Supplemental material, DS_10.1177_1941738118778510 for Socioeconomic Factors for Sports Specialization and Injury in Youth Athletes by Neeru A. Jayanthi, Daniel B. Holt, Cynthia R. LaBella and Lara R. Dugas in Sports Health: A... more
Supplemental material, DS_10.1177_1941738118778510 for Socioeconomic Factors for Sports Specialization and Injury in Youth Athletes by Neeru A. Jayanthi, Daniel B. Holt, Cynthia R. LaBella and Lara R. Dugas in Sports Health: A Multidisciplinary Approach
Rhythmic gymnastics injuries have not been studied thoroughly especially in the United States. Existing research studies are predominantly from Europe or Canada or from more than 15 years ago. The purpose of our study was to provide an... more
Rhythmic gymnastics injuries have not been studied thoroughly especially in the United States. Existing research studies are predominantly from Europe or Canada or from more than 15 years ago. The purpose of our study was to provide an updated description of injury patterns among rhythmic gymnasts in the United States. A retrospective chart review was conducted of 193 rhythmic gymnastics injuries in 79 females, ages 6-20. Patients were seen between January 2010 and March 2020 in a hospital-based pediatric sports medicine clinic. Gymnast demographics, injury locations, and injury types were collected as available. Descriptive and bivariate statistical analysis was performed using general linear mixed models. Our cohort had a mean age of 14.61 ± 2.61 years. Overuse injuries (76.7%) were more common than acute injuries (23.3%). The most common injury types were strain (20.7%), nonspecific pain (15.5%), and tendinitis/tenosynovitis (10.36%). The most frequently injured body regions were lower extremity (75.1%), followed by trunk/back (19.2%), upper extremity (4.7%), and head/neck (1.0%). The most common injured body parts were foot (24.9%), ankle (15.5%), knee (15.0%), lower back (14.0%), and hip (13.0%). General linear mixed models revealed that older age (p=0.001) and higher competitive level (p=0.016) were associated with a greater number of diagnoses. Gymnasts with foot injuries were older than gymnasts with ankle (p=0.026), hip (p<0.0001), and knee (p=0.002) injuries. Gymnasts with higher BMI-for-age percentile were more likely to have acute injuries than overuse (p=0.035). Our data showed that injuries among rhythmic gymnasts were most frequently located in the lower extremities, specifically the foot, followed by trunk/back. Additionally, the most frequent injury types were strains and nonspecific pain, and overuse was the most prevalent mechanism. Gymnasts with foot injuries were older than gymnasts with ankle, hip, and knee injuries. Higher BMI is a predictor of acute injuries.
Research Interests:
OBJECTIVES Young male gymnasts are a frequently injured, yet infrequently studied population. Literature on gymnastics injuries has focused primarily on female gymnasts at elite and collegiate levels. Gymnastics equipment, rules, and... more
OBJECTIVES Young male gymnasts are a frequently injured, yet infrequently studied population. Literature on gymnastics injuries has focused primarily on female gymnasts at elite and collegiate levels. Gymnastics equipment, rules, and training methods have continued to evolve over the past few decades so the previous data likely does not reflect current injury patterns. Our study aimed to provide a description of injury patterns for contemporary club-level, pre-collegiate male gymnasts. METHODS This was a retrospective chart review of 163 gymnastics injuries from 84 male subjects ages 4-19 years. Subjects were seen between 2010-2019 in pediatric sports medicine clinics. Gymnast demographics, injury locations, injury types, and gymnastics apparatus were collected as available. RESULTS Our cohort had a mean age of 12.5 ± 3.0 years, gymnastics participation for 8.1 ± 2.9 years, and gymnastics level of 7.4 ± 1.7. Overuse injuries (59.5%) were more common than acute injuries (40.5%). The most common injury locations were lower extremity (42.3%), followed by upper extremity (32.5%), spine/trunk (19.6%), and head/neck (5.5%). The leading injury types were strains (16.6%) and apophysitis (12.9%). The most common apparatus for injury was floor (25%) followed by vault (20%). Binomial logistic regressions revealed that higher gymnastics level (OR = 5.19, p = .031) and younger age (OR = 4.05, p = .012) were predictors of lower extremity injuries. CONCLUSION Our data show that injuries among club-level, young male gymnasts were most frequently located in the lower extremities. This contrasts older studies of primarily elite male gymnasts where injuries were more common in upper extremities. Overuse injuries were most prevalent in our cohort, and the most frequent injury types were strains and apophysitis.
