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Jokela A, Aho J, Kosola J, Stenroos A, Sinikumpu JJ, Maffulli N, Lempainen L. Heel pain in young athletes - not always Sever's Disease: A Narrative Review. Foot (Edinb) 2024; 60:102114. [PMID: 39029380 DOI: 10.1016/j.foot.2024.102114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 06/06/2024] [Accepted: 06/15/2024] [Indexed: 07/21/2024]
Abstract
Heel pain is a prevalent issue in young athletes, often arising from overuse and increased sporting demands. While Sever's Disease is the predominant cause, various other entities, including stress-related injuries and pathologies like tumors and bone lesions, contribute to this condition. The complex hind foot anatomy, encompassing ossicles, physis, and soft tissues, may lead to heel pain. This study aims to provide physicians with a clinically oriented narrative review of adolescent heel pain, supported by illustrative cases. CONCLUSION: This study aims to offer physicians a comprehensive understanding of the concepts surrounding heel pain in adolescents. By presenting clinically relevant information and illustrated cases, it seeks to enhance medical practitioners' ability to diagnose and manage heel pain effectively in this specific demographic.
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Affiliation(s)
- Aleksi Jokela
- Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Joni Aho
- University of Turku, Turku, Finland
| | - Jussi Kosola
- Department of Orthopaedics and Traumatology, Kanta-Häme Central Hospital, Hämeenlinna, Finland; University of Helsinki, Helsinki, Finland; Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland; Department of Orthopaedics and Traumatology, Hyvinkää Hospital, Hyvinkää, Finland
| | - Antti Stenroos
- Department of Orthopaedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Juha-Jaakko Sinikumpu
- Department of Children and Adolescents, PEDEGO unit and MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, University of Salerno School of Medicine, Surgery and Dentistry, Salerno, Italy; Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK; Institute of Science and Technology in Medicine, Keele University School of Medicine, Stoke on Trent, UK
| | - Lasse Lempainen
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland; FinnOrthopaedics / Hospital Pihlajalinna, Turku, Finland; Ripoll y De Prado, FIFA Medical Centre of Excellence, Madrid, Spain.
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2
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Gul A, Khan Z. The Role of MRI Scan in Sports-Related Anterior Cruciate Ligament Injuries: A Case Report-Based Literature Review. Cureus 2024; 16:e55941. [PMID: 38601397 PMCID: PMC11004851 DOI: 10.7759/cureus.55941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Sports-related knee injuries are a common presentation in general practice in Australia among patients of the adolescent age group. A complete understanding of the anatomy, mechanism of injury, history, focused clinical examination of the knee joint, and proper investigations can help make a proper diagnosis. Injuries can be prejudicial to ligaments, tendons, muscles, and bones. Here, we present a case of rupture of the anterior cruciate ligament (ACL) following a fall while playing football. The patient visited the emergency department where an initial radiography was performed, which was unremarkable, and was consequently discharged from the emergency department on painkillers. Later, he presented with swelling and worsening pain in general practice, and magnetic resonance imaging (MRI) confirmed a diagnosis of ACL rupture. Therefore, he was referred to an orthopedic surgeon for further treatment and management. The patient was managed conservatively and underwent physiotherapy.
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Affiliation(s)
- Amresh Gul
- General Practice, Lifeline Hospital, Salalah, OMN
| | - Zahid Khan
- Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR
- Cardiology, Barts Heart Centre, London, GBR
- Cardiology and General Medicine, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR
- Cardiology, Royal Free Hospital, London, GBR
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3
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Gremillion MJ, Martinez A, Ghanta RB, Borici N, Kushare I. An assessment of the diagnosis, treatment, and outcomes of lower extremity stress fractures in pediatric and adolescent populations. PHYSICIAN SPORTSMED 2023; 51:572-581. [PMID: 36328959 DOI: 10.1080/00913847.2022.2143247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To present one of the first descriptive case series of pediatric and adolescent lower extremity stress injuries, their management, and outcomes in athletes and non-athletes. METHODS The IRB-approved retrospective study included patients under 18 years at a tertiary children's hospital who were diagnosed with a lower extremity stress fracture/reaction. Demographic data, mechanism of injury, physical exam, radiographic findings, treatment, & outcomes were collected. Descriptive statistical analysis was conducted. RESULTS Ninety-seven patients with stress injuries on clinical exams and on radiographs or MRI were included. The average age when diagnosed was 11.7 years (range 1.1-18 years) and the most common injuries were to the tibia (n = 33, 28.4%) and the least common involved were the cuneiforms (n = 4, 3.4%). Patients under the age of 14 were more likely to experience cuboid and calcaneal stress injuries (mean age 5.5 and 8.3 years respectively). Nineteen patients (19.6%) had high-risk stress fractures, with the average age of 14.9 years versus 11.6 for those with low risk (p-value = 0.01) and return to activity time being 15 weeks compared to 10.5 (p-value = 0.027). The most common forms of treatment were controlled ankle motion (CAM), walker boots (58.6%), and physical therapy (PT) (38.1%). The mean Lower Extremity Function Score of the patient population was 73.8, indicating no clinically important difference from full functionality. CONCLUSION Lower extremity stress injuries in this cohort were most seen in the tibia, although patients younger than 14 had a high number of cuboid and calcaneal stress injuries. Those with high-risk stress fractures were older and took longer to recover from when compared to low-risk injuries. Treatment is commonly conservative, with CAM boots and PT being the most frequently utilized interventions and serving as a successful approach to treatment, with patients returning to activity at an average of 11.4 weeks, which is comparable to similar studies.
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Affiliation(s)
| | | | - Ramesh B Ghanta
- Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Neritan Borici
- Baylor College of Medicine, Houston, TX, USA
- Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA
| | - Indranil Kushare
- Baylor College of Medicine, Houston, TX, USA
- Department of Orthopedic Surgery, Texas Children's Hospital, Houston, TX, USA
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4
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Strosser S. Youth Sport Specialization and Risk of Injury: A General Review. Clin J Sport Med 2023; 33:652-657. [PMID: 37104869 DOI: 10.1097/jsm.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/02/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE The purpose of this literature review was to analyze, understand, and disclose prior empirical findings about the injury risks associated with youth sport specialization. DATA SOURCES Articles were included in this review if they examined the association between youth sport specialization status and injury. Nine articles from 5 journals met these criteria. All articles summarized the findings of cross-sectional (N = 5) or cohort studies (N = 4). MAIN RESULTS Each article included in this review indicated that specialized youth athletes are more susceptible to injury. Only 5 studies assessed the injury risks linked to specialization independent of sport training volume. These studies produced contradictory results. CONCLUSIONS Although specialized youth athletes are more prone to injury, future research is needed to determine the independent and inherent injury risk associated with specialization. Nevertheless, youth athletes should refrain from specialization until at least adolescence.
