Overuse or Undertrained? Injuries in adolescences

Overuse or Undertrained?Injuries in adolescences Chris Peterson DO TheSportsMedicineClinic.com

Definition • Repetition without Recovery • Constant Vibration • Malpositioning of Limbs • Psychological • Under-Trained

The Statistics on Adolescent Injuries • 30 Million kids in sports • 1/3 of childhood injuries are d/t sports • Athletic injuries are the most common reason for ER visits (4th for GP) • Football has highest rate of injury

The Statistics on Adolescent Injuries Soccer: 5.6 injuries/1000 player hours Risk of injury Increases with skill level Elite youth has highest Exposure (2 vs. 1 match/week) Games>Practice

Common Throwing Injuries • Youth Baseball: Injury Rates Increase of overall injury rate by 5% per year.

Population • Poor Trunk Proprioception and Reflex • Postural Sway • Trunk Displacement following Perturbation • Weak Hamstrings • Prior Injury

Shoulder at Risk • Ill-defined symptoms-ignored • Posterior tightness or stiffness • Inability to “get loose” • Tries to “play through” • “I rushed my warm up” • Multiple teams

Overuse or Under-trained • Asymmetric pathology in the shoulder and elbow is prevalent and, with overuse, can progress to disabling injury. • Joint injury occurs as a result of the body’s inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage.

Common Throwing Injuries • Traditional Thinking: • Increasing arm strength by increasing pitching (different from throwing).

Comparing Injured vs Healthy Pitchers • There is little evidence to support current safety recommendations for adolescent pitchers.

Common Throwing Injuries • Where does the velocity come from? Historically-50% Arm/50% Body Current-20% Arm/80% Trunk “X-factor” • What does this mean to me? Time to change my focus!!!

Posture • Thoracic Kyphosis=Shoulder Killer • Tight Hips-Contra lateral Side

What to expect when you are expecting. • Shoulder Injuries: • Growth Plate Changes (good and bad) • Internal Impingement • GIRD • SICK Shoulder

Where’s the Data? • Role of BMI in overuse injuries • “Athletic BMI” • 20-25 • Lower rate of injuries

Overuse or Under-trained • The athletic build population has a lower tendency to suffer overuse soft tissue injuries • Commencing physical activity at a younger age may have a positive effect in preventing overuse injuries

Preventing Throwing Injuries • Recommendation: • Maintain throwing but limit pitching • Work on entire kinetic chain • 3 months of “active rest” per year • Throw the curveball after you shave

Pitchers Report Card • Mechanics • Functional Strength • Pitch Count

Preventing Throwing Injuries • Do not throw to warm up…….. • Warm up to throw. • Core

Bottom Line • Biomechanics (Orthotics) • Neuromuscular Training • Prevention Programs (PEP, F-MARC-11+) • Compliance • Unable to eliminate all Risk • Need Full Rehab Prior to RTS

Overuse or Under-trained • Who is right? • Darwin was right.

Overuse or Under-trained • Time to look away from the pathology and work on players anatomy. • Prevention is now more important than ever.

Overuse or Under-trained • “Athletes are dysfunctional” • Goal: “Health Dysfunctional Athlete”

Overuse or Undertrained? Injuries in adolescences