Research Interests:
Research Interests:
Research Interests:
Following a concussion, it is common for children and adolescents to experience difficulties in the school setting. Cognitive difficulties, such as learning new tasks or remembering previously learned material, may pose challenges in the... more
Following a concussion, it is common for children and adolescents to experience difficulties in the school setting. Cognitive difficulties, such as learning new tasks or remembering previously learned material, may pose challenges in the classroom. The school environment may also increase symptoms with exposure to bright lights and screens or noisy cafeterias and hallways. Unfortunately, because most children and adolescents look physically normal after a concussion, school officials often fail to recognize the need for academic or environmental adjustments. Appropriate guidance and recommendations from the pediatrician may ease the transition back to the school environment and facilitate the recovery of the child or adolescent. This report serves to provide a better understanding of possible factors that may contribute to difficulties in a school environment after a concussion and serves as a framework for the medical home, the educational home, and the family home to guide the stu...
Research Interests:
Participation in gymnastics in the United States has grown in recent decades, yet available epidemiology data is limited by small, heterogeneous studies which rarely include male and club-level gymnasts. At all levels, gymnastics has one... more
Participation in gymnastics in the United States has grown in recent decades, yet available epidemiology data is limited by small, heterogeneous studies which rarely include male and club-level gymnasts. At all levels, gymnastics has one of the highest injury rates among girls’ sports. Across all disciplines, artistic gymnasts have the highest rates of injury. Sprains and strains are the most common injury types. Extremity injuries comprise approximately 75% of all gymnastics injuries, and ankle sprain is the most common diagnosis at every level. Lower extremity injuries are more common in female gymnasts, while upper extremity injuries are more common in male gymnasts. Increasing training hours and higher levels of gymnastics are associated with greater injury incidence and severity as well as more overuse injuries compared to acute injuries. At all levels, injuries occur most commonly during tumbling and dismount/landing with floor exercise being the most common injury apparatus. Although more overall injuries occur during practice, competition injury rates are 2–6 times higher per exposure time, and competition injuries tend to be more severe. Catastrophic injuries are rare and are most commonly reported at the college level.
[ ]two articles, ‘Fit for life? The burden of future disability associated with a low cardiorespiratory fitness in adolescence’ (see page 128) from Dr Pontus Henriksson and colleagues and ‘Effects of sedentary behaviour interventions on... more
[ ]two articles, ‘Fit for life? The burden of future disability associated with a low cardiorespiratory fitness in adolescence’ (see page 128) from Dr Pontus Henriksson and colleagues and ‘Effects of sedentary behaviour interventions on markers of cardiometabolic risk in adults: systematic review with meta-analyses’ (see page 144) from Dr Paddy Dempsey and colleagues, examine the negative health effects of sedentary behaviour and how establishing healthy behaviours during childhood and adolescence result in long-term benefits An added attraction to the annual meeting will feature the ‘AMSSM Physical Activity and Exercise Medicine Summit: Advancing Education, Clinical Practice, and Research for the Sports Medicine Physician ’
Research Interests:
Research Interests:
Purpose: We aimed to identify clinically meaningful Post-Concussion Symptom Scale (PCSS) scores in pediatric concussion patients relative to patients with referral orders and prolonged recovery. Prolonged recovery is defined as greater... more
Purpose: We aimed to identify clinically meaningful Post-Concussion Symptom Scale (PCSS) scores in pediatric concussion patients relative to patients with referral orders and prolonged recovery. Prolonged recovery is defined as greater than 30 days to return-to-learn (RTL) and return-to-play (RTP). Methods: Patients aged 8-17 years reporting to a tertiary care concussion clinic were invited to participate from August 2014 through February 2018 in a prospective cohort study. Participant data collected through electronic medical records included PCSS at initial visit, ordered referrals (ophthalmology, physical therapy, occupational therapy, neuropsychology, child psychology, neurology, or other …
Research Interests: Pediatrics and Medicine
This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have fi led confl ict of interest statements with the American Academy of Pediatrics. Any confl icts have been... more
This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have fi led confl ict of interest statements with the American Academy of Pediatrics. Any confl icts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.