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Iwatsu J, Yabe Y, Sekiguchi T, Momma H, Tsuchiya M, Kanazawa K, Yoshida S, Sogi Y, Nagatomi R, Hagiwara Y. Knee pain in young sports players aged 6-15 years: a cross-sectional study in Japan. BMC Sports Sci Med Rehabil 2023; 15:16. [PMID: 36750958 PMCID: PMC9906902 DOI: 10.1186/s13102-022-00606-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 12/09/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Knee is the most commonly injured part of the body in young athletes. Knee pain in several studies have been seen to be more prevalent in active adolescents compared to inactive, although common in both groups. Nevertheless, few studies with large sample size have been published reporting the difference of the prevalence of knee pain for each sport among young sports players. This study investigated the point prevalence of knee pain among young sports players aged 6-15 years old according to age, sex, and sports discipline. Furthermore, this study investigated the association between knee pain and sports discipline among young sports players. METHODS A cross-sectional study was conducted using a self-reported questionnaire on young sports players aged 6-15 years from the Miyagi Amateur Sports Association. Multivariable logistic regression models were used to examine the association between knee pain and sports discipline and were adjusted for age, sex, body mass index (BMI), training days per week, and training hours per weekday and weekend. RESULTS A total of 7234 young sports players were included. The point prevalence of knee pain was 10.9%. Females (13.3%) had more knee pain than males (9.8%). Young, 13-year-old sports players had the highest prevalence of knee pain (19.1%). The multivariable analysis showed that the highest odds ratio [95% confidence interval] was observed for handball players (2.42 [1.01-5.81]). In addition, hand ball, mini-basketball (odds ratio 1.85; 95% CI 1.38-2.47), and basketball (odds ratio 1.66; 95% CI 1.23-2.26) were significantly associated with knee pain, compared with football. The lowest odds ratio was observed for swimming (0.34 [0.05-2.54]), followed by karate (odds ratio 0.38; 95% CI 0.16-0.89) and baseball (odds ratio 0.47; 95% CI 0.35-0.64). CONCLUSION The prevalence of knee pain among young athletes differed according to age, sex, and sports discipline. Their parents and clinicians should recognize this information to manage knee pain among young sports players.
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Affiliation(s)
- Jun Iwatsu
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Yutaka Yabe
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Takuya Sekiguchi
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Haruki Momma
- grid.69566.3a0000 0001 2248 6943Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575 Japan
| | - Masahiro Tsuchiya
- grid.412754.10000 0000 9956 3487Department of Nursing, Faculty of Health Science, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai 981-8522 Japan
| | - Kenji Kanazawa
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Shinichirou Yoshida
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Yasuhito Sogi
- grid.69566.3a0000 0001 2248 6943Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 Japan
| | - Ryoichi Nagatomi
- grid.69566.3a0000 0001 2248 6943Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575 Japan ,grid.69566.3a0000 0001 2248 6943Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575 Japan
| | - Yoshihiro Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. .,Department of Medicine and Science in Sports and Exercise, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
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Distribution of pediatric hand fractures: age- and bone maturation-dependent differences. Emerg Radiol 2023; 30:33-39. [PMID: 36322223 DOI: 10.1007/s10140-022-02093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To investigate the distribution and characteristics of fractures of bones of the hand on radiographs with respect to age and skeletal maturity of the fractured bone, and to identify predictors of surgery. METHODS This cross-sectional, retrospective study included children (≤ 18 years) with hand fractures who underwent radiographic examinations (2019-2021). Fracture location, presence of displacement (≥ 2 mm), angulation (≥ 10°), articular extension, and if skeletally immature, then physeal involvement and Salter-Harris grade were recorded. Mann-Whitney U, Kruskal-Wallis, Fisher's exact, and chi-square tests as well as logistic regression analyses were used. RESULTS Study group of 508 (350 boys, 158 girls; median age, 11.9 years) included 575 (63% phalangeal, 37% metacarpal, and 0.3% carpal) fractures. Younger children were more likely to sustain phalangeal and older children carpal and metacarpal fractures (median ages: 10.8 vs 12.3 and 13.8 years, p < 0.001); and fractures of the small finger accounted for 50% of metacarpal and 43% of phalangeal fractures. Fracture displacement (12% vs 22%, p = 0.02) and angulation (25% vs 49%, p < 0.001) were more common with mature than immature bones. A third of immature bones had physeal involvement and the most common pattern was Salter-Harris type II (89%). Surgical intervention was uncommon (11%) and independent predictors were displacement (OR = 3.99, 95% CI 1.95-8.19, p < 0.001) and articular extension (OR = 5.11, 95% CI 2.00-13.07, p < 0.001). CONCLUSION While younger children were more likely to sustain phalangeal than metacarpal fractures and less likely to have displacement and angulation when compared to older children; only displacement and articular extension were significant independent predictors of surgery.
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7
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Farooqi A, Talwar D, Tata R, Harwood K, Maguire K. Comparison of pediatric performance athlete injuries presenting to emergency departments. PHYSICIAN SPORTSMED 2023; 51:64-72. [PMID: 34696657 DOI: 10.1080/00913847.2021.1996863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports. METHODS The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3-18 years) related to gymnastics, dance, or cheerleading from 2015-2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI). RESULTS A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68-74%) and occurred in a sports-related setting (65%, 95% CI: 57-72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43-68%) and resulted in an orthopedic diagnosis (63-71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29-51%) and non-orthopedic diagnoses (29-38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%). CONCLUSION Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes.
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Affiliation(s)
- Ali Farooqi
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States
| | - Divya Talwar
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Ravi Tata
- Drexel School of Medicine, Philadelphia, Unites States
| | - Kathleen Harwood
- Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
| | - Kathleen Maguire
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States.,Department of Orthopaedics, Clinical Orthopaedic Surgery, Children's Hospital of Pennsylvania, Philadelphia, PA, United States
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8
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Nguyen JC, Gendler L, Guariento A, Nguyen MK, Hong S, Grady MF, Caine D. MRI findings of growth plate fractures of the knee: are there age- and fracture-dependent differences? Skeletal Radiol 2023; 52:1321-1329. [PMID: 36598521 DOI: 10.1007/s00256-022-04262-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/20/2022] [Accepted: 12/09/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To investigate MRI findings in children with physeal fractures of the knee with respect to age, location, and articular involvement. METHODS Children with physeal fractures who underwent knee MRI between 2008 and 2021 were included. Two radiologists retrospectively reviewed all examinations to determine articular involvement, findings of physeal instability (perichondral disruption, periosteal entrapment), and internal derangement (cruciate ligament injury, meniscal tear, chondromalacia). Independent samples t, Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests were used to compare findings. RESULTS Fifty-six patients (37 boys, 19 girls; mean age: 12.2 ± 2.5 years; 32 distal femur, 24 proximal tibial fractures) included 24(43%) intraarticular fractures. Fractures were more common in the tibia than the femur (67% versus 25%, p = 0.004) and intraarticular fractures were more common in older than younger children (13.1 ± 2.0 versus 11.5 ± 2.7 years, p = 0.01), to associate with chondromalacia (46% versus 12%, p = 0.02) and undergo surgery (33% versus 10%, p = 0.04) when compared to extraarticular fractures. Perichondral disruption (n = 44, 79%) and periosteal entrapment (n = 13, 23%) did not significantly differ based on location or articular involvement (p > 0.05). At a median follow-up of 17.5 months (interquartile range: 1.25-34), 3 patients (2 intraarticular, 1 extraarticular fractures) developed osteoarthritis, osteochondral lesion, and leg-length discrepancy from growth arrest, which required additional surgery. CONCLUSION Intraarticular physeal fractures were more common with older children, associate with chondromalacia, and underdo surgical intervention when compared to extraarticular fractures of the knee. While MRI findings of physeal instability were common, no significant differences were found between fractures based on anatomic location or fracture pattern.
