There’s general consensus that overuse injuries in teenage athletes can be reduced by carefully monitoring playing load for the young athletes. Recommendations have been put forth to encourage multi-sport participation, limit number of months played per year, and limit number of hours of sport participation per week as ways to reduce the risk of overuse injury.
Athletes’ behavior, however, is often different. Many teenage athletes participate in high school and club sports, often at the same time. The result is that training loads are frequently much higher than what is recommended.
There is convincing evidence that major factors contributing to noncontact ACL tear risk include improper mechanics when landing from a jump or when rapidly changing direction. Training programs to reduce this risk have focused on improving landing mechanics and improving strength imbalances. Typically, these programs are incorporated into a team warm-up.
Two recently published scientific studies show that ACL injury prevention warm-up programs are very effective in reducing the risk of getting a noncontact ACL tear, and these programs lead to improved athletic performance. These are two really great reasons to utilize ACL injury prevention warm-ups for your sport.
Shoulder instability is a common occurrence with collision-based sports such as tackle football and rugby. Extensive available data suggests that repeat instability events for high school age athletes is exceptionally common, and for that reason orthopedic surgeons have become more likely to recommend surgery for first time shoulder instability.
However, recently published data shows that shoulder instability events can often be managed non-surgically with high rates of successful return in the same season. Furthermore one study indicates a very high rate of continued sport participation in the following season. This study shows that first time shoulder instability for athletes participating in collision-based sports can be managed without surgery in a much higher percentage of patients than we have previously believed.
With fall soccer seasons now getting underway in the U.S. it’s important to note that upper extremity injuries happen more often than you probably think. Published studies in all age groups, including adults, show injury rates in the upper extremities at about 20% of all injuries.
In some ways the upper extremity injuries tend to be more “serious” than lower extremity injuries, with a large percentage of fractures (broken bones) and dislocations. Many will require urgent treatment in the emergency department. The overwhelming majority occurs from falls rather than player to player contact.
The Little League World Series is well underway now, and it’s interesting to note the peak pitching speed of some of the athletes. This article notes that several pitchers are in the 65mph to 75mph range and one player actually hit 81mph on one of his pitches in this year’s tournament.
But at what cost? There is an interesting database that puts young pitchers into various categories based upon age, pitching speed, and maximum distance on the throw. An observational study published a few years ago suggests that pitchers in the three standard deviation range or higher on the accompanying chart are “elite” and at risk for arm injury.
Orthopedic surgeons will commonly recommend lower extremity strengthening for any of their patients with chronic painful conditions and almost everyone who’s had knee surgery. Strength gains and strength symmetry are necessary for proper function but individuals who have one of these conditions frequently report one common drawback: the exercises needed to increase muscle strength often lead to significant knee pain.
Blood flow restriction (BFR) training is becoming increasingly popular as a means of strengthening using low loads and without the same type of risk of increased joint pain found with traditional methods of strength training.
Sports medicine specialists and team physicians want to see all of our athletes succeed to the best of each of their abilities. But we’re also in a position to see the many things that unfortunately go wrong for younger athletes, including overuse injuries, burnout, and psychological stress.
It’s believed that two of the main causative factors in the above problems are early sport specialization and high intensity training at a very young age. For the younger athletes it’s believed that sport specialization hampers the opportunity to develop proper neuromuscular skills and general fitness.
A recently published study showed that young athletes interested in a baseball career at the highest professional level can minimize the risk of overuse injuries and have the potential for greater future longevity by participating in multiple sports during high school.
We are now about two weeks away from the start of the 2019 Little League World Series. There will be a lot of baseball, of course, but there’ll also be a lot of Fortnite and other video games being played. With that in mind I thought it would be interesting to take a look at an article published in 2018 showing a strong association between videogame playing and risk of shoulder and elbow injuries in baseball players.
Researchers from the Tohoku University School of Medicine in Japan found that players who spent three or more hours daily on videogames were 5.6 times more likely to have felt elbow or shoulder pain in the prior year than those who played videogames for less than an hour a day.
Could this possibly be real? Do we actually need to add extensive videogame playing to the list of risk factors for shoulder and elbow injuries amongst young baseball players?
We now have a solid understanding of the behaviors that place a thrower at risk for elbow injuries, but making inroads in changing that behavior remains a challenge. For example, 40% of youth pitchers report throwing in chronic elbow pain, and 25% of Major League Baseball pitchershad “Tommy John” surgery at some point in their career.
The reality is that surgery to reconstruct a torn ulnar collateral ligament (UCL) does not make the elbow stronger and better than it was before the injury. Many pitchers do successfully compete again after surgery but it’s likely due to extensive rehabilitation to correct underlying functional issues as much as it is to skillful surgery.
Last week I provided an update on heat illness warning signs and in the post recommended that all individuals follow a good hydration strategy. Our bodies are made up of 70% water, so it makes sense that hydration should be a good component of overall health.
But there is a lot of noise out there on exactly the type of hydration strategy to follow. What should you drink? How much should you drink? When should you drink? Here’s an easy to remember hydration strategy that is gaining a lot of traction amongst healthcare professionals as well as athletic performance specialists: take half your body weight in pounds, and drink that amount in ounces of water every day.
