Prevention and Treatment of Youth Running Injuries: Are they just little adults? Andrew Cannon, PT, MHS, SCS, CSCS Director of Sports Medicine, NRHN Team Physical Therapist, Merrimack College Board Certified in Sports Physical Therapy
% Of Young People Overweight16 Overweight is1412 defined as being in10 the 95%for body 8 mass index 6 Blue age 6-11 4 Green age 12-17 2 0 1963-70 1971-74 1976-80 1988-94 1996-00
Do they need to be active? % of young people who are overweight14 inactivity and poor diet causes12 300,000 preventable deaths every10 year in the USA 8 Only tobacco causes more preventable deaths 6 Evidence suggests that some 4 chronic adult diseases may begin to 2 develop in childhood 0 Government guidelines and clinical 1963-70 1971-74 1976-80 1988-94 recommendations emphasize the age 6-11 importance of children being age 12-17 physically active Fulton, JE. Assessment of Physical Activity, Ped Ex Sci 13:113124,2001
Do they need to play sports? Whatever happened to gym class? Daily participation in 50 physical education by 45 % of high school 40 35 students 30 25 girlsSammann, P. Active Youth. Human Kinetics, 1998Sammann, 20 boys 15 10 5 0 1991 1993 1995
Does academic performance relate to physical activity? 7,961 school kids Age 7-15 Consistently across age groups and gender academic performance was correlated with physical activity and fitness measurementsDwyer T, Relation of academic performance to physical activity and fitness in children.Ped ExSci 13:225-237 children.Ped 2001
Is my 13 year old a kid? Children are not small adults Anatomy and physiology is developing and not mature Despite these concepts which are intuitively understood in the broadest sense, in practice, especially in athletic pursuits, these distinctions are forgotten or worse, ignored
How come the other kid is faster, stronger, more coordinated?
Should anybody but parents care? 50% of all children, age 5-18, participate in organized sport programs 18 million will incur sports related injury this year. 50% of these are overuse type injuries Annual cost to treat these preventable injuries is $1.2 billion Hawkins, D:Overuse Injuries in Youth Sport. Med Sci Sprt Exer. 33:1701-1707, 2001 Exer.
Why should kids not run? 1. Not medically cleared 2. Parents want them to 3. Parents want them to 4. Parents want them to 5. Parents want them to
Are boys and girls equally injured? What will they injure? High school X-C, 13.1/1000 athletic exposures Girls, 16.7/1000, Boys 10.9/1000 Girls higher initial injury rate for shin, hip, foot Girls higher reinjury rate knee, calf, foot 70 60 50 40 30 20 10 0 LE UE BACK
Will my child get injured? 18 million will incur sports related injury this year. 24% of injuries from stumbling, falling 22% of injuries from twist or misstep 18% from push, kick from opponent Higher rate of injury in competition than training
What type of injury is it? Overuse Traumatic
Overuse Injury Prevention Pre-participation screening Athlete/parent/patient education No pain = no gain??
Pain may be the result of a sport injury Pain is a natural response to something being wrong Pain is the barometer for activity continue or stop Adults have prior experience to qualify pain Trends can clarify the level of pain and injury
Youth specific risks A child with a shorter stride length subjects themselves to more repetition of heel strike to cover the same distance as an adult Immature cartilage is more susceptible to shear forces than adult cartilage Asynchrony of bone growth and muscle tendon elongation. Bone grows first which is the stimulus for muscle tendon elongation, the delay may be 3-6 months, during which time flexibility is significantly decreased
Overuse injury progression Pain only during high levels of activity Activity stops, then pain stops Pain will then persist after the activity stops Pain worsens with performance altered Progresses to pain with ADL and with sleep
What are the variables?? Pain present after activity for greater than 2 hours must significantly decreases activity Location Frequency Duration Intensity Training/competition Surface, equipment
There is always an expert with a new way, technique
Good Resources National Youth Sports Safety Foundation, nyssf.org American College of Sports Medicine, acsm.org. National Strength and Conditioning Ass. Nsca-lift.org www.northeastrehab.com Mom’s team Aap.org
Should your child lift weights?? Stretch and perform light exercise for 10 minutes 6-8 exercises of 10-15 reps, they could do 2-3 more 1-3 sets, minimum of 1-2 minutes between sets If doing 2 sets, when almost 3, 2x, increase resistance Focus on better, smoother, not heavier, faster They must succeed!!
Is the psychological part overrated ? Pressed by peers, coaches and parents they are more likely toignore injury when it first begins or to use it as an escape technique