Research Interests:
Pediatric Orthopedics and Sport Injuries - Libros de Medicina - Ortopedia pediatrica - 70,57
Research Interests:
Research Interests:
Tienda online donde Comprar Pediatric Orthopedics and Sport Injuries al precio 74,10 € de Cynthia LaBella | John F. Sarwark, tienda de Libros de Medicina, Libros de Pediatria - Ortopedia pediatrica
Research Interests:
All-new guide on the diagnosis and treatment and referral of orthopaedic problems and sports injuries. The new Pediatric Orthopaedics and Sports Injuries: A Quick Reference Guide efficiently delivers the essential guidance and... more
All-new guide on the diagnosis and treatment and referral of orthopaedic problems and sports injuries. The new Pediatric Orthopaedics and Sports Injuries: A Quick Reference Guide efficiently delivers the essential guidance and how-to-do-it recommendations you need. Turn here for concise summaries of disorders and injuries. Proven evaluation, treatment, and rehabilitation approaches. Practice-tested tips, and invaluable clinical pearls. Efficiently respond to diverse clinical challenges: Common sports injuries, Trauma, Limb disorders, Spine disorders Hip and pelvis disorders, Infections, Tumors, Skeletal dysplasias. Plus, you’ll find step-by-step help with musculoskeletal examination and evaluation; casting and splinting; imaging techniques, and rehabilitation strategies. The book features many illustrations, clinical photographs and radiographic images to demonstrate physical examination techniques and pathologic physical findings, as well as tables and figures to aid in diagnosis. ...
Background: Vestibular/ocular motor dysfunction can occur in pediatric concussions, which can impair reading, learning, and participation in athletics. This study evaluated 3 clinical tools for identifying postconcussion vestibular/ocular... more
Background: Vestibular/ocular motor dysfunction can occur in pediatric concussions, which can impair reading, learning, and participation in athletics. This study evaluated 3 clinical tools for identifying postconcussion vestibular/ocular motor dysfunction: (1) Post-Concussion Symptom Scale (PCSS), (2) Convergence Insufficiency Symptom Survey (CISS), and (3) Vestibular/Ocular Motor Screening (VOMS). Hypothesis: Evaluating vestibular/ocular motor dysfunction with multiple clinical tools will capture more symptomatic patients than any 1 tool alone. Study Design: Cross-sectional data from a prospective cohort study. Level of Evidence: Level 4. Methods: Patients were between 8 and 17 years old and seen in a tertiary care pediatric sports medicine clinic between August 2014 and February 2018. Data were collected from initial visit and included VOMS, PCSS, and CISS. Descriptive statistics, Pearson’s correlations, and logistic regressions were used to describe relationships between clinica...
Research Interests:
Selected Issues in Sport-Related Concussion (SRC|Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement is title 22 in a series of annual consensus documents written for the practicing team physician. This document... more
Selected Issues in Sport-Related Concussion (SRC|Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement is title 22 in a series of annual consensus documents written for the practicing team physician. This document provides an overview of selected medical issues important to team physicians who are responsible for athletes with sports-related concussion (SRC). This statement was developed by the Team Physician Consensus Conference (TPCC), an annual project-based alliance of six major professional associations. The goal of this TPCC statement is to assist the team physician in providing optimal medical care for the athlete with SRC.