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Affiliation(s)
- Jie C Nguyen
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd , Philadelphia, PA, USA. .,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Liya Gendler
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd , Philadelphia, PA, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Andressa Guariento
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd , Philadelphia, PA, USA
| | - Michael K Nguyen
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - Shijie Hong
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd , Philadelphia, PA, USA
| | - Matthew F Grady
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Divison of Orthopedic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dennis Caine
- Kinesiology and Public Health Education, Division of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA
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Abstract
Overuse injuries are well described for both upper and lower extremities among skeletally immature athletes. To our knowledge, there is no description in the literature of an overuse injury affecting the medial tibial physis that is different from the typical Osgood-Schlatter disease or tibial tubercle apophysitis. In this article we present a 13-year-old athlete with medial proximal tibial widening or epiphysiolysis from overuse playing soccer. We need to be aware that with increased early sports specialization we may see injuries we have not seen before. [Orthopedics. 2022;46(6):e345-e347.].
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10
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McLellan M, Allahabadi S, Pandya NK. Youth Sports Specialization and Its Effect on Professional, Elite, and Olympic Athlete Performance, Career Longevity, and Injury Rates: A Systematic Review. Orthop J Sports Med 2022; 10:23259671221129594. [PMID: 36353394 PMCID: PMC9638532 DOI: 10.1177/23259671221129594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/07/2022] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Limited data are available on the long-term consequences of early sports specialization in high-level athletes. PURPOSE To evaluate the existing literature on the effects of sports specialization among professional, Olympic, and other elite athletes. STUDY DESIGN Systematic review; Level of evidence, 3. METHODS We performed a systematic review of studies from 1990 to 2021 on youth sports specialization in professional, elite, and/or Olympic athletes following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. An elite athlete was defined as one who performed at the highest level of his or her sport, beyond college level. Data were summarized according to 6 objectives: (1) definitions of specialization, age at specialization, and participation in other sports; (2) motivation for specialization; (3) athlete perspectives on specialization; (4) performance data; (5) specialization and injury risk; and (6) career longevity. RESULTS From 8756 articles, 29 studies were included, of which 17 (58.6%) were survey-based studies. Of the 8 articles that commented on injury risk, all demonstrated reduction in injury risk in athletes who delayed specialization. Performance benefits were apparent with later specialization in 7 of 9 articles; the remaining 2 showed benefit with earlier specialization in marathon runners and soccer players. There were less definitive results on career longevity, with 5 of 9 articles finding no association between career longevity and sports specialization. CONCLUSION Although current data on sports specialization in elite, professional, and Olympic athletes are mostly retrospective and survey-based evidence, most sports demonstrate better performance after youth multisport engagement, and youth sports specialization was linked with increased injury risk in athletes at the highest levels of competition.
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Affiliation(s)
- Maddison McLellan
- School of Medicine, University of California, Irvine, Irvine,
California, USA
| | - Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San
Francisco, San Francisco, California, USA
| | - Nirav K. Pandya
- Department of Orthopaedic Surgery, University of California, San
Francisco, San Francisco, California, USA
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11
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Emmet D, Roberts J, Yao KV. Update on Preventing Overuse Injuries in Youth Athletes. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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12
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Wu AC, Rauh MJ, DeLuca S, Lewis M, Ackerman KE, Barrack MT, Heiderscheit B, Krabak BJ, Roberts WO, Tenforde AS. Running-related injuries in middle school cross-country runners: Prevalence and characteristics of common injuries. PM R 2022; 14:793-801. [PMID: 34053194 DOI: 10.1002/pmrj.12649] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/11/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Understanding the prevalence and factors associated with running-related injuries in middle school runners may guide injury prevention. OBJECTIVE To determine the prevalence of running-related injuries and describe factors related to a history of injury. DESIGN Retrospective cross-sectional study. SETTING Survey distributed online to middle school runners. METHODS Participants completed a web-based survey regarding prior running-related injuries, training, sleep, diet, and sport participation. MAIN OUTCOME MEASUREMENTS Prevalence and characteristics differentiating girls and boys with and without running-related injury history adjusted for age. PARTICIPANTS Youth runners (total: 2113, average age, 13.2 years; boys: n = 1255, girls: n = 858). RESULTS Running-related injuries were more prevalent in girls (56% vs. 50%, p = .01). Ankle sprain was the most common injury (girls: 22.5%, boys: 21.6%), followed by patellofemoral pain (20.4% vs. 7.8%) and shin splints (13.6% vs. 5.9%); both were more prevalent in girls (p < .001). Boys more frequently reported plantar fasciitis (5.6% vs. 3.3%, p = .01), iliotibial band syndrome (4.1% vs. 1.4%, p = .001) and Osgood-Schlatter disease (3.8% vs. 1.2%, p = .001). Runners with history of running-related injuries were older, ran greater average weekly mileage, ran faster, had fewer average hours of sleep on weekends, skipped more meals, missed breakfast, and consumed less milk (all p < .05). Girls with history of running-related injuries reported higher dietary restraint scores, later age of menarche, more menstrual cycle disturbances, and higher likelihood of following vegetarian diets and an eating disorder diagnosis (all p < .05). Runners with no history of running-related injuries were more likely to have participated in ≥2 years of soccer or basketball (p < .001). CONCLUSIONS Most middle school runners reported a history of running-related injuries and certain injuries differing by gender. Modifiable factors with the greatest association with running-related injuries included training volume, dietary restraint, skipping meals, and less sleep. Sport sampling, including participation in ball sports, may reduce running-related injury risk in this population.
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Affiliation(s)
- Alexander C Wu
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Mitchell J Rauh
- Doctor of Physical Therapy Program, San Diego State University, San Diego, California, USA
| | - Stephanie DeLuca
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Margo Lewis
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn E Ackerman
- Sports Medicine, Boston Children's Hospital; Neuroendocrine Unit, Massachusetts General Hospital; and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Bryan Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison, Wisconsin, USA
| | - Brian J Krabak
- Rehabilitation, Orthopedics and Sports Medicine, University of Washington, Seattle, Washington, USA
| | - William O Roberts
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Adam S Tenforde
- Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
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Liu X, Imai K, Zhou X, Watanabe E. Influence of Ankle Injury on Subsequent Ankle, Knee, and Shoulder Injuries in Competitive Badminton Players Younger Than 13 Years. Orthop J Sports Med 2022; 10:23259671221097438. [PMID: 35647208 PMCID: PMC9134446 DOI: 10.1177/23259671221097438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/02/2022] [Indexed: 12/26/2022] Open
Abstract
Background: In recent years, there has been a trend in badminton toward more specialized training at an earlier age. Accompanying this trend is the increased frequency of injuries in young players. Ankle injury is the most common injury in pediatric sports; however, its influence on subsequent injuries is rarely considered. Purposes: To evaluate the incidence of ankle, knee, and shoulder injuries in youth badminton and to investigate the influence of ankle injuries on subsequent ankle, knee, and shoulder injuries. Study Design: Descriptive epidemiology study; Level of evidence, 3. Methods: A custom-designed questionnaire was used to survey Japanese players 7 to 12 years of age who attended national elementary school–level badminton tournaments between May and September 2019. Information including the players’ characteristics, training history, injuries in the previous 12 months, and ankle injury histories were collected. Logistic regression was used for analysis. Results: A total of 478 players were included in the study, with 71 ankle injuries, 74 knee injuries, and 48 shoulder injuries reported. The injury incidence rates (per 1000 hours of play) were 0.23 (95% CI, 0.18-0.29) for the ankle, 0.24 (95% CI, 0.19-0.30) for the knee, and 0.16 (95% CI, 0.11-0.20) for the shoulder; 90.1% of ankle injuries, 25.7% of knee injuries, and 33.3% of shoulder injuries were acute. Previous ankle injury was significantly associated with subsequent ankle injury (adjusted Odds Ratio (OR), 3.05; 95% CI, 1.54-6.07; P < .05), knee injury (adjusted OR, 2.03; 95% CI, 1.12-3.69; P < .05), and shoulder injury (adjusted OR, 2.46; 95% CI, 1.26-4.83; P < .05). Conclusion: The study results indicated that previous injury to the ankle significantly increased the occurrence of subsequent ankle, knee, and shoulder injuries. Emphasizing protection and prevention of ankle injuries may help lower future injury risk in young badminton players.
