Examination, Diagnosis, Treatment, and Prevention of Sports Injuries Unique to the child Athlete

Injuries unique to the Child Athlete Macro trauma Microtrauma Broken Radius Ligament Injuries Avulsion Fractures Overuse Injuries Severs Osgoods- Schlatters Salter-Harris Fractures

Increase in overuse injuries: Due to increase emphasis and participation in organized sports Inappropriate Coaching Lay people giving medical advise

Growth Spurts Growth cartilage: Injuries has different effects and requires different diagnosis and treatments Psychological vulnerability Susceptible to inappropriate coaching and training

Salter- Harris Fracture Growth Cartilage Injury May cause arrest of the growth process Limb length discrepancy

History: Trauma or Overuse

Observation Inspection Rang of Motion

Provocative Tests: Kemps, Adams, Stork. Determine if it’s the Anterior or Posterior Elements a. Pars Interarticularis, Facet Joint, Pedicle, SI Joint.

Must begin at the Hip and end at the foot. Observation in standing posture: a. Frontal, Lateral, posterior Eval of posture, symetry and alignment Sitting Examination: Check patellar alignment, ACL integrity, Muscle imbalance. Joint line pain in heel to knee check.

Supine Exam: Lachmans, McMurrays, Varus/valgus Stress Look for ligamentous Injuries: If hemarthrosis strong indication of cruciate injury Cross Leg: Lateral Ligament, cartilage, popliteal tendon

Apleys Hip Extensors: Ely’s, Internal/external rotation. Internal rotation in flexed position: Slipped Capital Epiphysis

Sitting: Look for swelling Palpation medial, anterior talus, lateral ligaments( 85% ) ROM: Inversion, Eversion, Plantar Flexion, Dorsi Flexion Tests: Drawers, Varus stress

Check for syndesmosis sprain Kneeling: Achilles, calcanius,metatarsalgia

Check for Navicular, 2 nd metatarsal fracture Liz- Frank fracture Interosseus sprain Plantar fascitis

Examine in relation to spine: Range of Motion standing Provocative Tests: sitting, prone for stability.

Reactive sympathetic Dystrophy Clinical syndrome of excessive pain following surgery or injury A. Most common in individual sports: Gymnastics, ice skating B. Disorder of Autonomic Nervous System C. Etiology unclear D. Multiple Psychological complex

Injury Prevention Early detection key to overuse injuries Growth spurts: Decrease training demands Exercise programs: Resistance Training most important: Wayne Wescot