youth athlete considerations for sports PT

main reason youth drop their sport

not having fun

when do long bone growth plates close

males: 15-17 y/o

females: 13-15 y/o

what system often lags behind osseous development

musculotendinous system

theoretical athlete development model

1. sports specialization and development

- encourage multi-sport until >15 y/o

2. biological maturation and utilization of percentage of predicted adult height

- growth spurts are correlated to injury risk

3. motor deficits and neuromuscular training

- identify and rectify early

4. overload workload progression

training risks

- hours training per week for sport > age = 2.4x likely to sustain an overuse injury

- playing one sport 8+ months/year = 1.6x likely to sustain an overuse injury

- previous injury not addressed properly = 40-70% chance of happening again

what level of specialization is a the highest risk of injury

highly specialized:

- year round training (>8months)

- single main sport

- quit all sports to focus on one

*low risk of acute injury

stress + recovery =

adaptatoin

fitness - fatigue =

performance

teenagers need how many hours of sleep

8-10 hours/night

- less than that = 1.7x more likely to sustain an injury

lack of sleep can lead to

- poor decisions about food

- decreased mental sharpness

- reduced tissue healing capacity

possible signs of adolescent stress

- physical sx not associated w/ injury

- moodiness/anger

- behavioral changes

- cognitive difficulties

- relationship strain

S&C strategies to reduce injury and improve performance in young athletes

- needs analysis

- monitor rapid growth changes

- optimize the dose response

- use effective training modes in combination

- start early during childhood

- use risk stratification to individualize and protect

- enhance adherence

youth resistance training dosage

- 1-3 sets of 6-15 reps for UE and LE

- specific exercise for abdominal and lower back

- 1-3 sets of 3-6 reps for power

commonality in youth sports

male 14-18 y/o, usually playing football, usually concussion

intermediate phase rehab of ankle sprain

pain w/ palpation reduces

- manual therapy, strength, intro to power, plyo, agility

advanced phase return to activity of ankle sprains timeline

gd 1: 1-4 weeks

gd 2: 8-12 weeks

gd 3: 12+ weeks

risk of CAI

- poor proprioception

- decreased endurance

- decreased DF and peroneal strength

- previous hx

osgood-schlatter disease overvie

- apophysitis of tibial tuberosity due to repetitive overload

- affects 1 in 10 adolescent athletes

- more common in plant/support leg (soccer players)

risk factors for osgood-schlatter

- high training loads

- quads strong and tight, hamstrings weak

- COM behind support leg

- higher arches

- DF <10

- vitamin D deficiency

osgood-schlatter prognosis

- typically coincides w/ Risser Stage 1

- no treatment = 80% will have full resolution within 2 years

- structured PT = 3-6 months

osgood-schlatter management

- activity modif until sx mild

- ankle mobility

- hip and HS control

- quad tension reduced

- no NSAID

calcaneal apophysitis overview

heel pain until proven otherwise

- up to 22% of repetitive stress injuries in adolescents

calcaneal apophysitis risk factors

- obesity

- hx of OSD

- rapid growth spurts

- high frequency of high speed/high impact sports

- limited ankle DF

- pronated foot posture

calcaneal apophysitis management

- address mid and forefoot mobility issues

- heel lifts may be better than custom orthotics

- typically 4-12 week RTS

- eccentric training within pain tolerance