Research Interests:
OBJECTIVE Balance deficits are common after concussions in pediatric patients. This study evaluates 3 clinical tools for identifying postconcussion balance deficits in a pediatric population: (1) Post-Concussion Symptom Scale (PCSS); (2)... more
OBJECTIVE Balance deficits are common after concussions in pediatric patients. This study evaluates 3 clinical tools for identifying postconcussion balance deficits in a pediatric population: (1) Post-Concussion Symptom Scale (PCSS); (2) Balance Error Scoring System (BESS); and (3) physical examination measures of balance: tandem gait (TG) and Romberg test. SETTING Data were collected in a tertiary care outpatient pediatric sports medicine clinic. PARTICIPANTS English-speaking patients aged 8 to 17 years who presented to a tertiary care hospital-based pediatric sports medicine clinic and diagnosed with concussion between August 2014 and February 2018 were invited to participate. A total of 614 patients were screened and/or approached during the inclusion period and 500 were enrolled. Of those enrolled, 423 patients had complete data collected and analyzed. DESIGN This is a cross-sectional, observational data set from a longitudinal, prospective study. MAIN MEASURES Data extracted from patients' electronic medical records included physical examination, PCSS, and BESS scores from their initial visit. Descriptive statistics were calculated for the outcome measures. A logistic regression was performed to evaluate significant contributors to abnormal BESS score (≥25). RESULTS There were 423 patients (56.7% female; 14.7 ± 2.01 years old) included in the study. Overall, we identified 336 patients (79.4%) with balance difficulties. Of the 336 with balance difficulties, 284 (84.5%) reported "balance problems" and/or "dizziness" on PCSS, 153 (45.5%) had abnormal BESS scores (≥25), and 100 (29.8%) had an abnormality on either TG or Romberg test. CONCLUSION Balance difficulties were identified in close to 80% of children with concussions. Using PCSS and BESS along with physical examination measures, TG and Romberg test, identified more patients with balance deficits than using TG and Romberg test alone.
Research Interests:
ABSTRACT Selected Issues in Sport-Related Concussion (SRC | Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement is title 22 in a series of annual consensus articles written for the practicing team physician. This... more
ABSTRACT Selected Issues in Sport-Related Concussion (SRC | Mild Traumatic Brain Injury) for the Team Physician: A Consensus Statement is title 22 in a series of annual consensus articles written for the practicing team physician. This document provides an overview of select medical issues important to team physicians who are responsible for athletes with sports-related concussion (SRC). This statement was developed by the Team Physician Consensus Conference (TPCC), an annual project-based alliance of six major professional associations. The goal of this TPCC statement is to assist the team physician in providing optimal medical care for the athlete with SRC.
ABSTRACT Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly,... more
ABSTRACT Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth.
Research Interests:
The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV2 pandemic. The writing group held a... more
The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an iterative process and expert consensus to finalize this guidance statement that is intended to provide clinicians with a clinical framework to return athletes of all levels to training and competition during the pandemic. The statement is not intended to address treatment, infection control principles, or public health issues related to SARS-CoV2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.
Research Interests:
Abstract The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV-2 pandemic. The writing... more
Abstract The American Medical Society for Sports Medicine (AMSSM) convened a writing group to address the current evidence and knowledge gaps regarding preparticipation evaluation of athletes during the SARS-CoV-2 pandemic. The writing group held a series of meetings beginning in April 2020. The task force reviewed the available literature and used an iterative process and expert consensus to finalize this guidance statement that is intended to provide clinicians with a clinical framework to return athletes of all levels to training and competition during the pandemic. The statement is not intended to address treatment, infection control principles, or public health issues related to SARS-CoV-2. The AMSSM task force acknowledges the clinical uncertainty, evolving public health objectives, and the limited data currently available to create this guidance statement.
