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Youth lower limb overuse injuries (2) - Coggle Diagram
Youth lower limb overuse injuries (2)
Facts
Process of growth and maturation leads to increased risk of certain injuries (rapid growth ~ increased injury risk)
Injuries often accompanied by: decreased strength, neuromuscular control
Further research: investigate whether/the extent to which low strength, poor neuromuscular control increases risk of injury, or to what extent it is a result of disuse due to pain. Knowing that injury prevention programs such as 11+ focus on both these things and lowers risk of injury - likely precipitating.
Pain can be persistent (Patella femoral pain often lasts >12/12)
Phased/graded recovery and return to sport
Start: increase strength, decrease participation in sport, education
Continue: increase strength, manage training load, intensity, education
Early specialisation = > injury risk
risk factors
Female > male
decreased strength (particularly KE, hipAbd)
Decreased neuromuscular control
sport: free play ratio below 2:1
training hours per week exceed age
Apophyseal injuries common
Difficulties
Don't miss red flags
Perthes
Slipped capital femoral epiphysis (SCFE)
Creativity
Make an 'activity ladder' resource to use in patient education. This would monitor the amount of activity and monitor pain levels, providing clear visual representation of when to 'step back a rung'
Easy walking/cycling (low level)
fast walking/medium-hard cyling
Slow running
Stair climbing
running/jumping medium speed
Running/jumping high speed (high level)
Pain score
0-2 (ok)
3-10 (not ok)
Benefits/Ideas
Deliver relevant information (education) is a meaningful way.
Sleep is very important [61% injury risk reduction]
Diet is too [64% reduction], nutrition
With consent, refer those with suspect/inadequate nutritional intake due to significant increase in injury risk, worst cases (REDs) associated sequel include: decrease in metabolic rate, menstruation, bone health, immunity, protein synthesis etc.
Feelings
Due to my inexperience in this area: greater complexity than working with adult population due to developing body, mind, parents, coach involvement etc I do not feel confident in my ability to temper my communication.education to a diverse audience. In practice, reflecting on the language I use after consults and discussing different approaches with colleagues who are more familiar with the population would be beneficial. If feeling braze I would benefit from asking a colleague to listen to a session and provide feedback to me after I have verbalised my own reflections.
Priorities
Adolescent safety and wellbeing
Physical safety: pain reduction, timely and successful return to sport
Mental health considerations
: to what extent is a patient's identity tied to being an 'athlete', to what extent is their mental state (depression/anxiety etc) managed by exercise, to what extent is they community involvement/social connection dependent on sport?
Allow adequate rest:
the need to temper expectations of athlete, parents and coach. Long term sustainability, future injury minimisation/prevention. Activity modification as needed.
Nutrition
Sleep