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Examination, Diagnosis, Treatment, and Prevention of Sports Injuries Unique to the child Athlete Injuries unique to the Child Athlete Macro trauma Microtrauma Broken Radius Overuse Injuries Ligament Injuries Severs Avulsion Fractures Osgoods- Schlatters Salter-Harris Fractures Increase in overuse injuries: Due to increase emphasis and participation in organized sports Inappropriate Coaching Lay people giving medical advise Growth Spurts Growth cartilage: Injuries has different effects and requires different diagnosis and treatments Psychological vulnerability Susceptible to inappropriate coaching and training Salter- Harris Fracture Growth Cartilage Injury May cause arrest of the growth process Limb length discrepancy History: Trauma or Overuse History: Trauma or Overuse Observation Inspection Rang of Motion Provocative Tests: Kemps, Adams, Stork. Determine if it’s the Anterior or Posterior Elements a. Pars Interarticularis, Facet Joint, Pedicle, SI Joint. Must begin at the Hip and end at the foot. Observation in standing posture: a. Frontal, Lateral, posterior Eval of posture, symetry and alignment Sitting Examination: Check patellar alignment, ACL integrity, Muscle imbalance. Joint line pain in heel to knee check. Supine Exam: Lachmans, McMurrays, Varus/valgus Stress Look for ligamentous Injuries: If hemarthrosis strong indication of cruciate injury Cross Leg: Lateral Ligament, cartilage, popliteal tendon Apleys Hip Extensors: Ely’s, Internal/external rotation. Internal rotation in flexed position: Slipped Capital Epiphysis Sitting: Look for swelling Palpation medial, anterior talus, lateral ligaments( 85% ) ROM: Inversion, Eversion, Plantar Flexion, Dorsi Flexion Tests: Drawers, Varus stress Check for syndesmosis sprain Kneeling: Achilles, calcanius,metatarsalgia Check for Navicular, 2nd metatarsal fracture Liz- Frank fracture Interosseus sprain Plantar fascitis Examine in relation to spine: Range of Motion standing Provocative Tests: sitting, prone for stability. Reactive sympathetic Dystrophy Clinical syndrome of excessive pain following surgery or injury A. Most common in individual sports: Gymnastics, ice skating B. Disorder of Autonomic Nervous System C. Etiology unclear D. Multiple Psychological complex Injury Prevention Early detection key to overuse injuries Growth spurts: Decrease training demands Exercise programs: Resistance Training most important: Wayne Wescot