Throwing Injuries In Children

children baseball throwing injury Little Leaguer Youth Pitcher Elbow

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

In baseball, especially at the beginning of the season, there is an increase in elbow problems amoung young players. The most common elbow problem is the medial apophysitis named « Little Leaguer or Youth Pitcher Elbow ».

The elbow joint is composed of 3 bones : upper arm bone (humerus) and 2 bones in the forearms (radius and ulna). Muscles, ligaments and tendons keep the elbow joints together.

Little Leaguer Elbow

little leaguer Youth Pitcher Elbow humerus ulna radius medial apophysis epicondyle

This injury occurs when repetitive throwing creates an extremely strong pull on the tendons and ligaments of the elbow. The pain felt to prominence inside the elbow.

« Pitcher’s elbow » can become serious if the case gets worse. Repeated pull can tear ligaments and tendons of the bones. The tear can take tiny pieces of bone like when a plant takes piece of the soil when it uprooted. This can destabilize bone growth, which can create a deformity.

Symptoms

« Pitcher’s elbow » can cause pain in the elbow. If any of these symptoms occur, it’s recommended to stop the throws :

  • Elbow pain
  • Decreased movement amplitude
  • Locking or snagging in the elbow joint

Treatment

Elbow injuries by lanching movements can become complicated cases, if they’aren’t treated.

Non-surgical treatment

Younger children respond better to non-surgical treatment :

  • Stop throwing because continuing to do this can create major complications and may reduce a child’s ability to remain active in a throwing sport.
  • Use an ice bag to decrease swelling
  • If the pain continues after a few days of complete rest in the affected area or if the pain reoccurs when the throwing starts, stop the activity again until the child is treated.
  • Improve the technique of launched

Surgical treatment

Surgery is sometimes necessary for serious injuries, mainly for girls older than 12 years old and boys older than 14 years old.

Depending on the child’s injury, surgery may includes bone fragment removal, bone grafting or reattaching a ligament back to the bone.

Recovery time

The recovery time depends on the age of the athlete and the severity of the injury. If the injury detected early and the modification of the activity begins, there will be little time required for the athlete to start the sport again.

However, if the athlete continues to play despite the pain and other symptoms, it will take several months to heal the injury. Or it’s possible that the injury becomes permanent.

Prevent

The recommendation for a child to be safe is 15 for 8-10 years old, 100 for 11-12 years old and 125 for 13-14 years old. This involves training and competitions. To avoid pitching injury, young pitchers should play 3-4 inning each game.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Sudden Cardiac Death

sudden, cardiac, death, hearth, sport, athlete, scd

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Sudden cardiac death (SCD) is an extremely rare event. The most common reason for cardiac death related to sports is the cardiomyopathy hypertrophic, an abnormal enlargement of cardiac muscle. It’s a rare heart disease that predispose a person of SCD because of physical exertion.

Commotio cordis is another reason for SCD. It’s a direct trauma to the chest at a specific moment in the cardiac cycle and this trauma triggers a dangerous arrtyhmia (abnormal rhythm) of electrical system of the heart. A commotio cordis usually arrives in sports where a blunt projectile, such as baseball ball or hockey puck, hits the athlete’s chest.

Treatment

Cardiac arrhythmias that threaten the lives of young athletes are very difficult to treat. The immediate use of AED (automated external defibrillator) can provide an advantage.

Prevent

sudden, cardiac, death, sport, hearth, athlete, scd

Unfortunately, the only way to prevent death from hypertrophic cardiomyopathy is to identify the disease and recommend the athlete avoid any strenuous activities. Cardiac ultrasound can diagnose this condition. Some experts have called for the screening of athletes with ultrasound or electrocardiograms (EKG), although this screening is controversial because of the high cost and scarcity of this condition.

However, athletes with cardiac symptoms such as dizziness, fatigue, shortness of breath in relation to physical activity, palpitations, convulsions and especially syncope (fainting) must stop the competitions and must do deeper tests.

In addition, a family history of cardiac abnormalities justifies a complete cardiac evaluation. Especially a known parent with hypertrophic cardiomyopathy or a history unexplained sudden death in a family member.

There is the creation of different forms of protection for the chest and pads, but unfortunately no method has prevented this tragic event. The rules regularly change in the sport and some times to try to avoid commotio cordis. For example in baseball and softball, it’s the limitation of the use of aluminium bat. This rule can protect the pitcher by decreasing the speed of the ball after contact with the bat. There are other rules too, such as using a softer ball and teaching players to turn their chest when the ball is hit by the bat.

