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Monthly Archives: October 2016

Basketball and Volleyball

Acute and overuse injuries are common in jumping sports likebasketball and volleyball. Acute injuries include bruises(contusions); cuts and scrapes (lacerations); ankle, knee, or finger sprains or fractures; shoulder dislocations; eye injuries; and concussions. Overuse injuries include patellar tendonitis (also called jumper’s knee) or Osgood-Schlatter disease, spondylolysis (stress fracture of the spine), rotator cuff tendinopathy, stress fractures, and shin splints.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent basketball and volleyball injuries. Also included is an overview of common basketball and volleyball injuries.

Injury prevention and safety tips

  • Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for regular health well-child checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes should be in good condition, appropriate for the surface and laces tied.
    • Ankle braces or tape applied by a certified athletic trainer can prevent or reduce the frequency of ankle sprains.
    • Knee pads have been shown to reduce knee abrasions and contusions (bruises).
    • Buddy tape (tape around the injured finger and the one beside it) can prevent reinjury to an injured finger. X-rays should be obtained in all “jammed” fingers.
    • Mouth guards prevent dental injuries.
    • Protective eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials.
  • Environment. A safe playing area is clean and clear. Goalposts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle sprains

Ankle sprains, one of the most common injuries in jumping sports, can prevent athletes from being able to play. They often happen when a player lands from a jump onto another player’s foot, causing the ankle to roll in (invert). They are more likely to happen if a player had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays are often needed to look for a fracture.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains. Tape and an ankle brace can also support the ankle, enabling an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays are often needed to look for a fracture. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs (NSAIDs), and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury or knee cap dislocation. Anterior cruciate ligament (ACL) tears are more common in females than males.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Athletes who return to play with a torn ACL risk further joint damage. Athletes with an ACL tear are usually unable to return to their sport until after reconstruction and rehabilitation.

Patellar tendonitis (jumper’s knee) is a common overuse injury seen from repetitive jumping and landing from jumps. It causes pain in the front of the knee with jumping, sometimes associated with a bump, and can be severe. It is treated with ice, stretching, NSAIDs, and relative rest.

Shoulder injuries

Shoulder injuries in volleyball can occur from repetitive hitting (spiking) or serving. Shoulder injuries in basketball can occur from diving or rebounding.

Athletes usually feel the shoulder pop out of joint when their shoulders are dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called a dislocation. Risk of dislocation recurrence is high for youth participating in these sports. Shoulder strengthening exercises, braces and, in some cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in volleyball, usually due to weak muscles of the shoulder blade and trunk. Often rehabilitation exercises and rest from excessive hitting or serving are all that is needed.

Eye injuries

Eye injuries commonly occur in sports that involve balls but can also result from a finger or another object in the eye. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Head injuries

Concussions can occur after an injury to the head or neck contacting the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion may be more susceptible to another injury than an athlete with no history of concussion.

About Running

 Running, as a sport, can involve a number of different forms, including the following:

  • Cross-country. A sport in which teams of runners compete on long-distance road running courses.
  • Track and field. A sport that includes track events, like sprints, distance running, hurdles, and relays, and field events that involve throwing and jumping.
  • Marathon. A long-distance (about 26 miles) road running event.
  • Triathlon. A 3-part event that includes swimming, cycling, and running. Distances vary depending on the age of the athletes.

Running injuries are common and there can be a variety of causes. Running injuries can be caused by improper training (for example, doing too much too fast), mechanical problems (for example, high arch or flat foot), or previous injuries. Other causes may be the environment (for example, uneven or hilly terrain; hot or cold weather conditions) or previous injuries. While not all injures can be prevented, the risk of injuries can be reduced.

The following is information from the American Academy of Pediatrics about how to prevent running injuries. Also included is a list of common running injuries.

General injury prevention and safety tips

Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routine well-child checkups.

Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport- specific conditioning. Also important are proper warm- up and cool-down exercises.

Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.

Nutrition. Eating healthy and the right amount of calories is important. A good rule to follow is to eat an extra 100 calories for every mile run.

Strength Training

 Strength training (or resistance training) uses a resistance to increase an individual’s ability to exert force. It involves the use of weight machines, free weights, bands or tubing, or the individual’s own body weight. This is not the same as Olympic lifting, power lifting, or body building, which requires the use of ballistic movements and maximum lifts and is not recommended for children.

The following are answers from the American Academy of Pediatrics (AAP) to common questions about strength training.

What are the risks of strength training?

The risks of participating in an unsupervised strength training program include injury to the discs and growth plates of the spine and even occasionally death from weights landing on the chest wall. A well-supervised program has a coach-to-student ratio of 1:10 or less and proper certification of the instructor. Significant injuries are rare in well-supervised programs, but can include stress fractures of the shoulder (osteolysis) or spine (spondylolysis), muscle strains, disc herniation, and tendinitis. Misuse of anabolic steroids to improve physique is another possible risk.

What are the benefits of strength training?

Strength training improves muscle strength and stamina. Regular participation in strength training improves cardiac (heart) health, body composition, and bone mineral density, and decreases cholesterol levels. It is particularly helpful foroverweight (obese) youth because it increases lean body mass and metabolic rate without the extra stress on the body. In some sports (like swimming or tennis), strength training may prevent common rotator cuff problems. Research also shows a possible reduction in knee injuries in girls when strength training is combined with a plyometric (jumping) program.

