1. The Adolescent and the Aging Athlete

2. Who is the Aging Athlete? Middle Aged 45- 64yrs old Elderly 65-84 Populations 85 years plus are considered very old Explosive population for the next several decades

3. Aging Athlete Aging is more complex after the age of 65 Some changes include: Neuromuscular changes Decreased reaction time Strength in muscles, tendons and ligaments

4. Common Injuries for this Age Group Subacromial bursitis Adhesive capsulitis Subacromial impingement syndrome Trochanteric bursitis Back pathology Degenerative meniscal tears Partial tears of the triceps surae Post traumatic ankle instability Plantar fasciitis

5. Other Concerns Strength, flexibility, balance Osteoporosis/ osteoarthritis

6. Rehabilitation Considerations Similar rehabilitation can be given to aging athletes Caution and slower progressions should be used

7. Who is the adolescent athlete? “period from beginning of puberty until maturity” –Girls: puberty begins at 10- 14 years of age Boys: puberty begins at 12-16 years of age Can be involved in recreational or organized sport

8. Posture in Children and Adolescents Faulty posture Requires repetitive assessment to accurately record habitual postures May not require treatment due to the body’s ability to realign itself during natural growth

9. Adolescent Sport Participation Increased sport participation numbers = higher injury rates Swimming Jogging Basketball Volleyball Weight training Intrinsic/ extrinsic factors Non-modifiable Modifiable Prevention

10. Common Injuries/ Conditions seen in Adolescent Athletes Epiphyseal plate injury Apophysitis Fractures Avulsion Fractures Osgood-Schlatter’s Elbow Osteochondritis dissecans Swimmer’s shoulder Jumper’s knee Gymnast’s back Little League elbow tendinitis

11. Bone Growth Skeletal immaturity Open epiphyseal plates Skeletal maturity Closed epiphyseal plates Sport participation increases during bone growth years

12. Epiphyseal Plate Injury Usually distal femoral, distal tibial, or proximal tibial May produce a disrupted growth plate and cause permanent deformity

13. Apophysitis/ Avulsion Fracture Common sites: Ischial tuberosity Pubic tubercle ASIS AIIS Lesser trochanter MOI: abrupt muscular contraction DD: muscle strain X-ray: Rule out iliac crest fx or avulsion fx Tx:

14. Fractures/ Dislocations Upper extremity: Clavicle Proximal humorous (stress fx) Wrist Scaphoid, TFCC Elbow dislocations Single occurrence Shoulder Instability

15. Rehabilitation Considerations Skeletal immaturity Proper treatment can allow for full healing May require surgery if complications arise