Research Interests:
Aim: Neurosensory tests have emerged as components of sport-related concussion management. Limited normative data are available in healthy, nonconcussed youth athletes. Patients & methods/results: In 2017 and 2018, we tested 108 youth... more
Aim: Neurosensory tests have emerged as components of sport-related concussion management. Limited normative data are available in healthy, nonconcussed youth athletes. Patients & methods/results: In 2017 and 2018, we tested 108 youth tackle football players immediately before their seasons on the frequency-following response, Balance Error Scoring System, and King-Devick test. We compared results with published data in older and/or and nonathlete populations. Performance on all tests improved with age. Frequency-following response and Balance Error Scoring System results aligned with socioeconomic status. Performance was not correlated across neurosensory domains. Conclusion: Baseline neurosensory functions in seven 14-year-old male tackle football players are consistent with previously published data. Results reinforce the need for individual baselines or demographic-specific norms and the use of multiple neurosensory measures in sport-related concussion management.
Research Interests:
Research Interests:
Approximately 10–30% of athletes with concussion will experience symptoms that last beyond the expected recovery time period (2 weeks for adults and 4 weeks for children). Persistent post-concussion symptoms are not caused by a single... more
Approximately 10–30% of athletes with concussion will experience symptoms that last beyond the expected recovery time period (2 weeks for adults and 4 weeks for children). Persistent post-concussion symptoms are not caused by a single pathological process within the brain but rather a collection of a variety of symptoms that are often complicated by pre-existing and noninjury factors. Athletes with persistent symptoms require a multidisciplinary, symptom-targeted treatment approach that can include cervical spine rehabilitation, sub-symptom threshold exercise training, vestibular and visual therapy, psychological cognitive behavioral therapy, academic/work adjustments, lifestyle changes involving sleep hygiene, and nutrition/hydration. With proper treatment, most athletes with persistent symptoms will recover completely without any long-term sequelae. A very small proportion, however, may experience long-term deficits. Further research is needed examining the potential long-term effects of multiple concussions, especially those that are associated with prolonged recovery.
Research Interests:
Research Interests:
Research Interests:
Concussions can result in auditory processing deficits even in the absence of hearing loss. In children and adolescents, the extent to which these impairments have functional consequences for everyday listening, such as the ability to... more
Concussions can result in auditory processing deficits even in the absence of hearing loss. In children and adolescents, the extent to which these impairments have functional consequences for everyday listening, such as the ability to understand speech in noisy environments, is unknown. Case-control study. Forty youth comprised the participants: 20 had sustained a concussion and were recovering from their injury, and 20 controls had sustained non-concussive orthopaedic (e.g. musculoskeletal) injuries. All were evaluated on the Hearing in Noise Test, an audiologic index of the ability to hear sentences in adverse listening conditions. Children and adolescents recovering from concussions demonstrated an overall impaired ability to perceive speech in noisy backgrounds compared to a peer control group. This deficit also emerged across trials in the most taxing listening condition, and with respect to published, age-normative values. Functional listening skills-such as the ability to und...
Research Interests:
Research Interests:
Research Interests:
Current trends among young athletes towards earlier specialization age and year-round training on multiple teams has raised concern for increased injury risk. Our previous analyses showed higher risk for injury in highly specialized young... more
Current trends among young athletes towards earlier specialization age and year-round training on multiple teams has raised concern for increased injury risk. Our previous analyses showed higher risk for injury in highly specialized young athletes. The goal of this research was to determine whether sports specialization and injury patterns vary by sports type. In this clinical case-control study, injured athletes (aged 7-18 years) were recruited from sports medicine clinics and compared to similarly aged uninjured athletes recruited from primary care clinics. Participants completed a survey reporting age, gender, sport type, specialization patterns, and details regarding sports-related injuries in the previous 6 months. Clinical diagnoses were collected from patients' medical records. Injuries were classified as acute, overuse, or serious overuse. Of 1,190 athletes enrolled, 26% (313) were single-sport specialized (reported participation in one sport and trained >8 months/yea...