Who should not participate in strength training?

Strength training is not recommended for people with the following:

  • Uncontrolled high blood pressure
  • Seizure disorders
  • Prior history of childhood cancers treated with chemotherapy

Children with complex congenital heart disease should get an OK by a pediatric cardiologist before starting a strength training program.

When can my child start strength training?

The proper age is based on the following:

  • Maturity (if the child has reached certain developmental milestones)
  • The type of sport the child wants to play
  • A desire to participate
  • The discipline to train several times a week
  • The ability to listen and follow directions

Most young athletes have these characteristics and can maintain proper balance and postural control around 7 or 8 years of age.

What are the key components in a strength training program?

To get the most out of strength training, athletes should

  • Include aerobic training along with strength training.
  • Train 2 to 3 times a week for 20 to 30 minutes.
  • Warm up and cool down for at least 10 minutes.
  • Practice all lifts without weights to make sure form and technique are correct. As techniques are mastered, weights can be slowly added.
  • Work all major muscle groups including the core. Joints should be moved through a full range of motion.
  • Do 2 to 3 sets of 8 to 15 repetitions.
  • Train for a minimum of 8 weeks.
  • Gradually increase weights by no more than 10% per week.

How can injuries be prevented?

To prevent injuries, keep the following in mind:

  • Use proper techniques when lifting.
  • Adjust machines for height.
  • Always wear proper clothing and closed-toe shoes with good traction.
  • Always weight train with proper supervision and spotting.
  • Start each session with a 10- to 15-minute warm-up. Avoid rapid breathing (hyperventilation), bearing down, or holding your breath while lifting.
  • No 1-repetition maximums, maximum weights, or ballistic maneuvers should be performed before reaching skeletal maturity.
  • Stop lifting at once if pain is felt.

Tips for Football

 Football is a fast-paced, aggressive, contact team sport that is very popular among America’s youth. Football programs exist for players as young as 6 years all the way through high school, college, and professional.

Injuries are common because of the large number of athletes participating. However, the risk of injuries can be reduced. The following is information from the American Academy of Pediatrics (AAP) about how to prevent football injuries. Also included is an overview of common football injuries.

Injury prevention and safety tips

  • Supervision. Athletes should be supervised and have easy access to drinking water and have body weights measured before and after practice to gauge water loss.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes. Football shoes should be appropriate for the surface (turf versus cleats). Laces should be tied securely.
    • Pants. Football pants should fit properly so that the knee pads cover the knee cap, hip pads cover the hip bones, the tailbone pad covers the tailbone, and thigh pads cover a good share of the thigh. Pads should not be removed from the pants.
    • Pads. Shoulder pads should be sized by chest measurement. They must be large enough to extend ¾ to 1 inch beyond the acromioclavicular joint. Athletes should have adequate range of motion, and the pads should not ride up into the neck opening when raising the arms.
    • Helmets. The helmet should be fitted so that the eyebrows are 1 to 1½ inches below the helmet’s front rim. The back of the helmet should cover the back of the head, and the athlete’s ear openings should be in the center of the helmet ear openings. Jaw pads should be snug against the athlete’s jaw. The chin strap should be centered over the chin and tightened to prevent movement of the helmet on the head. The helmet padding and chin strap should be tight enough to prevent any rotation of the helmet on the head. Face masks should be attached to the helmets. Additional protection can be provided by a clear Plexiglas shield.
    • Mouth guards can help prevent oral or facial injuries but not concussions.
  • Environment. A safe playing field is level and cleared of debris, equipment, and other obstacles. Field goal posts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle injuries

Ankle sprains are some of the most common injuries in football. They can prevent athletes from being able to play. Ankle sprains often happen when an athlete gets blocked or tackled with the foot firmly in place, causing the ankle to roll in (invert). An ankle sprain is more likely to happen if an athlete had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays may be needed.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains and enable an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays may be needed. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs, and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Medial collateral ligament sprains can be treated in a hinged brace and allowed to return to play. Athletes who return to play with a torn anterior cruciate ligament (ACL) risk further joint damage. Athletes with an ACL tear should not return to their sport until the ligament has been reconstructed and they have been cleared by the surgeon.

Shoulder injuries

Shoulder injuries can occur from diving for a ball or from blocking or tackling.

Athletes usually feel their shoulder pop out of place when it is dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called adislocation. Risk of dislocation recurrence is high for youth participating in football. Shoulder strengthening exercises, stabilization braces and, in many cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in football, usually due to weak muscles of the back and trunk. Often rehabilitation exercises and rest from excessive blocking or tackling drills are all that is necessary to treat this type of pain.

Eye injuries

Eye injuries commonly occur in football usually due to a finger poking through the face mask. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from high-impact and repetitive arching of the back. Symptoms include low back pain that feels worse with back extension activities. Treatment of spondylolysis includes rest and physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes are advised to limit repetitive arching of the spine (blocking and weight lifting) and high-impact activities (running and jumping). Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Head injuries

Concussions occur if the head or neck hits the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. If a concussion has occurred, it is again important to make sure the helmet was fitted properly. If the concussion occurred due to the player leading with the head to make a tackle, he should be strongly discouraged from continuing that practice.