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Affiliation(s)
- Xiaoxuan Liu
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kazuhiro Imai
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan
| | - Xiao Zhou
- Department of Life Sciences, Graduate School of Arts and Sciences, University of Tokyo, Tokyo, Japan
| | - Eiji Watanabe
- Institute of Sport, Senshu University, Kawasaki, Kanagawa, Japan
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14
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Feng J, Kong H, McClellan C, Raney E, Foss M, Cowley J, Wick J. Pediatric orthopedic injury prevention for team sports post COVID-19. J Family Med Prim Care 2022; 11:833-838. [PMID: 35495833 PMCID: PMC9051720 DOI: 10.4103/jfmpc.jfmpc_1632_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/07/2021] [Accepted: 02/04/2022] [Indexed: 11/09/2022] Open
Abstract
Queries of youth orthopedic sports injuries from the U.S. National Electronic Surveillance System, a database from the Consumer Product Safety Commission, demonstrate decreased orthopedic injuries related to team sports during the COVID-19 pandemic, indicative of reduced sports participation. Multiple articles have shown that COVID-19 had a marked effect on the physical and psychological wellbeing of the youth. The lockdown resulted in a cessation in school attendance and sports activities, especially team sports. Though increased emphasis has been placed on children infected by COVID-19, less attention has been given to healthy children. Numerous articles discussed the physical and psychological benefits for the youth returning to physical activity and sports; however, few have addressed detraining and deconditioning concerns postpandemic. This article discusses a safe return to team sports for the youth experiencing physical and psychological changes related to the pandemic. Orthopedic injuries are anticipated to increase as restrictions are relaxed. A multidisciplinary team presents a review of common youth sports orthopedic injuries, a discussion of psychological issues youths have experienced during COVID and why sports participation is beneficial for youth, and a risk assessment for pain and limited range of motion for youth returning to sports. The intent of this article is to increase awareness of the physical and psychological changes experienced by youth due to their inability to participate in team sports during the pandemic. Family medicine and primary care providers need to recognize the increased risks for injury and proactively encourage the youth to return to sports in a safe manner.
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15
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Carsen S, Grammatopoulos G, Zaltz I, Ward L, Smit K, Beaulé PE. The Effects of Physical Activity on Physeal and Skeletal Development. JBJS Rev 2021; 9:01874474-202110000-00002. [PMID: 34637401 DOI: 10.2106/jbjs.rvw.21.00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
» There is increasing evidence in the literature regarding the important health impact of and risk factors for injury in youth sport. » Increasing pediatric and adolescent activity intensity, such as is seen in earlier single-sport focus and specialization, may be associated with morphological changes in the growing skeleton. » Chronic subacute injury to the developing physes in the active child can lead to stress on the growth plate and surrounding tissues that induces developmental morphological changes in the joint. » There is evidence to suggest that frequent participation in sports that place particular stress across the physes of the proximal humerus, the proximal femur, and the distal radius can be associated with an increased risk of inducing developmental and morphological changes that could lead to future joint dysfunction and premature degeneration. » Additional research is necessary to better define the pathoetiology of activity-mediated morphological changes, as well as to create and validate parameters for safe involvement in competitive physical activities.
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Affiliation(s)
- Sasha Carsen
- Division of Orthopaedic Surgery, CHEO (the Children's Hospital of Eastern Ontario), Ottawa, Ontario, Canada
| | | | - Ira Zaltz
- Department of Orthopedic Surgery, Beaumont Health, Royal Oak, Michigan
| | - Leanne Ward
- Division of Endocrinology, CHEO (the Children's Hospital of Eastern Ontario), Ottawa, Ontario, Canada
| | - Kevin Smit
- Division of Orthopaedic Surgery, CHEO (the Children's Hospital of Eastern Ontario), Ottawa, Ontario, Canada
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada
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16
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Quandt SA, Arnold TJ, Talton JW, Miles CM, Mora DC, Arcury TA, Daniel SS. Musculoskeletal injury symptoms among hired Latinx child farmworkers in North Carolina. Am J Ind Med 2021; 64:620-628. [PMID: 34002867 DOI: 10.1002/ajim.23255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/26/2021] [Accepted: 05/03/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Although children 10-17 years can be hired to work in agriculture, little research has addressed possible musculoskeletal injuries. Children may be at particular risk for these injuries because of the repetitive and load bearing nature of work tasks. Existing research relies on child workers to self-report musculoskeletal injuries. METHODS In 2017, 202 Latinx child farmworkers ages 10-17 employed across North Carolina completed survey interviews. In 2018, 145 of these children (94 [64.8%] current farmworkers) completed a physical examination and second interview. The examination obtained findings for upper and lower extremity as well as back injuries. RESULTS Positive indicators for musculoskeletal symptoms were few in either current or former child farmworkers. The knee was most common site for positive indicators with 15.4% of children having at least one. Combining all anatomical sites, 29.0% of children had at least one positive indicator, with no significant difference between current and former farmworkers. Overall, boys had significantly more indicators of knee injuries than girls (21.3% vs. 4.1%), indicators of ankle injuries were found only in the youngest workers (9.5% of children 11-13 years), and significantly fewer current farmworkers had indicators of lower back injuries than former farmworkers (6.4% vs. 17.7%). CONCLUSIONS Expectations of injuries come from previous studies using child farmworker self-reports, adult farmworker injury rates, and sports medicine pediatric findings. Hired child farmworkers may not perform activities as repetitious and load-bearing as children in sports training or adult farmworkers. Additional research using physical examination is needed to confirm these findings.