Research Interests:
Research Interests:
In recent years, there has been extensive media focus on youth sports injuries, especially concussions. While youth sports training and competition are more intense than ever, the focus on the ‘injury risk’ downside of youth sport is... more
In recent years, there has been extensive media focus on youth sports injuries, especially concussions. While youth sports training and competition are more intense than ever, the focus on the ‘injury risk’ downside of youth sport is unfortunate because the benefits of sports participation (improvements in overall health1 and bone density;2 lower rates of overweight/obesity,3 cardiovascular disease,3 diabetes,3 risk-taking behaviours,4 depression4 and teen pregnancy;5 and enhanced self-esteem4 and peer socialisation4) far outweigh the risks for children and teens. In fact, the injury risk for youth aged 6–12 years in organised sports, even in contact/collision sports such as American football, is well below the risk of injury in typical recreational activities such as riding a bicycle or playing on a playground. Additionally, the recent focus on improving safety in organised youth sports has led to rule changes that have reduced specific acute injuries (eg, breakaway bases in baseball/softball, securing movable goalposts in soccer, limiting contact/collision drills and teaching safer tackling techniques in …
Research Interests:
Research Interests:
To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine. A retrospective review of patients (ages 10-18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back... more
To determine if adolescent athletics increases the risk of structural abnormalities in the lumbar spine. A retrospective review of patients (ages 10-18) between 2004 and 2012 was performed. Pediatric patients with symptomatic low back pain, a lumbar spine MRI, and reported weekly athletic activity were included. Patients were stratified to an &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;athlete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;non-athlete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; group. Lumbar magnetic resonance and plain radiographic imaging was randomized, blinded, and evaluated by two authors for a Pfirrmann grade, herniated disc, and/or pars fracture. A total of 114 patients met the inclusion criteria and were stratified into 66 athletes and 48 non-athletes. Athletes were more likely to have abnormal findings compared to non-athletes (67 vs. 40 %, respectively, p = 0.01). Specifically, the prevalence of a spondylolysis with or without a slip was higher in athletes vs. non-athletes (32 vs. 2 %, respectively, p = 0.0003); however, there was no difference in the average Pfirrmann grade (1.19 vs. 1.14, p = 0.41), percentage of patients with at least one degenerative disc (39 vs. 31 %, p = 0.41), or disc herniation (27 vs. 33 %, p = 0.43). Body mass index, smoking history, and pelvic incidence (51.5° vs. 48.7°, respectively, p = 0.41) were similar between the groups. Adolescents with low back pain have a higher-than-expected prevalence of structural pathology regardless of athletic activity. Independent of pelvic incidence, adolescent athletes with low back pain had a higher prevalence of spondylolysis compared to adolescent non-athletes with back pain, but there was no difference in associated disc degenerative changes or herniation.
Research Interests:
All-new guide on the diagnosis and treatment and referral of orthopaedic problems and sports injuries. The new Pediatric Orthopaedics and Sports Injuries: A Quick Reference Guide efficiently delivers the essential guidance and... more
All-new guide on the diagnosis and treatment and referral of orthopaedic problems and sports injuries. The new Pediatric Orthopaedics and Sports Injuries: A Quick Reference Guide efficiently delivers the essential guidance and how-to-do-it recommendations you need. Turn here for concise summaries of disorders and injuries. Proven evaluation, treatment, and rehabilitation approaches. Practice-tested tips, and invaluable clinical pearls. Efficiently respond to diverse clinical challenges: Common sports injuries, Trauma, Limb disorders, Spine disorders Hip and pelvis disorders, Infections, Tumors, Skeletal dysplasias. Plus, you'll find step-by-step help with musculoskeletal examination and evaluation; casting and splinting; imaging techniques, and rehabilitation strategies. The book features many illustrations, clinical photographs and radiographic images to demonstrate physical examination techniques and pathologic physical findings, as well as tables and figures to aid in diagnosis. Streamline orthopedic problem-solving: Etiology/epidemiology, Signs and symptoms, Differential diagnosis, How to make the diagnosis, Treatment, Rehabilitation, Expected outcomes/prognosis, Coding for proper payment, and when to refer.