Stats

  • Fortunately, SCD is extremely rare in the sport. For the majority of people do sports to cardiac benefits.
  • In young athetes, the most common causes of SCD are 25-30% hypertrophic cardiomyopathy and 20% commotio cordis.
  • Coronary artery abnormalities are the cause of 14% of SCD in athletes.
  • Marc-Vivian Foe, a Cameroonian soccer star had a sudden cardiac death during a match in 2003.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Steroids

sport injury steroids performance enhancing drug

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

We regularly read in news articles, the use of anabolic steroids or performance enhancing drugs by elite athlete. But you should know that these dangerous drugs are more and more used by children in college, high-school and middle school.

What

sport injury steroids performance enhancing drug

Anabolic steroids are synthetic derivatives of testosterone. Testosterone is a male sex hormone. Steroids help to create new proteins to increase the size and strength of muscles. The body is already doing this process naturally but steroids increase the activity of this normal process. Find performance enhancing drugs in communities, gyms or internet is easy.

Steroids are consumed orally or by injection. Anabolic steroids in themselves aren’t effective. However, when they’re used at the same time with a strength training, they increase the strength in an impressive way.

Side effects

sport injury steroids performance enhancing drug side effect acne

sport injury steroids performance enhancing drug side effect acne

sport injury steroids performance enhancing drug side effect acne

Performance enhancing drugs allow an athlete to have bigger and more powerful muscles, but users may have deadly health problems. Performance enhancing drugs have several side effects that continue to work even after you stop using them. Users are also more likely to have risky behaviors such as having unsafe sex or taking illegal drugs.

Symptoms of use of anabolic steroids are :

  • Acne (often severe) visible on the face and back

  • Severe mood change such as extreme aggression or suicidal behavior

  • Premature balding, breast enlargement (gynecomastia), irreversible shrinking of testicles in boys.

  • Deeper voice, shrinking breast and clitoral enlargement in girls

  • Dangerous enlargement of the heart that can increase bad cholesterol and blood pressure.

  • Irreversible liver damage

  • In children, premature closure of the growth plates, stopping normal growth of bones.

sport injury steroids performance enhancing drug side effect gynecomastia

sport injury steroids performance enhancing drug side effect gynecomastia

sport injury steroids performance enhancing drug side effect gynecomastia

A reason to take anabolic steroids

Anabolic steroids may be advisable for people who have lost testicular function like men with a testicular tumor. They’re also advised in some type of anemia to stimulate the bone morrow.

Prevent

The true is the problems of performance enhancing drugs aren’t solely related to elite athletes. Children are also exposed to this every day. Ask kids what they know about these drugs. Ask them if they know anyone in their school class who uses these drugs. Ask them if they know the dangers of these drugs. If you think that your children or children in your family might be experiencing these drugs, talk to your doctor.

It’s also important to talk to coaches and ask them if leagues or schools require annual physical exams for athletes. A physical examination by a doctor can detect the use of performance enhancing drugs in athletes (doping test). Ask coaches if any of their athletes have experienced performance enhancing drugs.

Stats

As many as four 4 American children and teens are using performance enhancing drugs such as anabolic steroids.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Shoulder Instability Or Dislocations

shoulder instability anatomy

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Shoulder is the most mobile joint of the body. This allows you to lift your arm, rotate your arm and lift your arm over your head. It’s possible to have a greater range of motion with less stability.

How

Shoulder instability

This happens when the humerus head (the upper arm bone) is forced out of the shoulder’s cavity. Usually this happens as a result of a sudden traumatic injury.

Once the shoulder is dislocated, the shoulder is vulnerable to repeat. When the shoulder is loose and slips several times, it’s called a chronic shoulder instability.

The shoulder is made of 3 bones : humerus (upper arm bone), scapula (shoulder blade) and clavicle (collarbone).

Dislocation shoulder

shoulder dislocation anatomy

This may be partial, which means that the arm’s ball partially comes out from the cavity. This is called a subluxation. This can be complete which means that the arm’s ball comes out completely from the cavity.

Symptoms

Symptoms of chronic shoulder instability are :

  • Pain caused by the shoulder injury

  • Repeated shoulder’s dislocation

  • Repeated instance of the shoulder giving out

  • A persistent sensation of the shoulder that is loose, slipping out of the joint or hanging.

Diagnosis

Specific tests help assess shoulder instability (including general relaxation of ligaments). A doctor may prescribe imaging tests such as X-rays, CT Scan or MRI to confirm the diagnosis and identify other problems.

Treatment

First, chronic shoulder instability treated with nonsurgical options. If these options don’t relieve pain and instability, surgery may be needed.

Nonsurgical treatment

shoulder dislocation treatment non surgical

Generally, it often takes several months of nonsurgical treatment before success can be assessed. Nonsurgical treatments includes :

  • Activity modification

  • Non-steroidal anti-inflammatory medication

  • Physical therapy

Surgical treatment

shoulder dislocation treatment surgery bankart repair

Often, surgery is often required to repair torn or stretched ligaments so that they can maintain the shoulder joint in place.

