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 .

SLAP Tears

slap tear anatomy shoulder

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.

SLAP is an acronym for superior labrum anterior to posterior. The labrum is a rim of tissue that adds depth to the bony socket of the shoulder. The superior or « top » portion or the labrum is important and frequently injured because the biceps attaches to this region.

How

SLAP tears happens because of physical activity with repetitive overhead movements or physical shock. Tears created because of overhead movements are common among athletes as basball pitchers or tennis players. Tears created due to physical shocks are often a fall on a hand stretched with the arm over the head or fall directly on the shoulder.

Diagnosis

slap tear anatomy shoulder

SLAP tears are very difficult to diagnose only with a physical exam because of different shoulder problems. Using a MRI with or without contrast helps a lot.

Treatment

The first step is to do a nonsurgical treatment. While the SLAP tear likely will not heal, a study confirmed that many have improvement of symptoms and function. If nonsurgical treatment (such as physical therapy) isn’t successful, surgery is being considered.

Surgery is usually done arthroscopically and involves reattaching the torn labrum to the top of the cavity. Generally, bone anchors loaded with sutures are inserted into the top of the cavity. The sutures are passed through the torn area of the labrum. The sutures are tied, which brings the torn labrum to the bone.

Prevention

Although it’s difficult to avoir acute SLAP tears, it’s possible to prevent chronic tears, especially with athletes who make overhead movements, maintaining balance in the shoulder.

Exercices that strengthen the muscles around the shoulder blades and exercises that stretch posterior shoulders are recommended to reduce the risk of SLAP chronic tears.

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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 .

This Problem Is Blocking Your Success

problem

What’s up ? This is THE stephane ANDRE !!! I watched an Olivier Roland’s video and I learned some good stuff.

In the last Leonardo da Vinci’s biography written by Walter Isaacson (who is also the author of the Steve Jobs biography, 2011), we can see that he was an extremely curious man. This curiosity allowed him to explore several different areas, boost his creativity and make a huge contribution to art. But the downside is that he kept changing projects.

Because of this, Leonardo da Vinci left a mind-blowing number of unfinished works of art. There are several scientific fields where he could have advanced the humanity of 2 centuries, if he worked more and published his results.

Attitude

This show us that we all have different attitudes to things that interest us, to our projects. We can explore something because we want to know how it works or master it to improve our lifestyle.

Attitude is very important in life. For example when you do something you like, you don’t have the same attitude as for something you like moderately or not at all. The last project you did, did you give the best of yourself to the end or not ? The question is whether you’re aware of the mission you want to accomplish through the project.

Mission

mission

In a project, the mission, the goal is essential. There are many people around me who say they want to be successful. They say things like : «  Yes, I want to be successful, if I find success around the corner, I would not say no. It would be cool ». But that doesn’t happen like that. To succeed in a mission, it’s necessary to give the best of oneself. And it can take many years, so don’t be naive. With internet, there is a myth that makes everyone believe that in 2-3 years we can be a millionaire, that’s wrong.

When I created my blog, I had friends who also had their blog or YouTube channel, but they all stopped. We didn’t have the same mission and the same attitude when we started. You can see in the top left of my blog this sentence : « I’m building my legacy ». This is my mission.

It’s really good to be curious, but once you’ve found something that interests you, focus on it. Work on this passion in « Guerrilla » mode to develop it, because it will become your main source of income. When I say « Guerrilla », it means that you give the best of yourself. You want to know what skill you have to learn, you want to learn from the best players in the field, you do tests to innovate, etc.

With a definite mission, a « Guerrilla » attitude and patience, you’ll have the success you deserve in your project.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-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.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-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

Articular Cartilage Injuries

articular cartilage injury

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

Definition

Articular cartilage is difficult to understand because there are 3 types of cartilages in the body : articular of hyaline cartilage (covers joint surfaces), fibrocartilage (knee meniscus, vertebral disk) and elastic cartilage (outer ear). These cartilage’s types differ in their structure, elasticity and strength.

Articular cartilage is a complex element, it’s a living tissue that is on the joint’s surface. The function is to provide a low friction surface to allow the joint to withstand weight loads through the range of motion needed to perform activity of daily living. To put it simply, articular cartilage is a very thin shock absorber. It’s built in 5 distinct layers and each layer has a structural and biochemical difference.

Injury

articular cartilage injury

Articular cartilage injury may be due to trauma or progressive degeneration (wear and tear). This can be mechanical destruction, a direct blow or other trauma. The healing of articular cartilage cells depends on the severity of the damage and the location of the lesion. Articular cartilage has no direct blood supply so it has very little ability to repair itself. It the lesion penetrates the bone under the cartilage, the bone provides blood in the area which improves the chances of healing.

Mechanical degeneration (wear and tear) of articular cartilage occurs with progressive loss of normal cartilage structure and function. This loss begins with the softening of the cartilage, then progresses to fragmentation. As the loss of articular cartilage lining continue, the underlying bone no longer has any protections against normal wear and tear of daily life and begins to get damaged leading to osteoarthritis.

In many cases, a patient experiences knee swelling and vague pain. At this stage, continuous physical activity isn’t possible. If a loose body is present, words such as « locking » or « catching » might be used to explain the problem. With wear and tear , the patient often experiences stiffness, decreased range of motion, joint pain and/or swelling.

Diagnostic

The physician examines the knee to look for a decrease in range of motion, pain along the joint line, swelling, fluid on the knee, abnormal alignment of the joint’s bones, and ligament or meniscal injury.

Cartilage lesions are difficult to diagnose and it’s possible that the use of magnetic resonance imaging (MRI) or arthroscopy may be necessary. Plain X- rays don’t usually diagnose articular cartilage problems but they used to rule out other abnormalities.

Treatment

articular cartilage injury treatment

 

Articular cartilage injury that doesn’t penetrate the bone doesn’t repair itself. A lesion that penetrates the bone can heal but the type of cartilage created is structurally unorganized and doesn’t work as well as the original cartilage.

Lesion less than 2 cm have the best prognosis and the best treatment options. These options are arthroscopic surgery using techniques to remove damaged cartilage and increase blood flow from the underlying bone (drilling, pick procedure or microfracture ).

For smaller lesion of articular cartilage surgery is not required.

For larger lesion, it’s necessary to transplant the articular cartilage from another area of the body. Talk to your doctor or specialist to have more information about the decision to have a surgical operation.

For patients with osteoarthritis, non-surgical treatment consists of physical therapy, lifestyle modification (for example reducing activity), bracing, supportive devices, oral and injection drugs (like non-steroidal inflammatory drugs, cartilage protective drugs) and medical management.

Surgical options depend on the severity of osteoarthritis and may provide a reduction in symptoms that are usually short-lived. Total osteoarthritis may relieve the symptom of advanced osteoarthritis but this usually requires a change in the lifestyle and/or level of activity of the patient.

Statistics

Based on published studies, the overall prevalence of articular cartilage injury in the knee is 36% among all athlete and 59% among asymptomatic basketball players and runners.

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-Steph