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Affiliation(s)
- Sara A. Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Taylor J. Arnold
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Christopher M. Miles
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Dana C. Mora
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
- Department of Community Medicine, National Research Center in Complementary and Alternative Medicine, NAFKAM, Faculty of Health Science UiT The Arctic University of Norway Tromsø Norway
| | - Thomas A. Arcury
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
| | - Stephanie S. Daniel
- Department of Family and Community Medicine Wake Forest School of Medicine Winston‐Salem North Carolina USA
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17
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Heath MR, Janosky JJ, Pegno A, Schachne JM, Fabricant PD. Age Is More Predictive of Safe Movement Patterns Than Are Physical Activity or Sports Specialization: A Prospective Motion Analysis Study of Young Athletes. Am J Sports Med 2021; 49:1904-1911. [PMID: 33914649 DOI: 10.1177/03635465211008562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Movement quality and neuromuscular balance are noted predictors of acute injury. Early sports specialization and extremely high activity levels have been linked to elevated risk of injury. PURPOSE To investigate for any relationships among quality of physical movement, quantity of physical activity, and degree of sports specialization in a healthy cohort of active children and adolescents. STUDY DESIGN Cross-sectional study with prospectively collected data. METHODS Healthy children between the ages of 10 and 18 years were recruited and completed the Hospital for Special Surgery Pediatric Functional Activity Brief Scale to assess quantity of physical activity and the Jayanthi scale to assess degree of sports specialization (high, score of 2 or 3; low, score of 0 or 1). Movement quality was assessed using motion analysis sensors during 5 repetitions of 4 different jumping and squatting motions, with a maximum score of 100 per participant. Independent-samples t tests were used to compare participants with high versus low specialization on physical activity and movement quality. A Spearman correlation was used to determine the relationship between quantity of physical activity and movement quality, and linear regression was used to assess for the effect of participant age on relevant covariables. RESULTS Final analyses included 147 participants (72% male) with a mean ± SD age of 13.4 ± 2.2 years. Participants who were highly specialized displayed better movement quality than did participants with low sports specialization (27.6 ± 14.0 vs 19.8 ± 10.1; P < .01). Participants who were highly specialized had significantly higher activity levels (24.6 ± 5.9 vs 18.1 ± 6.9; P < .001). Movement quality was moderately correlated with physical activity level (r = 0.335; P < .001). Physical activity; hours of organized sports activity; hours of free, unorganized physical activity; and specialization level were not significant predictors of movement quality when controlling for age. Age alone predicted 24.2% of the variance in the overall movement quality score (R2 = 0.242; B = 3.0; P < .001). CONCLUSION This study found that sports specialization and physical activity levels were not associated with movement quality when controlling for age, which was the most important variable predicting athletic movement quality. Although all participants displayed movement patterns that were associated with high risk for injury, overall movement quality improved with advancing chronological age. CLINICAL RELEVANCE All young athletes should ensure that neuromuscular training accompanies sport-specific training to reduce risk of injury.
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Affiliation(s)
| | | | - Angelo Pegno
- Hospital for Special Surgery, New York, New York, USA
| | - Jonathan M Schachne
- Hospital for Special Surgery, New York, New York, USA.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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18
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Constantinou D, Saragas NP, Ferrao PN. Bilateral Navicular Stress Fractures with Nonunion in an Adolescent Middle-Distance Athlete: A Case Report. Curr Sports Med Rep 2021; 20:236-241. [PMID: 33908907 DOI: 10.1249/jsr.0000000000000837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Demitri Constantinou
- Centre for Exercise Science and Sports Medicine and FIMS Collaborating Centre of Sports Medicine, Faculty of Health Sciences, University of the Witwatersrand, SOUTH AFRICA
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19
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Larraín C, Salinas M. LESIONES DEPORTIVAS POR SOBREUSO EN NIÑOS Y ADOLESCENTES. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Orejel Bustos A, Belluscio V, Camomilla V, Lucangeli L, Rizzo F, Sciarra T, Martelli F, Giacomozzi C. Overuse-Related Injuries of the Musculoskeletal System: Systematic Review and Quantitative Synthesis of Injuries, Locations, Risk Factors and Assessment Techniques. SENSORS (BASEL, SWITZERLAND) 2021; 21:2438. [PMID: 33916269 PMCID: PMC8037357 DOI: 10.3390/s21072438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/19/2022]
Abstract
Overuse-related musculoskeletal injuries mostly affect athletes, especially if involved in preseason conditioning, and military populations; they may also occur, however, when pathological or biological conditions render the musculoskeletal system inadequate to cope with a mechanical load, even if moderate. Within the MOVIDA (Motor function and Vitamin D: toolkit for risk Assessment and prediction) Project, funded by the Italian Ministry of Defence, a systematic review of the literature was conducted to support the development of a transportable toolkit (instrumentation, protocols and reference/risk thresholds) to help characterize the risk of overuse-related musculoskeletal injury. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to analyze Review papers indexed in PubMed and published in the period 2010 to 2020. The search focused on stress (overuse) fracture or injuries, and muscle fatigue in the lower limbs in association with functional (biomechanical) or biological biomarkers. A total of 225 Review papers were retrieved: 115 were found eligible for full text analysis and led to another 141 research papers derived from a second-level search. A total of 183 papers were finally chosen for analysis: 74 were classified as introductory to the topics, 109 were analyzed in depth. Qualitative and, wherever possible, quantitative syntheses were carried out with respect to the literature review process and quality, injury epidemiology (type and location of injuries, and investigated populations), risk factors, assessment techniques and assessment protocols.
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Affiliation(s)
- Amaranta Orejel Bustos
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valeria Belluscio
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Leandro Lucangeli
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System (BOHNES), Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (A.O.B.); (V.B.); (V.C.); (L.L.)
| | - Francesco Rizzo
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Tommaso Sciarra
- Joint Veterans Defence Center, Army Medical Center, 00184 Rome, Italy; (F.R.); (T.S.)
| | - Francesco Martelli
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
| | - Claudia Giacomozzi
- Department of Cardiovascular and Endocrine-Metabolic Diseases and Aging, Italian National Institute of Health, 00161 Rome, Italy;
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21
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Jungesblut OD, Berger-Groch J, Hoffmann M, Schroeder M, Krajewski KL, Stuecker R, Rupprecht M. Electromagnetic navigation reduces radiation exposure for retrograde drilling in osteochondrosis dissecans of the talus. BMC Musculoskelet Disord 2021; 22:135. [PMID: 33536008 PMCID: PMC7860038 DOI: 10.1186/s12891-021-04010-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Retrograde drilling in osteochondrosis dissecans (OCD) is a widely used surgical intervention. A radiation-free electromagnetic navigation system (ENS)-based method was compared with the standard freehand fluoroscopic (SFF) method regarding clinical applicability. Methods We performed a clinical cohort study at a department of Orthopaedics in a Level 1 children’s hospital with 40 patients (20 SFF and 20 ENS). Retrograde drilling of the talar dome was used in patients with unstable medial OCD (MRI stage 2 according to Hepple’s revised classification; stage 2 according to the International Cartilage Repair Society). The outcome measurements were: (a) Intraoperative fluoroscopy exposure and length of surgery and (b) Postoperative serial follow-up MRIs every 6 months. Results 22 female and 18 male patients aged 13.8 ± 1.6 years (range: 11–17 years) were included. Using the ENS technique, length of surgery was significantly reduced to 20.2 ± 6.4 min compared to 36.1 ± 11.8 min (p < 0.01) for the SFF technique. The average x-ray radiation time for the SFF technique was 23.5 ± 13.5 sec and 1.9 ± 1.7 sec for the ENS technique (p < 0.01). Radiation exposure was significantly reduced from 44.6 ± 19.7 mSv (SFF technique) to 5.6 ± 2.8 mSv (ENS technique) (p < 0.01). Intraoperative perforation of cartilage occurred once in the SFF group. Correct placement of the drilling channel was verified in all patients on follow-up MRI after six months and a timely healing was seen after two years. Conclusions The ENS method provides for a significant reduction in length of surgery and radiation exposure. ENS was without intraoperative cartilage perforation. The clinical and radiological follow-up parameters are comparable for SFF- and ENS-guided retrograde drilling. Trial registration WF – 085/20, 05/2020 “retrospectively registered” https://www.aerztekammer-hamburg.org/ethik_kommission.html.
