Are kids just little adults?

3. 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

4. TIMES HAVE CHANGED!

5. % Of Young People Overweight
16
 Overweight is
14
12
defined as being in
10
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

6. Do they need to be active?
 % of young people who are
overweight
14  inactivity and poor diet causes
12 300,000 preventable deaths every
10 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

7. 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 girls
Sammann, P. Active Youth. Human Kinetics, 1998
Sammann, 20 boys
15
10
5
0
1991 1993 1995

8. 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 measurements
Dwyer T, Relation of academic performance to physical
activity and fitness in children.Ped ExSci 13:225-237
children.Ped
2001

9. 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

10. How come the other kid is faster,
stronger, more coordinated?

11. 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.

12. 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

13. 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

14. 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

15. What type of injury is it?
 Overuse
 Traumatic

17. Overuse Injury Prevention
 Pre-participation
screening
 Athlete/parent/patient
education
 No pain = no gain??

18.  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

19. Overuse Injury Contributing Factors
 Muscle tendon imbalance (tight, weak)
 Inadequate/inappropriate rehab from prior
injury
 Anatomic malalignment
 Training errors
 Poor conditioning
 Increased psychological stress, (adult/peer)

20. 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

21. 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

22. 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

23. There is always an expert with a
new way, technique

24. SAID
SPECIFIC
ADAPTATIONS
IMPOSED
DEMANDS

25. Overuse Growth Plate Injuries

27. 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

28. 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!!

29. Is the psychological part
overrated ?
Pressed by peers, coaches and
parents they are more likely to
ignore injury when it first begins or
to use it as an escape technique

38. THANKS