Research Interests:
American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and... more
American football remains one of the most popular sports for young athletes. The injuries sustained during football, especially those to the head and neck, have been a topic of intense interest recently in both the public media and medical literature. The recognition of these injuries and the potential for long-term sequelae have led some physicians to call for a reduction in the number of contact practices, a postponement of tackling until a certain age, and even a ban on high school football. This statement reviews the literature regarding injuries in football, particularly those of the head and neck, the relationship between tackling and football-related injuries, and the potential effects of limiting or delaying tackling on injury risk.
Research Interests:
ABSTRACT Purpose: To determine whether the degree of sports specialization, weekly training volumes, and growth rates are independent risk factors for injury in young athletes. Methods and Study Design: This multi-center prospective... more
ABSTRACT Purpose: To determine whether the degree of sports specialization, weekly training volumes, and growth rates are independent risk factors for injury in young athletes. Methods and Study Design: This multi-center prospective cohort study followed injured young athletes recruited from sports medicine clinics and uninjured athletes recruited during their sports physical at primary care clinics. At baseline, all athletes were 8-18 years old and completed a survey reporting training volumes, degree of sports specialization, Tanner stage, and had height and weight measured. This same data was collected from each participant at 6 month intervals for up to 3 years (2010-2012). Results: There were 1206 participants (50.7% male) who evaluated at baseline while longitudinal follow up data collection is ongoing at time of submission. There were 837 injured participants with a total of 859 unique injuries with 360 uninjured participants that served as controls. Injured athletes were older than uninjured athletes (14.0 +/- 2.2 vs. 12.9 y/o +/-2.6, p&lt;0.001), reported a higher average hours/week playing organized sports (11.3 +/- 6.9 vs. 9.4 +/-8.2 ; p&lt;0.001), and higher average hours/week in total (gym, free play, organized) sports activity (19.7 +/-9.8 vs 17.6 +/-10.3; , p&lt;0.001). Using a six point specialization score designed for this study, injured athletes had a significantly higher degree of specialization than uninjured athletes (3.3 +/- 1.6 vs. 2.7 +/- 1.6; OR 1.27, p&lt;0.001), even after adjusting for hrs/week in total sports activity and age (p&lt;0.001). Injured athletes had similar annual calculated growth rate at baseline (4.75 vs 4.75 cm/yr). Young athletes who participated in more total hours then age (p=0.004) and who participated in &gt; 2 times organized sports then free play (p=0.004) were more likely to be injured. Young athletes at risk for serious overuse injury also participate in more total hours then age and are more specialized. Conclusions: Injured young athletes are older and spend more total sports hours/week and in hours/week of organized sports. There is an independent risk of injury in athletes that are more specialized, even when accounting for hours/week of sports participation and age. There is also a risk of injury and serious overuse when participating in more sports hours/week then age and all types of injury if participates in more then twice organized sports then free play hours. There does not appear to be a relationship between growth rate and increased risk of injury in the baseline data. Clinical Relevance: Determining the degree of sports specialization and weekly training volumes may help pediatricians identify young athletes at higher risk for all type and serious overuse injury. Acknowledgements: 2 Consecutive American Medical Society for Sports Medicine Foundation Grant
Research Interests:
Adolescent girls who participate in competitive or recreational sports are at higher risk for anterior cruciate ligament injuries than adolescent boys, but through neuromuscular training and knowledgeable coaching some of these injuries... more
Adolescent girls who participate in competitive or recreational sports are at higher risk for anterior cruciate ligament injuries than adolescent boys, but through neuromuscular training and knowledgeable coaching some of these injuries may be preventable.
