Overuse or Undertrained? Injuries in adolescences Chris Peterson DO TheSportsMedicineClinic.com.
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Transcript of Overuse or Undertrained? Injuries in adolescences Chris Peterson DO TheSportsMedicineClinic.com.
Overuse or Undertrained?Overuse or Undertrained?Injuries in adolescences Injuries in adolescences
Chris Peterson DOChris Peterson DO
TheSportsMedicineClinic.comTheSportsMedicineClinic.com
Definition Definition
Repetition without RecoveryRepetition without Recovery Constant VibrationConstant Vibration Malpositioning of LimbsMalpositioning of Limbs PsychologicalPsychological Under-TrainedUnder-Trained
The Statistics on Adolescent The Statistics on Adolescent InjuriesInjuries
30 Million kids in sports30 Million kids in sports 1/3 of childhood injuries are d/t 1/3 of childhood injuries are d/t
sportssports Athletic injuries are the most Athletic injuries are the most
common reason for ER visits (4common reason for ER visits (4thth for for GP)GP)
Football has highest rate of injuryFootball has highest rate of injury
The Statistics on Adolescent The Statistics on Adolescent InjuriesInjuries
Soccer:Soccer:
5.6 injuries/1000 player hours5.6 injuries/1000 player hours
Risk of injury Increases with skill levelRisk of injury Increases with skill level
Elite youth has highestElite youth has highest
Exposure (2 vs. 1 match/week)Exposure (2 vs. 1 match/week)
Games>PracticeGames>Practice
Common Throwing InjuriesCommon Throwing Injuries
Youth Baseball: Injury RatesYouth Baseball: Injury Rates
Increase of overall injury rate by 5% Increase of overall injury rate by 5% per year. per year.
PopulationPopulation
Poor Trunk Proprioception and ReflexPoor Trunk Proprioception and Reflex Postural SwayPostural Sway Trunk Displacement following Trunk Displacement following
PerturbationPerturbation Weak HamstringsWeak Hamstrings Prior InjuryPrior Injury
Shoulder at RiskShoulder at Risk
Ill-defined symptoms-ignoredIll-defined symptoms-ignored Posterior tightness or stiffnessPosterior tightness or stiffness Inability to “get loose”Inability to “get loose” Tries to “play through”Tries to “play through” “ “I rushed my warm up”I rushed my warm up” Multiple teamsMultiple teams
Overuse or Under-trainedOveruse or Under-trained
Asymmetric pathology in the shoulder Asymmetric pathology in the shoulder and elbow is prevalent and, with and elbow is prevalent and, with overuse, can progress to disabling overuse, can progress to disabling injury.injury.
Joint injury occurs as a result of the Joint injury occurs as a result of the body’s inability to properly coordinate body’s inability to properly coordinate motion segments during the pitching motion segments during the pitching delivery, leading to further structural delivery, leading to further structural damage.damage.
Common Throwing InjuriesCommon Throwing Injuries
Traditional Thinking:Traditional Thinking: Increasing arm strength by Increasing arm strength by
increasing pitching (different from increasing pitching (different from throwing).throwing).
Comparing Injured vs Comparing Injured vs Healthy PitchersHealthy Pitchers
There is little evidence to support There is little evidence to support current safety recommendations for current safety recommendations for adolescent pitchers.adolescent pitchers.
Common Throwing InjuriesCommon Throwing Injuries
Where does the velocity come from?Where does the velocity come from?
Historically-50% Arm/50% BodyHistorically-50% Arm/50% Body
Current-20% Arm/80% TrunkCurrent-20% Arm/80% Trunk
““X-factor”X-factor” What does this mean to me?What does this mean to me?
Time to change my focus!!!Time to change my focus!!!
PosturePosture
Thoracic Kyphosis=Shoulder KillerThoracic Kyphosis=Shoulder Killer
Tight Hips-Contra lateral SideTight Hips-Contra lateral Side
What to expect when you are What to expect when you are expecting.expecting.
Shoulder Injuries:Shoulder Injuries: Growth Plate Changes (good and Growth Plate Changes (good and
bad)bad) Internal ImpingementInternal Impingement GIRD GIRD SICK ShoulderSICK Shoulder
Where’s the Data?Where’s the Data?
Role of BMI in overuse injuriesRole of BMI in overuse injuries ““Athletic BMI”Athletic BMI”
20-2520-25 Lower rate of injuriesLower rate of injuries
Overuse or Under-trainedOveruse or Under-trained
The athletic build population has a The athletic build population has a lower tendency to suffer overuse soft lower tendency to suffer overuse soft tissue injuries tissue injuries
Commencing physical activity at a Commencing physical activity at a younger age may have a positive younger age may have a positive effect in preventing overuse injurieseffect in preventing overuse injuries
Preventing Throwing InjuriesPreventing Throwing Injuries
Recommendation:Recommendation: Maintain throwing but limit Maintain throwing but limit
pitchingpitching Work on entire kinetic chainWork on entire kinetic chain 3 months of “active rest” per year3 months of “active rest” per year Throw the curveball after you Throw the curveball after you
shaveshave
Pitchers Report CardPitchers Report Card
MechanicsMechanics Functional StrengthFunctional Strength Pitch CountPitch Count
Preventing Throwing InjuriesPreventing Throwing Injuries
Do not throw to warm up……..Do not throw to warm up…….. Warm up to throw.Warm up to throw. CoreCore
Bottom LineBottom Line
Biomechanics (Orthotics)Biomechanics (Orthotics) Neuromuscular TrainingNeuromuscular Training Prevention Programs (PEP, F-MARC-Prevention Programs (PEP, F-MARC-
11+)11+) ComplianceCompliance
Unable to eliminate all RiskUnable to eliminate all Risk Need Full Rehab Prior to RTSNeed Full Rehab Prior to RTS
Overuse or Under-trainedOveruse or Under-trained
Who is right?Who is right? Darwin was right.Darwin was right.
Overuse or Under-trainedOveruse or Under-trained
Time to look away from the Time to look away from the pathology and work on players pathology and work on players anatomy.anatomy.
Prevention is now more important Prevention is now more important than ever.than ever.
Overuse or Under-trainedOveruse or Under-trained
““Athletes are dysfunctional”Athletes are dysfunctional”
Goal:Goal:
““Health Dysfunctional Athlete”Health Dysfunctional Athlete”