The Centers for Disease Control and Prevention ( CDC) estimates that high school sports participation has grown from four million during the 1971-72 school year to 7.2 million in the 2005-06 school year. That same study found that high school athletes account for an estimated two million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually!
As children become involved in sports at younger and younger ages and the development of the junior and senior high school athletics programs grow, the need for medical expertise of physical therapists trained in pediatrics and sports injury prevention and rehabilitation has grown exponentially. Several key “factors” come into play when working with this age group:
1) Psychological/emotional differences – multiple factors of social, peer, family, coach/team dynamics and maturity need to be considered. Talking to a 12- or 16-year-old about their injury is much different than talking to a 20- or 30- year-old.
2) Physical Development - even among similar age groups, adolescents vary greatly in physical development and growth. Before puberty, bones are typically weaker than ligaments and other structures, whereas in adults, the bones are stronger and the ligaments are the weak link! Many times with adults, there may be warning signs that exercise may be problematic, such as joint or cartilage pain. Youth athletes may not feel this same pain and be raring to go, even though they need to rest!
3) Participation in “year round” sports - club, recreational and school practice and competition also place a strain on adolescent body structures with overuse injuries. It is not uncommon to find youth athletes that are practicing one sport year round while competing in a second but different sport at the same time!
These unique factors and trends all have resulted in a growing need for prevention and education to allow these young athletes to perform at their best with minimal risk of injury. The “team” involved in this task includes the physician, the physical therapist, the parents, the coaches and of course, the youth athlete!
Recent sport physical evaluations by Physical Therapy Partners showed the following areas of risk identification listed in order of increasing occurrence in the tested population.
1) Shoulders: weakness in the posterior shoulder muscles resulting in shoulder laxity, tendonitis, impingement syndrome and risk for rotator cuff tear injury.
2) Ankles: instability in the ankle muscles. The majority of students had history of previous sprains/strains that never were properly or totally strengthened following the initial injury. This resulted in repetitive chronic ankle sprains.
3) Hips: weakness in the pelvic rotator cuff muscles and gluteus medius. This often appeared with improper over training of the anterior hip flexors and lack of strengthening of the abductors and extensors.
4) Low Back: poor “core development” in students with recent growth spurts and those students involved in impact athletics.
5) Knees: overdevelopment of the quad muscles and not enough attention to hamstring muscles. Also, improper teaching of jump landing and pivot moves.
6) Cardiovascular training: 10 percent of the students tested showed abnormal responses to blood pressure/HR monitoring in a sub-maximal treadmill test.
The good news is that the majority of these risk areas and potential injuries can be prevented with proper evaluation, education and exercises. The physical therapist has expertise in exercise metabolism, training adaptations, sports biomechanics and exercise prescription. For several years , Physical Therapy Partners has offered a unique evaluation program, P.E.P. (Prevention – Education – Performance), which encompasses the goal of prevention of sports injuries. The rehabilitation agency employs physical and occupational therapists with experience in performing risk assessment and providing individual treatment programs to reverse any weaknesses identified. Together with the physician, parents, and coaches, the physical therapist can help the youth athlete prevent injury and enjoy athletics!
Pam Wenndt is co-owner of Physical Therapy Partners, currently located in the Cortright Square office building in Waterloo, with a new state-of-the-art clinic opening in January 2009 at the corner of San Marnan Drive and Ansborough Avenue. For further information, contact 319-233-6995.
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