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Youth Lower Limb Overuse Injuries Mind Map 2 - Coggle Diagram
Youth Lower Limb Overuse Injuries
Mind Map 2
What are the recommendations for physical activity in the youth population (5-17)?
WHO GUIDELINES
At least 60mins of moderate to vigorous-intensity physical activity daily
Physical activity of amounts >60 mins daily will provide additional health benefits
Most of daily physical activity should be aerobic
Vigorous-intensity should be incorporated, inc these that strengthen muscle and bone, at least 3 x week
Why are youth susceptible
to overuse injuries?
Growth and Development Relationship to Sport Injuries
boys can grow 8-10cm per year (peak height at 13-14)
girls can grow 7-9cm per year (peak height at 11-12)
Growth
decreased bone mineral density
increased tensile forces on muscle attachments
reduced flexibility
Maturation/Development
immature structures
developing brain which is vulnerable to concussions
underdeveloped neuromuscular system
mismatch in biological age between athletes
What are the
risk factors?
Prior injury
Overuse injuries more likely to occur during adolescent growth spurt
Lack of lean tissue mass
Increase in joint hypomobility
Higher training volumes
Females
What are the different types of
youth overuse injuries?
Sever's Lesion
Osgood Schlager Lesion
Patella tendon attachment to tibial tuberosity
Diagnosis:
pain reproduced by isometric knee extension
tenderness on palpation
pain at patella tendon insertion
girls may have reduced hip abduction strength
Treatment
Patient education and exercise
activity modification
Manage training load, pain intensity, psychological factors
Exercise training protocols (Rathleff et al)
Sinding-Larsen-Johansson Lesion
Osteochondrosis Lesions
AIIS, ASIS
Lesser trochanter
Ischial tuberosity
Navicular
Patellofemoral Pain
Second most common knee pain among adolescents
Can last 6-76 months
Diagnosis:
Diffuse anterior knee pain
Pain with activities loading the knee eg stairs, squatting, lunges
Weak hip muscles
Psychological considerations: Anxiety, depression, fearful of movement, catastrophisation
Treatment
Education
Exercise therapy
pain management
Address psychological factors
Loading training protocols (Rathleff et al.)
Burnout
Mental Strain
How do you minimise the risk of
developing overuse injuries?
Accommodate for Growth and Maturation
IOC Guidelines for training load prescription
Small increases/decreases in load
Individual / flexible loading
Adjust for psychological stresses
Schedule recovery
Injury Prevention
Exercise Programs
(Example)
PEP Program (Prevent Injury & Enhance Performance)
Reduce number of ACL injuries
Education, stretching, strengthening, plyometrics, sports-specific agility drills
(Example)
Footy First
(AFL players)
warm up, hamstring strength exercise, balance, landing and changing direction exercises
Groin strength, hip strength ex's
Sleep
Diet
Mental health
Clinical Practice Guideline
Recommend exercise based prevention programs to reduce knee and ACL injury
implement a program before training sessions
Soccer players (esp female) should use program
Female programs inc proximal control ex's, strength & plyometric ex's
Multiple sessions per week, >20mins
Should start in pre-season and continue across season
Must ensure high compliance
Encourage programs for 12-25yo in high risk sport
Early specialisation in Young Athletes
What is it? Specialisation that occurs before 12 years of age
Training parameters
< 16 hours of training per week
Organised sport: 'free play' 2:1
training hours not more than age
Adhering to evidence based load guidelines
Recommendations
education to parents, coaches and athletes of increased risk of harm
<12 years old partake in wide range of physical activities
'free play' should be encouraged
delay specialisation until after age of 12
social, emotional and psychological maturity should be considered in when to specialise
Athletes who maintain broader sporting base until older than 12 are more likely to be 'successful' in chosen sport
physical harm associated with sport specialisation (overuse injuries)
Early specialisation can lead to:
Lower perception of overall health
earlier cessation of sporting activity
Burnout
less fun
Psychological needs dissatisfaction