Research Interests:
Research Interests:
Research Interests:
ABSTRACT JAMA PEDIATRICS Concussion Among Female Middle-School Soccer Players John W. O&#39;Kane, MD: Amy Spieker, MPH; Marni R. Levy, BS; Moni Neradilek, MS: Nayak L. Polissar, PhD: Melissa A. Schiff, MD, MPH IMPORTANCE Despite... more
ABSTRACT JAMA PEDIATRICS Concussion Among Female Middle-School Soccer Players John W. O&#39;Kane, MD: Amy Spieker, MPH; Marni R. Levy, BS; Moni Neradilek, MS: Nayak L. Polissar, PhD: Melissa A. Schiff, MD, MPH IMPORTANCE Despite recent increased awareness about sports concussions, little research has evaluated concussions among middle-school athletes. OBJECTIVES To evaluate the frequency and duration of concussions in female youth soccer players and to determine if concussions result in stopping play and seeking medical care. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study from March 2008 through May 2012 among 4 soccer clubs from the Puget Sound region of Washington State, involving 351 elite female soccer players, aged 11 to 14 years, from 33 randomly selected youth soccer teams. Of the players contacted, 83.1% participated and 92.4% completed the study. MAIN OUTCOMES AND MEASURES Concussion cumulative incidence, incidence rate, and description of the number, type, and duration of symptoms. We inquired weekly about concussion symptoms and, if present, the symptom type and duration, the event resulting in symptom onset, and whether the player sought medical attention or played while symptomatic. RESULTS Among the 351 soccer players, there were 59 concussions with 43 742 athletic exposure hours. Cumulative concussion incidence was 13.0% per season, and the incidence rate was 1.2 per 1000 athletic exposure hours (95% CI, 0.9-1.6). Symptoms lasted a median of 4.0 days (mean, 9.4 days). Heading the ball accounted for 30.5% of concussions. Players with the following symptoms had a longer recover time than players without these symptoms: light sensitivity (16.0 vs 3.0 days, P = .001), emotional lability (15.0 vs 3.5 days, P = .002), noise sensitivity (12.0 vs 3.0 days, P = .004), memory loss (9.0 vs 4.0 days, P = .04), nausea (9.0 vs 3.0 days, P = .02), and concentration problems (7.0 vs 2.0 days, P = .02). Most players (58.6%) continued to play with symptoms, with almost half (44.1%) seeking medical attention. CONCLUSIONS AND RELEVANCE Concussion rates in young female soccer players are greater than those reported in older age groups, and most of those concussed report playing with symptoms. Heading the ball is a frequent precipitating event. Awareness of recommendations to not play and seek medical attention is lacking for this age group.
Research Interests:
Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The... more
Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The primary objectives of this clinical report are to define the ingredients of sports and energy drinks, categorize the similarities and differences between the products, and discuss misuses and abuses. Secondary objectives are to encourage screening during annual physical examinations for sports and energy drink use, to understand the reasons why youth consumption is widespread, and to improve education aimed at decreasing or eliminating the inappropriate use of these beverages by children and adolescents. Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents. Furthermore, frequent or excessive intake of caloric sports drinks c...
Research Interests:
OBJECTIVES: The objective of this study was to describe shoulder injuries in a nationally representative sample of high school athletes playing 9 sports. A national estimate of shoulder injuries among high school athletes was subsequently... more
OBJECTIVES: The objective of this study was to describe shoulder injuries in a nationally representative sample of high school athletes playing 9 sports. A national estimate of shoulder injuries among high school athletes was subsequently calculated. METHODS: Injury data were collected in 9 sports (boys’ football, soccer, basketball, wrestling, and baseball; girls’ soccer, volleyball, basketball, and softball) during the 2005–2006 through 2011–2012 academic years from a nationally representative sample of high schools via High School Reporting Information Online. RESULTS: During the 2005–2006 through 2011–2012 academic years, high school athletes in this study sustained 2798 shoulder injuries during 13 002 321 athlete exposures, for an injury rate of 2.15 per 10 000 athlete exposures. This corresponds to a nationally estimated 820 691 injuries during this time period. Rates of injury were higher in competition as compared with practice (rate ratio = 3.17 [95% confidence interval: 2....
Research Interests:
Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The... more
Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The primary objectives of this clinical report ...
Research Interests:
Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing... more
Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement pr...