only after acute phase • Osgood-Schlatter Disease • Cause: The tibialtuberosity becomes swollen or inflammed • Symptoms: The tibial tuberosity is often more prominent than normal; tenderness and pain increases during and after exercise, especially when contracting the quadriceps. • Treatment: Only exercise until it causes pain, ice massage, quadriceps stretches, patella knee strap, myofascial release techniques

12. Treatment Options For All Overuse Injuries • Less intense and less frequent activity involving the injured body part. • Proper warm-up and cool-down activities. • Proper training techniques • Apply ice after an activity • Consider anti-inflammatory medication if necessary. • Refer patient to a pharmacist

13. Prevention Joint range of motion exercises as well as stretching programs prescribed by clinicians have shown to help prevent sports injuries. Icing after activity can help speed up the remodeling process and prevent overuse injury.

14. Recommendations/Optimal Lifestyle Choices Children are at a time in their lives when they should be having fun and participating in as much diverse physical activity as possible. Young athletes who participatein multiple sports, are well rounded, and who avoidintensive training have themostpotential to remainactive for a lifetime andto avoid overuse injuries.

15. What Clinicians Can Do Train athletes gradually and encourage them to be well-rounded. Provide athletes, their parents, and coaches with prevention tips and treatment options. Make athletes and parents aware of environmental risk factors in order to minimize them. Determine a training program that will allow the body rest time to heal while maintaining physical benefits and increasing overall strength. When necessary, refer patients to athletic trainers who can provide safe ways to be active and train for a specific sport.

16. References Brenner, JS. (2007, June). Overuse Injuries, Overtraining, & Burnout in Child & Adolescent Athletes: Pediatrics. 119 (6), 1242-1245. Retrieved June 3, from Medline. Coaches’ Resources: Teaching Kids Safe Ways to Participate in Sports. (2014). STOP Sports Injuries. Retrieved June 3, 2014, from http://www.stopsportsinjuries.org/files/pdf/CoachesTeachingKids.pdf Feeley, B. (2014). Runner’s Knee. University of California, San Francisco Department of Orthopaedic Surgery. Retrieved June 4, 2014 from http://orthosurg.ucsf.edu/patient-care/divisions/sports-medicine/conditions/knee/runners-knee/#.U4_neRaHwV8 Gregory, B. & Nyland, J. (2013, July). Medial Elbow Injury in Young Throwing Athletes. Muscles Ligaments Tendons Journal. 3(2). 91-100. Retrieved June 4, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711707/ Krivickas, LS. (1997, Aug). Anatomical Factors Associated with Overuse Sports Injuries: Sports Medicine. 24 (2). 132-46. Retrieved June 3, 2014 from Medline. Overuse Injury. (2014). STOP Sports Injuries. Retrieved June 3, 2014, from http://www.stopsportsinjuries.org/overuse-injury.aspx Parents’ Resources: How To Encourage Success In a Young Athlete. (2014). STOP Sports Injuries. Retrieved June 3, 2014 from http://www.stopsportsinjuries.org/files/pdf/encourage_success.pdf Sports Injuries. (2014). Sports Injury Clinic. Retrieved June 4, 2014 from http://www.sportsinjuryclinic.net/sport-injuries

17. Picture References [Untitled photograph of therapist and patient] Retrieved June 4, 2014http://www.eliteperformanceinstruction.com/attachments/Image/sports_med_physical_therapy_web.JPG [Untitled photograph of two young girls with sports equipment] Retrieved June 4, 2014 from: http://jaymurdock.files.wordpress.com/2011/02/child-athlete-health-safety-tips-spry-2__crop-landscape-534x0.jpg?w=534 {Untitled photograph of children lying down in a line] Retrieved June 4, 2014 from: http://thumb9.shutterstock.com/display_pic_with_logo/91282/91282,1246630891,2/stock-photo-portrait-of-four-children-lying-in-a-line-33062815.jpg [Untitled photograph of five youth athletes] Retrieved June 4, 2014 from: http://1.bp.blogspot.com/_nE4knV9wRkM/Sik_iBS58FI/AAAAAAAAAAM/lacQ2tiu18w/s320/22180705.jpg [Untitled photograph of three young boys with balls] Retrieved June 4, 2014 from: http://mogosport.files.wordpress.com/2011/07/youth-athletes.jpg [Untitled photograph of developing boy]Retrieved June 4, 2014 from: http://parentingforeveryone.com/wp-content/uploads/2011/03/child_development_stages.jpg [Untitled photograph of angry coach] Retrieved June 4, 2014 from: http://mogosport.files.wordpress.com/2011/05/bad-sports-parent.jpg [Untitled photograph of ice pack] Retrieved June 4, 2014 from: http://0.tqn.com/d/physicaltherapy/1/0/f/1/hamstring-stretch.jpg [Untitled photograph of cartoon man stretching] Retrieved June 4, 2014 from: http://www.drdavidgeier.com/wp-content/uploads/2011/02/Ice-therapy.jpg [Untitled photograph of four young athletes] Retrieved June 4, 2014 from: http://www.bodybio.com/Data/Default/Images/newsletters/Issue14/children-sports.jpg

18. Context Memo This slideshow presentation is intended to educate Physical Therapists and other health care professionals about overuse injuries. Its purpose is to provide insight on how to minimize the risk for overuse injuries and how to treat them when they do occur. This presentation could be part of a continuing education course for clinicians or found on a website as a tool for clinicians looking to learn more about this topic.

19. Reflective Note Clinicians who do not receive a certification in sports medicine may be familiar with overuse injuries but most likely do not understand how to minimize the risks associated with them. I decided to create this presentation as quick way for clinicians to better inform themselves on the topic. This presentation could help prevent overuse injuries and treat conditions. It could also be a useful tool for clinicians to share with patients when asked to provide prevention or treatment tips. The presentation consists of certain terms that only healthcare and medical professionals would understand, therefore the presentation best fits in a health profession environment. I chose to present this information in PowerPoint because I think it is the best way to present a lot of information in a short amount of time. It is an easy way to present clinicians with everything they need to know in an easy to understand and brief format.

20. Note I think this project would be an excellent fit for my portfolio. It shows my ability to communicate with a specific audience and demonstrates my skills presenting information in a way that differs from a traditional article or essay. It also displays my knowledge of and passion for the topic.