Health Issues

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Pediatric Health & Injury Issues
in the Athletic Environment


There is a risk of injury associated with participation in sports or recreational activities
       In any sports activity, a risk of being injured exists when practicing and actual engaged in performing or competing. The risk of being injured increases with the intensive of participation and the length of time the athlete participates at high intensity levels.

       The leading causes of these
unintentional pediatric injuries included household accidents, general play, school activities, organized sports, car or bicycle accidents and unorganized sports. Household accidents include falls, burns, and cuts.

       Injuries from general play frequently resulted in a sprain, break or injury to the eye, face or head. Injuries from sports were most likely to result in deep brusing of soft tissue, sprains, broken bones, and concussions. Household accidents frequently resulted in injuries to the teeth, eyes, face or head. Injuries resulting from motor vehicle and bicycle accidents may not account for the largest number of injuries; however, the seriousness of these injuries can be much more serious.

       A survey of patients at the Soin Trauma and Emergency Center at Dayton Children’s reports leading reasons for injury include:
  • Sports (39 percent),
  • Playground injuries (13 percent),
  • Bike accidents (11 percent),
  • Motor vehicle crashes (9 percent),
  • Accidents involving nonmotorized wheel vehicles such as rollerblades, scooters and skateboards (6 percent).
       The risk of injury varies by the age of a child. Older children (ages 11 to 14) were more likely to suffer an injury during organized sports, whereas younger children (ages 0-5) were more likely to be injured in a household accident or general play.


        Chronic or persistent pain affects adults and children. Few pain medications have even been studied and approved forf use by young elementary school children. Orthopaedic surgeons, primary care sports medicine physicians, physician assistants, physical therapists, athletic trainers, registered dietitians, radio- logists, and exercise physiologists need to review scientific papers on improvements of how to safely and effectively treat pain that their young patients experience.

        Both nonsurgical and surgical issues in children, teens and young adults need to be quickly taken to a physician. Sports medicine experts are specifically trained to provide comprehensive assessment and treatment. Injuries can be more serious than parents and coaches want to acknowledge include:
  • ACL tears
  • Instability of the shoulders, hip, knee, ankle, and neck 
  • Joint cartilage problems, especially involving the knee and elbow
  • Overuse injuries 
  • Concussions
        Just because you participated in a non contact sport ddoes not mean you are not at risk. Many injuries go undiagnosed only to surface as a serious problem when athletes discontinue training, gain weight and adopt unhealthy eating and fitness habits.

     The risk of injury is reduced for the test an competitive due to better on and off ice training providing the athlete is not attempting to perform tasks for which they are physically and mentally not equipped to attempt.

     The following articles will assist you in understanding possible health and injuries that you may be confronted with as a coach, parent, or skater.
 

Juvenile Spondyloarthritis
     Juvenile onset spondyloarthritis (JSpA), also known as Juvenile Spondyloarthropathy, is the medical term for a group of childhood rheumatic diseases, which cause arthritis before the age of 16 and may span through adult life.

     JSpA typically causes pain and inflammation in the joints in the lower part of the body, for example, the pelvis, hips, knees and ankles. 

Pediatric Rheumatology
     Stress fractures can be classified into two groups. Fatigue fractures may occur when repetitive muscular forces or stresses are applied to a normal bone, and are most common in adolescents, athletes and military recruits.

     Problems in the diagnosis of stress fractures may arise from the absence of radiographic abnormalities in the early phase after the fracture has occurred. 

Stress Fractures in the Juvenile Skeletal System
     Stress fractures affecting the juvenile skeletal system are rare and are described as having a good prognosis. Precisely because these fractures are so rare, studies allowing clear and generally applicable conclusions are lacking.

     There was a significant correlation between clinical outcome recorded as "free of symptoms" and an early diagnosis (less than 2 weeks after first symptoms and a fracture line seen on MR tomography in contrast to a stress reaction with merely increased signal intensity.

Juvenile Stress Fractures may take time to heal
     The resolution of stress fractures in children and adolescents, while rare, can be protracted because of delays in diagnosis and inappropriate initial treatment, German and Austrian researchers report.

     Growth plates close and are replaced by solid bone – usually sometime during adolescence. The most common site of stress fracture (13 fractures) was the tibia (shinbone), followed by fractures to the metatarsals, the relatively long bones in the center of the foot.

References:

Safety and Injury Prevention - University of Miami  Common Childhood Illness and Concerns ... Unintentional injury is the leading cause of death among children ages 14 and under.

Answers to Pediatric Health Questions - Premier HealthNet What is the difference between a regular physical and a sports physical for children? ... history – including concussions, broken bones, surgeries, injuries that have caused restrictions ... Dr. Lauricella discusses pediatric health concerns.

Resources:

The following internet links have been gleaned from personal communications
combined with information from public institutions and athletic organizations/
associations that have a web presence with information concerning team and
individual sports programs:

Pediatric Health and Injury Issues
PDF  Pediatric Sports Training Issues
PDF  Juvenile Spondyloarthritis
PDF  Pediatric Rheumatology
PDF  Anterior Cruciate Ligament (ACLs)
PDF  Prolonged sitting can cause physical problems
PDF  Stress Fractures in Juvenile Skeletal System
PDF  Juvenile Stress Fractures take time to heal
PDF  Shin Splint Causes

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