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Affiliation(s)
- Oliver D Jungesblut
- Department of Pediatric Orthopedics, Altonaer Children's Hospital, Bleickenallee 38, 22763, Hamburg, Germany.,Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Josephine Berger-Groch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Michael Hoffmann
- Department of Trauma-, Orthopaedic Surgery and Sports Medicine , Asklepios Hospital St. Georg , Lohmühlenstr. 5, 20099, Hamburg, Germany
| | - Malte Schroeder
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Kara L Krajewski
- Department of Pediatric Orthopedics, Altonaer Children's Hospital, Bleickenallee 38, 22763, Hamburg, Germany
| | - Ralf Stuecker
- Department of Pediatric Orthopedics, Altonaer Children's Hospital, Bleickenallee 38, 22763, Hamburg, Germany.,Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Rupprecht
- Department of Pediatric Orthopedics, Altonaer Children's Hospital, Bleickenallee 38, 22763, Hamburg, Germany.,Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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22
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Carder SL, Giusti NE, Vopat LM, Tarakemeh A, Baker J, Vopat BG, Mulcahey MK. The Concept of Sport Sampling Versus Sport Specialization: Preventing Youth Athlete Injury: A Systematic Review and Meta-analysis. Am J Sports Med 2020; 48:2850-2857. [PMID: 31961703 DOI: 10.1177/0363546519899380] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The prevalence of youth athletes specializing in 1 sport has been increasing over the past decade. Subsequently, the rate of youth athlete injury has also been increasing. It is possible that an association exists between youth specialization and sports injury rate. PURPOSE To determine if sport sampling is associated with a lower sports injury rate in youths compared with youths who specialize in 1 sport. STUDY DESIGN Systematic review and meta-analysis. METHODS A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Embase, and the Cochrane library. Inclusion criteria included studies written in the English language, studies with athletes between 7 and 18 years of age, studies that report injury rates, and studies that specify if athletes were sport samplers or specialized in a sport. Data relevant to this study, including injuries and patient characteristics, were extracted and statistically analyzed. RESULTS The initial search identified 324 studies, 6 of which met inclusion criteria. From these 6 studies, the total participant number was 5736. Of those, 2451 (42.7%) were "sport samplers," 1628 (28.4%) were "sport specializers," and 1657 (28.9%) were considered "others" (ie, could not be classified as true samplers or true specializers). The average age of all the athletes was 14.6 years (range, 7-18 years). Sport specializers had a significantly higher injury risk than the sport samplers (RR, 1.37; 95% CI, 1.19-1.57; P < .0001). There was a higher risk of injury in the "others" group when compared with the "sport sampler" group (RR, 1.21; 95% CI, 1.14-1.29; P < .0001). There was a higher risk of injury in the "sport specializer" group over the "others" group (RR, 1.09; 95% CI, 1.04-1.14; P < .005). CONCLUSION Sport sampling is associated with a decreased risk of sports injury in youth athletes when compared with those who specialize in 1 sport. Injury rates increase as a youth athlete becomes increasingly specialized. Youth athletes would benefit substantially from participating in sport sampling.
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Affiliation(s)
- Seth L Carder
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Nicolas E Giusti
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Lisa M Vopat
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Armin Tarakemeh
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jordan Baker
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Bryan G Vopat
- The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Mary K Mulcahey
- Tulane University School of Medicine, New Orleans, Louisiana, USA
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23
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Affiliation(s)
| | - William Hennrikus
- Penn State College of Medicine, 30 Hope Drive, Hershey, PA 17033, USA.
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24
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Knapik DM, Rizzone KH, Voos JE. Timing and Reasons Behind Single-Sport Specialization in Soccer: A Survey of 64 Major League Soccer Athletes. Sports Health 2020; 12:355-360. [PMID: 32286914 DOI: 10.1177/1941738120911373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Single-sport specialization at the exclusion of other sports has become increasingly popular in youth sporting culture. The purpose of this study was to survey Major League Soccer (MLS) athletes to examine factors influencing the timing of single-sport specialization in soccer. HYPOTHESIS The majority of surveyed athletes will have participated in multiple sports prior to specialization and specialized primarily as a result of a coach's recommendation, with no significant impact on specialization timing stemming from birth or high school location, obtaining a collegiate scholarship, MLS experience, or position. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 4. METHODS Anonymous surveys were distributed to 3 MLS organizations and completed by MLS athletes during preseason physicals. Surveys evaluated the age and reason(s) behind an athlete's decision to specialize in soccer, birth location, geographic high school location for US-born athletes, participation in a developmental league, college scholarship, years in the MLS, and position played. RESULTS Approximately 74% (64/86) of athletes returned completed surveys. Athletes reported beginning soccer at a mean age of 5.1 ± 2.1 years and specializing at age 12.6 ± 4.3 years. Athletes who participated in no other sports prior to specialization (P < 0.001), athletes reporting soccer to be their first sport played at an advanced level (P < 0.001), and athletes receiving a college scholarship (P = 0.02) specialized at a significantly younger age. Internationally born athletes specialized at significantly younger ages when compared with US-born athletes (P < 0.001). CONCLUSION The majority of athletes participated in multiple sports prior to specialization and eventually specialized to focus exclusively on soccer. The timing of sport specialization in professional MLS athletes was not associated with multisport participation prior to specialization, playing soccer at an advanced level prior to other sports, receiving a college scholarship, or being born outside the United States. CLINICAL RELEVANCE Timing of sport specialization is associated with multiple factors prior to athlete promotion to the MLS that warrant further investigation to better understand the impact of specialization on injury incidence, performance, and career length.
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Affiliation(s)
- Derrick M Knapik
- University Hospitals Sports Medicine Institute, Cleveland, Ohio.,Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - James E Voos
- University Hospitals Sports Medicine Institute, Cleveland, Ohio.,Department of Orthopaedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
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25
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Abstract
Fractures are common in children, although accurate diagnosis is confounded by mimics of fractures some of which are unique to the pediatric population. Such fracture mimics include developmental variations of the growth plates, normal anatomic structures that simulate fracture lines, and/or metabolic disorders that alter the pattern of ossification. Although subtle clues on plain radiographs may help to discriminate between a true fracture or injury and a fracture mimic, MR imaging may be helpful to eliminate uncertainty or expedite diagnosis.
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Affiliation(s)
- Sarah D Bixby
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Main 2, 300 Longwood Avenue, Boston, MA 02115, USA.
