Sports injuries in children

Overuse Physeal Injuries in Youth Athletes

Context:

Despite rising awareness of the risks associated with sports participation, overuse injuries continue to increase in youth athlete populations. Physeal injuries are one type of overuse injury exclusive to pediatric populations that are often sustained during athletic practice or competition. Overuse physeal injuries are, in theory, preventable; however, little consensus has been reached surrounding the risk factors, prevention, and treatment strategies.

Objective:

This systematic review summarizes the best available evidence concerning overuse physeal injuries in youth and adolescent athletes. It can be used to develop prevention and treatment programs specific to this population.

Data Sources:

PubMed and Academic Search Complete (EBSCOhost) were explored using the keyword physeal injuries from January 1950 through May 2015 to identify 24 studies.

Study Selection:

Original research studies of athletic populations with mechanisms of injury related to sport were chosen.

Study Design:

Systematic review.

Level of Evidence:

Level 3.

Data Extraction:

Data were extracted as available from 24 eligible studies. Study quality was rated using the Oxford Centre for Evidence-based Medicine (OCEBM) guidelines.

Results:

Risk factors for injury include periods of accelerated growth, chronological age, body size, training volume, and previous injury. Injury prevention strategies currently emphasize participation limitations and sport-specific training programs in skeletally immature athletes. The most effective treatment after an overuse physeal injury was an extended period of active rest and joint immobilization when necessary.

Conclusion:

Overuse physeal injuries are multifactorial in nature. Muscular imbalances after accelerated growth periods predispose young athletes to overuse injuries. Modifiable risk factors such as flexibility, strength, and training volume should be regularly monitored to prevent these injuries.

Glenohumeral and Hip Range-of-Motion and Strength Measures in Youth Baseball Athletes

CONTEXT

The repetitive demands of throwing affect glenohumeral (GH) range of motion (ROM) and strength. Less is known about hip alterations in skeletally immature athletes.

OBJECTIVE

To compare GH and hip ROM and strength between age, position, and side of youth baseball athletes.

DESIGN

Cross-sectional study.

SETTING

Multicenter testing.

PATIENTS OR OTHER PARTICIPANTS

Seventy-two healthy baseball athletes. Participants' self-reported characteristics were age group (7-11 years [n = 28] or 12-18 years [n = 44]), position (pitcher [n = 22], position player [n = 47], unreported [n = 3]), and side (throwing or nonthrowing arm, lead or stance leg).

MAIN OUTCOME MEASURE(S)

Bilateral GH and hip internal- and external-rotation ROM were measured passively and summed for total arc of motion (TAM). Glenohumeral and hip rotation and gluteus medius strength were measured. Analyses included linear mixed models.

RESULTS

Glenohumeral internal rotation was less in throwing than in nonthrowing arms (P < .05) except in younger pitchers (P = .86). Compared with older athletes, younger athletes had more GH external rotation (103.3° ± 7.7° versus 97.5° ± 9.4°; P = .002), TAM (156.4° ± 8.7° versus 147.9° ± 10.9°; P = .04), and external rotation in throwing compared with nonthrowing arms (101.9° ± 1.2° versus 97.9° ± 1.1°; P < .001). Glenohumeral TAM was less in throwing than in nonthrowing arms (150.5° ± 2.1° versus 154.9° ± 1.3°; P = .01). Younger athletes had more hip internal rotation (38.9° ± 6.8° versus 31.2° ± 7.5°; P < .001) and TAM (68.4° ± 10.0° versus 60.7° ± 9.8°; P = .001) than older athletes. Lead-leg hip internal-rotation ROM was greater than in the stance leg (34.8° ± 8.9° versus 32.8° ± 7.7°; P = .01). Overall, older players were stronger than younger players (P < .05), and the throwing arm was stronger in internal rotation than the nonthrowing arm (10.12 ± 3.72 lb [4.59 ± 1.69 kg] versus 9.43 ± 3.18 lb [4.28 ± 1.44 kg]; P = .047).

CONCLUSIONS

Youth baseball athletes had typical GH ROM adaptations of less internal rotation and more external rotation in the throwing versus the nonthrowing arm. Greater ROM in younger athletes may be explained by prepubertal characteristics. We obtained hip-strength values in youth baseball athletes, and as expected, older athletes were stronger.

Sports injury pattern in school going children in Union Territory of Chandigarh

OBJECTIVE

To determine incidence of various types of sport injuries and other associated factors, among competitive sports playing school children of Chandigarh.

DESIGN

This study is a survey based study, and spanned for a period of one year. School going students in age group 11-18 years of Chandigarh (Union Territory) India, who were in competitive sports, were included for this survey after taking informed consent from concerned school authorities. 33 schools consisting of 36.165 students were analysed in the study, 7230 students were found to participate in 40 different categories of sports.

RESULTS

Total of 246 filled questionnaires were analyzed making it an injury frequency of 3.40% among 7230 participating young athletes in 12 months study duration. Estimated incidence rate, considering hours of exposure in practice, came out to be 48.07 injuries per 1000 h of exposure in practice among 246 injured cases. 40.2% of the injured children (99/246) attributed their injury to poor ground condition while other 30.5% (75/246) to faulty techniques. Rest attributed their injuries to poor fitness levels, improper use of equipment and other reasons. Of the 33 schools surveyed, 27.3% (9/33) had a doctor as health professional, 9.1% (2/33) had a physiotherapist while 66.6% of the schools (22/33) had no health care professional.

CONCLUSION

The incidence of sports injuries in the region is high as compared to the global data. The findings has highlighted the need for a nationwide surveillance system and then taking appropriate measures for future injury prevention and appropriate management.