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O'Dell MC, Jaramillo D, Bancroft L, Varich L, Logsdon G, Servaes S. Imaging of Sports-related Injuries of the Lower Extremity in Pediatric Patients. Radiographics 2017; 36:1807-1827. [PMID: 27726754 DOI: 10.1148/rg.2016160009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports. However, some injuries that occur almost exclusively in high-level athletes (eg, athletic pubalgia) are reviewed to increase awareness and understanding of these entities among pediatric radiologists who may not be familiar with them and thus may not look for them. Injuries are described according to their location (ie, hip, knee, or foot and ankle) and pathologic process (eg, apophysitis, osteochondritis dissecans). Examples of abnormalities and normal variants of the anatomy that are often misdiagnosed are provided. The injuries reviewed represent a common and growing subset of pathologic processes about which all pediatric and musculoskeletal radiologists should be knowledgeable. Understanding physeal injury is especially important because missed diagnoses can lead to premature physeal closure and osteoarthritis. ©RSNA, 2016.
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Affiliation(s)
- M Cody O'Dell
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
| | - Diego Jaramillo
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
| | - Laura Bancroft
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
| | - Laura Varich
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
| | - Gregory Logsdon
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
| | - Sabah Servaes
- From the Department of Radiology, Florida Hospital, University of Central Florida College of Medicine, 601 E Rollins St, Orlando, FL 32803 (M.C.O., L.B., L.V., G.L.); Department of Radiology, VA Palo Alto Health Care System, Stanford University Medical Center, Palo Alto, Calif (D.J.); and Department of Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa (S.S.)
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Popkin CA, Schulz BM, Park CN, Bottiglieri TS, Lynch TS. Evaluation, management and prevention of lower extremity youth ice hockey injuries. Open Access J Sports Med 2016; 7:167-176. [PMID: 27920584 PMCID: PMC5123732 DOI: 10.2147/oajsm.s118595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ice hockey is a fast-paced sport played by increasing numbers of children and adolescents in North America and around the world. Requiring a unique blend of skill, finesse, power and teamwork, ice hockey can become a lifelong recreational activity. Despite the rising popularity of the sport, there is ongoing concern about the high frequency of musculoskeletal injury associated with participation in ice hockey. Injury rates in ice hockey are among the highest in all competitive sports. Numerous research studies have been implemented to better understand the risks of injury. As a result, rule changes were adopted by the USA Hockey and Hockey Canada to raise the minimum age at which body checking is permitted to 13–14 years (Bantam level) from 11–12 years (Pee Wee). Continuing the education of coaches, parents and players on rules of safe play, and emphasizing the standards for proper equipment use are other strategies being implemented to make the game safer to play. The objective of this article was to review the evaluation, management and prevention of common lower extremity youth hockey injuries.
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Affiliation(s)
- Charles A Popkin
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | | | - Caroline N Park
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - Thomas S Bottiglieri
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
| | - T Sean Lynch
- Department of Orthopedic Surgery, Center for Shoulder, Elbow and Sports Medicine at Columbia University, New York, NY
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Quinn SL, Olivier B, Wood WA. The short-term effects of trigger point therapy, stretching and medicine ball exercises on accuracy and back swing hip turn in elite, male golfers - A randomised controlled trial. Phys Ther Sport 2016; 22:16-22. [PMID: 27579803 DOI: 10.1016/j.ptsp.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 02/29/2016] [Accepted: 04/01/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to compare the effect of myofascial trigger point therapy (MTPT) and stretching, MTPT and medicine ball exercises, and no intervention, on hip flexor length (HFL), golf swing biomechanics and performance in elite, male golfers. DESIGN Single blind, randomised controlled trial with two experimental groups (stretch group: MTPT and stretching; and the ball group: MTPT, a single stretch and medicine ball exercises) and one control group (no intervention). SETTING Professional golf academy. PARTICIPANTS One hundred, elite, male golfers aged 16-25 years. MAIN OUTCOME MEASURES HFL, 3D biomechanical analysis of the golf swing, club head speed (CHS), smash ratio, accuracy and distance at baseline and after the interventions. RESULTS Backswing hip turn (BSHT) improved in the ball group relative to the control group (p = 0.0248). Accuracy in the ball group and the stretch group improved relative to the control group (Fisher's exact = 0.016). CONCLUSIONS Other performance parameters such as: smash ratio, distance and CHS were not compromised by either intervention. This study advocates the use of MTPT combined with medicine ball exercises over MTPT combined with stretching in the treatment of golfers with shortened hip flexors - even immediately preceding a tournament.
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Affiliation(s)
- Samantha-Lynn Quinn
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
| | - Benita Olivier
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
| | - Wendy-Ann Wood
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa.
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Wall PDH, Fernandez M, Griffin DR, Foster NE. Nonoperative treatment for femoroacetabular impingement: a systematic review of the literature. PM R 2013; 5:418-26. [PMID: 23419746 DOI: 10.1016/j.pmrj.2013.02.005] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 02/08/2013] [Accepted: 02/12/2013] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Femoroacetabular impingement (FAI) has been identified as a common cause of hip pain in young adults. However, it is not known whether an effective nonoperative treatment exists and whether there is any evidence to support such a treatment. The purpose of this review is to establish whether nonoperative treatments exist for FAI in the published literature and whether there is any evidence to support their use. TYPE: A systematic review. LITERACY SURVEY: PubMed, Medline, EMBASE, CINAHL, AMED, and Cochrane Library databases were searched by using the following terms: femoroacetabular impingement, femoro-acetabular impingement, and hip impingement. The search was limited to English only but with no time constraints. METHODOLOGY The review was undertaken at 2 academic institutions within the United Kingdom; any article that described or provided evidence that related to a nonoperative treatment for FAI was included. Fifty-three articles met our criteria, of which, 48 were review and/or discussion based. SYNTHESIS Five articles summarized primary experiments that described or evaluated nonoperative treatment, of which, 3 reported favorable outcomes. Many review and/or discussion articles (31 [65%]) indicated that a trial of conservative care was appropriate. Activity modification was most frequently recommended (39 [81%]), and nearly half promoted physical therapy as a treatment (23 [48%]). CONCLUSION The review literature appears to promote initial nonoperative treatment for FAI. Although the available literature with experimental data is limited, there is a suggestion that physical therapy and activity modification confer some benefit to patients. Nonoperative treatment regimens, particularly physical therapy, need to be evaluated more extensively and rigorously, preferably against operative care, to determine the true clinical effectiveness.
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Affiliation(s)
- Peter D H Wall
- Warwick Orthopaedics, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom.
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