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26
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MR imaging of the shoulder in youth baseball players: Anatomy, pathophysiology, and treatment. Clin Imaging 2019; 57:99-109. [DOI: 10.1016/j.clinimag.2019.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/01/2019] [Accepted: 05/13/2019] [Indexed: 12/18/2022]
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27
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Nguyen JC, Lin B, Potter HG. Maturation-dependent findings in the shoulders of pediatric baseball players on magnetic resonance imaging. Skeletal Radiol 2019; 48:1087-1094. [PMID: 30607454 DOI: 10.1007/s00256-018-3130-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/15/2018] [Accepted: 12/03/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To compare the prevalence and characteristics of shoulder osseous and soft tissue findings on magnetic resonance imaging (MRI) with respect to skeletal maturation in symptomatic pediatric baseball players without a history of acute trauma. METHODS The IRB-approved, HIPAA-compliant retrospective study analyzed 87 consecutive pediatric baseball players (86 boys and 1 girl; mean age, 15.4 ± 2.1 years) with shoulder MRI performed between March 1, 2012 and September 30, 2017. In consensus, two radiologists assessed the MRI studies for findings involving the humerus, the glenoid, the labrum, the rotator cuff, and the acromioclavicular joint. Exact Cochran-Armitage trend and Mantel-Haenszel Chi-square tests were used to investigate the association between these findings and skeletal maturation. RESULTS The mean ages between players who are skeletally immature (37 shoulders), maturing (26 shoulders), and matured (24 shoulders) were significantly different (p < 0.001). Bone marrow edema (p < 0.001) and sclerosis (p < 0.001) within the proximal humeral metaphysis decreased with skeletal maturation. Glenoid remodeling (p = 0.038) was more severe in the skeletally immature players and the prevalence of Bennett lesions (p = 0.048) increased with skeletal maturation. The prevalence of labral tears, rotator cuff tendinosis, and acromioclavicular joint separation did not significantly change with skeletal maturation. CONCLUSIONS The change in the prevalence of findings within the proximal humerus and glenoid with skeletal maturation suggest differences in the distribution of stress within the shoulders of pediatric baseball players during development.
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Affiliation(s)
- Jie C Nguyen
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Bin Lin
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA
| | - Hollis G Potter
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th street, New York, NY, 10021, USA
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Valasek AE, Young JA, Huang L, Singichetti B, Yang J. Age and Sex Differences in Overuse Injuries Presenting to Pediatric Sports Medicine Clinics. Clin Pediatr (Phila) 2019; 58:770-777. [PMID: 30897956 DOI: 10.1177/0009922819837360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pediatric overuse injuries present with a gradual mechanism of onset and an underlying pathogenesis of microtrauma. We evaluated the clinical presentation of pediatric sports injuries to determine if differences exist between age and sex. A retrospective chart review was performed over a 6-year period; 6593 overuse injuries were included with the mean age of 13.4 years. Males presented with a greater proportion of apophysis, physis, and articular cartilage injuries ( P < .01). Females presented with greater bone, tendon, and "other" injuries ( P < .01). Children <9 years of age demonstrated apophysis and physis injuries. Conversely, children older than 15 years of age presented with tendon, bone, bursa, and other ( P < .01) overuse injuries. A significant number of pediatric athletes in this cohort reported playing through pain prior to clinical evaluation. Injury prevention programs need to educate children, and a red flag should be raised when pediatric athletes are participating with pain.
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Affiliation(s)
- Amy Elizabeth Valasek
- 1 Nationwide Children's Hospital, Columbus, OH, USA.,2 The Ohio State University, Columbus, OH, USA
| | | | - Lihong Huang
- 1 Nationwide Children's Hospital, Columbus, OH, USA.,2 The Ohio State University, Columbus, OH, USA
| | - Bhavna Singichetti
- 1 Nationwide Children's Hospital, Columbus, OH, USA.,2 The Ohio State University, Columbus, OH, USA
| | - Jingzhen Yang
- 1 Nationwide Children's Hospital, Columbus, OH, USA.,2 The Ohio State University, Columbus, OH, USA
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Ramkumar PN, Navarro SM, Luu BC, Haeberle HS, Karnuta JM, Stearns KL, Soloff L, Frangiamore SJ, Schickendantz MS. Epidemiology and Impact of Prior Musculoskeletal Injury and Orthopaedic Surgery on Draft Rank, Availability, and Short-term Performance in Major League Baseball: A Summary Analysis and Matched Cohort of 1890 Predraft Players. Orthop J Sports Med 2019; 7:2325967119844268. [PMID: 31106223 PMCID: PMC6501485 DOI: 10.1177/2325967119844268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Despite the many reports of injury rates in Major League Baseball (MLB), little is known about the epidemiology or impact of prior musculoskeletal injuries and surgical procedures among players entering the MLB draft. Purpose: To determine the (1) epidemiology of all musculoskeletal injuries and surgical procedures among players entering the MLB draft, (2) impact of injury or surgery on draft rank, (3) impact of injury or surgery on availability within the first 2 years of play in the MLB, and (4) impact of injury or surgery on performance. Study Design: Cohort study; Level of evidence, 3. Methods: We retrospectively reviewed 1890 medical records that were completed by MLB team physicians as preparticipation physical assessment prior to the draft from 2014 to 2018. Players were divided into 3 groups: noninjured, nonoperative, and operative. Draft status, overall draft rank, missed games, batting average, and earned run average for the first 2 seasons of MLB play were obtained for all available players. Players across all 3 groups were compared with linear, logistic, and beta regression models, controlling for age, position, injury status, and draft rank. Unadjusted differences among groups were assessed with 1-way analysis of variance. Results: Overall, 750 position players and 1140 pitchers were included, of whom 22.8% had no reported injury history; 48.8% reported injury treated nonoperatively; and 28.5% were treated operatively. The most common predraft injuries were elbow tendinitis (n = 312), ulnar collateral ligament injury (n = 212), and shoulder labral tear (n = 76). The most common predraft treatments were physical therapy (n = 922), ulnar collateral ligament reconstruction (n = 115), and fracture fixation (n = 69). Of the 1890 players, 719 were drafted and played for at least 2 years. No difference was found among noninjured, nonoperative, and operative groups in terms of draft rank, games missed, or performance. Players with a nonoperative injury had a decreased odds ratio of being drafted (0.738; P = .017). Conclusion: More than half of the players entering the MLB reported a history of musculoskeletal injury requiring treatment, and the most commonly affected joints were the shoulder and elbow. Musculoskeletal history did not affect draft rank, short-term availability, or performance for MLB prospects.
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Affiliation(s)
| | | | - Bryan C Luu
- Baylor College of Medicine, Houston, Texas, USA
| | | | | | | | - Lonnie Soloff
- Cleveland Indians Professional Baseball Organization, Cleveland, Ohio, USA
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Abstract
PURPOSE OF REVIEW Provide a comprehensive overview of lumbar spondylolysis, a frequent cause of lower back pain in children and adolescents, from evaluation to management. RECENT FINDINGS With the surge of structured sports participation in the pediatric population, spondylolysis is a common ailment that afflicts many young athletes due to rigorous competition that taxes the growing spine with repetitive extension and rotation. SUMMARY Spondylolysis is a fracture through the pars interarticularis. When a child presents with lower back pain, spondylolysis should be at the top of the differential. A thorough history and physical examination are essential. In addition, radiographs of the lumbar spine, anterior posterior and lateral views, MRI and, selectively, computed tomography are useful adjuncts to uncover a pars injury. Timely diagnosis facilitates early treatment which includes rest, optimizing bone health, brace treatment, and physical therapy. If delayed or untreated, spondylolysis may result in nonunion or pars defect. If symptomatic, patients may need surgery to fuse the lumbar facet joints or repair the par interarticularis.