Bankart lesions (tearing of the front labrum from the cavity) can be repaired surgically using suture anchors to reattach the ligaments to the bone.

Arthroscopy => Soft tissues of the shoulder can be repaired using tiny instruments and small incisions. It’s a procedure that is done the same day or outpatient. Arthroscopy is a minimally invasive surgery. The surgeon examines the inside of the shoulder with a small camera and performs the operation with special instruments.

Open surgery => These are patients who require open surgical intervention. This involves making a wider incision on the shoulder and performing the repair under direct visualization.

Rehabilitation

After surgery, the shoulder can be temporarily immobilized with a sling. When the sling is removed, it’s essential to do ligament rehabilitation exercises. These exercises improve the range of motion of the shoulder and avoid scarring during ligament healing. Thereafter, exercises for strengthening the shoulder will be added in the rehabilitation program.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Shoulder Impingement

shoulder impingement

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Impingement is the fact of having mechanical compression and/or tendon wear of the rotator cuff. Rotator cuff is composed of a serie of 4 muscles connected to the shoulder blade at the humeral head (upper part of the shoulder joint). The function of the rotator cuff is to maintain the humeral head within the glenoid (socket) during normal shoulder function and to participate in shoulder strength during activity. Normally, the rotator cuff glides gently between the inferior surface of the acromion, the bone at the point of the shoulder and the humeral head.

Causes

Any process that can interfere with rotator cuff being able to glide normally can cause impingement. The causes are :

  • Weakening

  • Degeneration of the tendon due to aging

  • Formation of the bone spurs

  • Inflammation of tissues on the space above the rotator cuff

  • Injury due to overuse

Overuse activities that can lead to impingement are most commonly seen in tennis players, pitchers and swimmers.

Diagnosis

shoulder impingement

Diagnosis can be made with the patient’s history and physical examination. Patients suffering impingement often complain of pain in the shoulder. This pain worsens with overhead activity and can be so strong that it causes an awakening during the night. Manipulation of the shoulder in a specific way by a doctor will usually reproduce the symptoms and confirm the diagnosis. X-rays are also useful for the evaluation of the presence of bone spurs and/or the narrowing of the subacromial space.

Treatment

The first thing to do is to eliminate identifiable causes or factor that contribute to the pain. This means temporarily avoiding activities like tennis, pitching or swimming. A non steroidal anti-inflammatory medication may also be recommended by your doctor. The treatment is based on exercises aimed at restoring flexibility and normal strength to the shoulder girdle, especially by strengthening the muscles of the rotator cuff and the muscles responsible for the normal movements of the scapula (shoulder blade). This program may be performed by a doctor, a certified athletic trainer or a qualified physiotherapist. Sometimes a cortisone injection may be helpful in the treatment.

Surgery

Surgery isn’t necessary in most case of shoulder impingement. But if the symptoms persist despite non-surgical treatment, surgical intervention may be beneficial. Surgery involves deriding or surgically removing, tissue that is irritating the rotator cuff. This can be done with open or arthroscopic technique. The result is favorable in about 90% of cases.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here .

Heat Illness

heat illness

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Every summer, hundreds of people experience sun-related illnesses and heat. Being prepared and hydrated avoids theses situations.

Why

When an athlete exercises, his/her body temperature increase and the body sweats to cool the body. During this process, body fluids and electrolytes are lost. If the boy is not recharged with fluids and electrolytes, it’s dehydration and it increase the risk of heat illness as a heat stroke.

Symptoms

Symptoms are :

  • Chills

  • Dark colored urine

  • Dry mouth

  • Headaches

  • Thirst

  • Weakness

If the heat illness progress, there are more serious symptoms like :

  • Difficulty breathing

  • Body temperature increasing to dangerous levels

  • Muscle cramps

  • Nausea

  • Tingling of the limbs

  • Death

How to prevent

The most effective treatments for heat illness are :

  • Proper training for the heat

  • Fluid replacement before, during, and after exertion

  • Appropriate clothing (light colored, loose fitting and limited to one layer)

  • Early recognition via direct monitoring of athlete by other players, coaches and medical staff

  • Monitoring the intensity of physical activity appropriate for fitness and how an athlete has acclimated to conditions.

  • If possible, having an athletic trainer on site during events and practices to properly prevent and treat heat illnesses.

In situations where the training program is intense or during a trip in a hot climate, an athlete should limit the intensity and duration of the training session. Thereafter, the athlete will increase the training’s intensity for a period of 7-14 days to allow to the body, the time to adjust to the climate and environmental conditions. For athletes with respiratory, gastrointestinal or other diseases, they should especially evaluate these new conditions.