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Bell DR, Post EG, Biese K, Bay C, Valovich McLeod T. Sport Specialization and Risk of Overuse Injuries: A Systematic Review With Meta-analysis. Pediatrics 2018; 142:peds.2018-0657. [PMID: 30135085 DOI: 10.1542/peds.2018-0657] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Sport specialization is theorized to increase the risk of sustaining overuse musculoskeletal injuries. OBJECTIVE To complete a systematic review and meta-analysis of the literature to determine if sport specialization is associated with overuse musculoskeletal injuries. DATA SOURCES An electronic search was conducted using the search terms "specialization," "year-round," "overuse," "repetitive stress," "injury," "young," "pediatric," and "sports." STUDY SELECTION Studies were included if their population was ≤18 years of age, if they compared athletes with high or single-sport specialization with athletes with low or multisport specialization, and focused on overuse injuries. DATA EXTRACTION Of the 12 articles that were identified for full-text review, 5 studies met all the inclusion criteria. Four studies provided adequate data for the meta-analysis. Quality scores on the modified Downs and Black scale ranged from 69% to 81%. RESULTS Athletes with high specialization were at an increased risk of sustaining an overuse injury compared with athletes with low (pooled relative risk [RR] ratio: 1.81; 95% confidence interval [CI]: 1.26-2.60) and moderate (pooled RR: 1.18; 95% CI: 1.05-1.33) specialization. Athletes with moderate specialization were at a higher risk of injury compared with athletes with low specialization (RR: 1.39 [95% CI: 1.04-1.87]). LIMITATIONS Four of the 5 studies included in this systematic review were included in the meta-analysis because of the lack of access to the original data set for 1 article. CONCLUSIONS Sport specialization is associated with an increased risk of overuse musculoskeletal injuries (Strength of Recommendation Taxonomy grade: B).
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Affiliation(s)
- David R Bell
- Wisconsin Injury in Sport Laboratory and .,Departments of Kinesiology and.,Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Eric G Post
- Wisconsin Injury in Sport Laboratory and.,Departments of Kinesiology and
| | - Kevin Biese
- Wisconsin Injury in Sport Laboratory and.,Departments of Kinesiology and
| | - Curtis Bay
- Athletic Training Department, A.T. Still University, Mesa, Arizona
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Abstract
Chronic musculoskeletal pain (CMP) is one of the main reasons for referral to a pediatric rheumatologist and is the third most common cause of chronic pain in children and adolescents. Causes of CMP include amplified musculoskeletal pain, benign limb pain of childhood, hypermobility, overuse syndromes, and back pain. CMP can negatively affect physical, social, academic, and psychological function so it is essential that clinicians know how to diagnose and treat these conditions. This article provides an overview of the epidemiology and impact of CMP, the steps in a comprehensive pain assessment, and the management of the most common CMPs.
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Affiliation(s)
- Jennifer E Weiss
- Pediatric Rheumatology, Seton Hall School of Medicine, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601, USA.
| | - Jennifer N Stinson
- Research Institute, Child Health Evaluative Sciences, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
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33
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Nguyen JC, Markhardt BK, Merrow AC, Dwek JR. Imaging of Pediatric Growth Plate Disturbances. Radiographics 2018; 37:1791-1812. [PMID: 29019753 DOI: 10.1148/rg.2017170029] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The growth plates, or physes, are visible on virtually all images obtained in skeletally immature children. The proper function of these growth plates depends on an intricate balance between chondrocyte proliferation, which requires nourishment from the epiphyseal vessels, and chondrocyte death, which requires the integrity of the metaphyseal vessels. Therefore, injury to the growth plate (ie, direct insult) or vascular compromise on either side of the growth plate (ie, indirect insult) can cause growth plate dysfunction. Direct growth plate insults occur most commonly with Salter-Harris fractures, and injuries that allow the transphyseal communication of vessels are at a higher risk for subsequent transphyseal bone bridge formation. Indirect insults lead to different sequelae that are based on whether the epiphyseal blood supply or metaphyseal blood supply is compromised. Epiphyseal osteonecrosis can result in slowed longitudinal bone growth, with possible growth plate closure, and is often accompanied by an abnormal secondary ossification center. In contrast, the disruption of metaphyseal blood supply alters endochondral ossification and allows the persistence of chondrocytes within the metaphysis, which appear as focal or diffuse growth plate widening. Imaging remains critical for detecting acute injuries and identifying subsequent growth disturbances. Depending on the imaging findings and patient factors, these growth disturbances may be amenable to conservative or surgical treatment. Therefore, an understanding of the anatomy and physiologic features of the normal growth plate and the associated pathophysiologic conditions can increase diagnostic accuracy, enable radiologists to anticipate future growth disturbances, and ensure optimal imaging, with the ultimate goal of timely and appropriate intervention. ©RSNA, 2017.
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Affiliation(s)
- Jie C Nguyen
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.C.N., B.K.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); and Department of Radiology, University of California at San Diego, Rady Children's Hospital and Health Center, San Diego, Calif (J.R.D.)
| | - B Keegan Markhardt
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.C.N., B.K.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); and Department of Radiology, University of California at San Diego, Rady Children's Hospital and Health Center, San Diego, Calif (J.R.D.)
| | - Arnold C Merrow
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.C.N., B.K.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); and Department of Radiology, University of California at San Diego, Rady Children's Hospital and Health Center, San Diego, Calif (J.R.D.)
| | - Jerry R Dwek
- From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (J.C.N., B.K.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (A.C.M.); and Department of Radiology, University of California at San Diego, Rady Children's Hospital and Health Center, San Diego, Calif (J.R.D.)
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Patel DR, Yamasaki A, Brown K. Epidemiology of sports-related musculoskeletal injuries in young athletes in United States. Transl Pediatr 2017; 6:160-166. [PMID: 28795006 PMCID: PMC5532190 DOI: 10.21037/tp.2017.04.08] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Over the past several decades there has been increased participation in sports by children and adolescents at earlier ages in the United States, as well as more intense participation and specialization in sports at very early ages. This trend has also partly contributed to the patterns of injuries seen in young athletes, and especially in recent years, injuries previously seen in mature athletes are being seen in young athletes. Overall, the vast majority of sport-related musculoskeletal injuries in children and adolescents are due to repetitive overuse and acute macrotrauma is less frequently seen in young athletes. Epidemiological data on sports injuries are provided by several national surveys. Investigators have used different methods to define sports injuries and the most widely used definition is based on athlete-exposure time. Certain aspects related to adolescent growth and development modulate the pattern of injuries. This article provides an overview of the epidemiology of sports-related musculoskeletal injuries seen in children and adolescents.
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Affiliation(s)
- Dilip R Patel
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Ai Yamasaki
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | - Kelly Brown
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
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35
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Patel DR, Villalobos A. Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Transl Pediatr 2017; 6:190-198. [PMID: 28795010 PMCID: PMC5532199 DOI: 10.21037/tp.2017.04.05] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Recurrent or chronic activity related knee pain is common in young athletes. Numerous intrinsic conditions affecting the knee can cause such pain. In addition, knee pain can be referred pain from low back, hip or pelvic pathology. The most common cause of knee pain in young athletes is patellofemoral pain syndrome, or more appropriately termed idiopathic anterior knee pain. Although, numerous anatomical and biomechanical factors have been postulated to contribute the knee pain in young athletes, the most common underlying reason is overuse injury. In this paper, we have reviewed selected conditions that case knee pain in athletes, including anterior knee pain syndrome, Osgood-Schlatter disease, Sinding-Larsen-Johanssen syndrome, juvenile osteochondritis dissecans (JOCD), bipartite patella, plica syndrome, and tendonitis around the knee.
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Affiliation(s)
- Dilip R Patel
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan 49008, USA
| | - Ana Villalobos
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan 49008, USA
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