When an athlete should hydrate

hydrate

It’s necessary to hydrate before, during and after a training session. Drinking 47cl (16 ounces) of water is recommended 1 hour before exercises. Hydration should continue with 11-23cl (4-8 ounces) of water every 15-20 minutes throughout the effort

There is a trick to track the hydration’s level is to weigh before and after a physical activity. If the athlete is lighter after a physical activity, this means that there a deficit of fluids (indicated by weight loss) and it’s necessary to recharge them. For the next physical activity, it will be essential to drink more to evaluate the losses (perspiration). An athlete who loses more than 2-3% of his/her bodyweight during exercise may decrease the performance and the body’s physiological function.

If the athlete is heavier after a physical activity, it means that there is a surplus of fluids (indicated by gain weight). For the next physical activity, it will be essential to drink less to evaluate the surplus.

How to treat it

When you see signs of heat illness or heat stroke, it may be an imminent danger of death. It’s necessary that a person immediately call for medical assistance while you’re cooling the person at risk.

Treatment included :

  • Getting the athlete to a shaded area

  • If it heat stroke, cool the athlete rapidly using cold water immersion. If immersion is not available you may use spray from a hose, cold water sponging, or placing cold towels over the entire body

  • Monitoring body temperature

  • Providing cool beverage if possible (i.e., if the athlete doesn’t have altered consciousness).

  • Getting medical assistance as soon as possible.

Heat exhaustion is a type of heat illness that can happen after several days of exposure to high temperature and improper or unbalanced fluid recharging.

Statistics

  • Heat stroke is a type of serious illness related to heat. It can cause death to athletes and this is probably the leading cause of athlete death during the months of July and August.

  • The body produces 1.8 liters (a half of gallon) of perspiration to cool the body every hour. If there are not enough fluids or the heat is overwhelming the body, the person may develop heat-related illness.

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-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food, click here.

Concussion

concussion
A blow to the head that makes the brain hit the skull

What’s up ? This is THE stephane ANDRE. With my training, I’m interessed in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

A concussion is a traumatic brain injury that alters mental state or creates others symptoms. Many people think they have no concussion because they have not lost consciousness. You must know that it’s possible to have a concussion without losing consciousness. Often football or rugby players say : « I just got my bell rung » when they have been hit on the head that makes the ears rings, but these symptoms are often consistent with concussion.

Signs

  • Balance problems

  • Difficulty communicating, concentrating

  • Dizziness

  • Drowsiness

  • Fatigue

  • Feeling emotional

  • Feeling mentally foggy

  • Headache

  • Irritability

  • Memory difficulties

  • Nausea

  • Nervousness

  • Numbness or tingling

  • Sadness

  • Sensitivity to light or noise

  • Sleeping more than usual or difficulty falling asleep

  • Visual problems (blurry or double vision)

  • Vomiting

Diagnostic

diagnostic

As soon as a concussion is suspected, a trained coach, certified athletic trainer or the team physician should immediately perform an initial « sideline » evaluation, including :

  • Symptoms list review

  • Focused neurological exam

  • Focused orientation exam that tests short-term memory recall such as the event, play, opponent, score or last meal.

  • Focused orientation exam that tests long-term recall such as name, birth date, place of birth.

  • Assessment of athlete’s ability to stay attentive to a complex task such as reciting months backwards.

If a person is suspected of having a concussion and there is no diagnosis, a concussion may place an athlete at risk of developing second impact syndrome. It’s a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has completely healed.

Second impact syndrome

Second impact syndrome is a potentially fatal injury that occurs when an athlete suffers a second head injury before the old head injury has been fully healed. Unfortunately, it’s complicated to know if the brain has been healed from the first injury. Even after all symptoms resolved, it’s possible that the healing isn’t complete and that it increases the risk to the brain of having the second impact syndrome. Neurocognitive testing can help doctors or physician decide when the athlete can return to the competition in the best conditions.

Neurocognitive testing

Neurocognitive testing

Neurocognitive testing is a questionnaire (usually on the computer) that athletes do that deals with several areas of brain function, including memory, problem solving, reaction times, brain processing speed and post-concussion symptoms. It’s most valid if the athlete has a pre-injury baseline test on file to compare the post concussion test. This information can be really helpful for the doctor or physician to decide when the athlete can return to the competition.

When to return to the competition

All athletes suffer concussion (whatever the gravity) should pass an evaluation by a qualified health care provider before returning to the competition. Athletes should return to competition after they have been completely cleared of all concussion symptoms and have no symptoms during and after physical tests.

Baseline testing is important for assessing concussion symptoms after an incident. The baseline testing often includes neurocognitive tests, symptom checklists, sideline assessment tools such as the Sideline Concussion Assessment Tool and balance testing.

Statistics

  • Athletes who have already had a concussion are more likely to have another concussion.

  • Children and teenagers are more likely to have concussion and take longer to heal than adults.

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-Steph