Protecting our young
Athletes
Michael Hatzakis Jr. MD
Rehab Options of Issaquah, WA
(425) 394-1200
Nancy Mitrano PT
Impact Physical Therapy, Seattle, WA
(425) 778-2325
Introduction


No matter how much time is spent on
injury prevention, sooner or later,
injuries happen
Acute or chronic
– Acute injuries, trauma
– Chronic, repetitive, overuse
activities
Introduction

Goal of talk:
– Help preparing pre-athletic programs to reduce
preventable injuries and reduce disability
– When an injury occurs, better able to quickly
identify problem and formulate an expedient
solution along with an individual prevention plan
– Help devise support infrastructure in teams to
handle prevention and injuries
Outline




Statistics and trends
Types of injuries
Common conditions and warning signs
General Paradigms of
treatment/prevention
Statistics

Cultural trends
– Significant increase in participation by
young children, particularly females

The most common injuries include sprains,
muscle strains, bone & growth plate
injuries, heat illnesses and repetitive motion
injuries
Statistics





30 mil youth participate in organized sports
3.5 million injuries each year
Almost one-third of all injuries incurred in
childhood are sports-related injuries
Most common are sprains and strains.
Sports and recreational activities comprise
more than 21 percent of all traumatic brain
injuries
Types of Injuries







Sprain and Strain
Overuse injuries
Fractures
Head injuries
Thoracic and abdominal
injuries
Heat and environmental conditions
Aggravations of health conditions
Survey of injury sites

Hip Pain:
– Bursitis or gluteal strains,
Either trauma or overuse
 Rest, inflammation subside
 Inadequate abductor strength
 Strengthen hip abductors
 Weak and tight hip adductors and abductors
associated with poor performance and higher injury
rates, especial in soccer players (Hrysomallis 2009 J.
Strength & Cond)
 Don’t forget to stretch flexors

Survey of injury sites

Knee Pain
– Patellofemoral Syndrome (Runner’s Knee)
(Chondromalacia)
– Pain behind the kneecap, walking,
running, or sitting, worse when walking
downhill, may have snapping, popping, or
grinding in the knee
– Overuse injury, plus, too tight quads
– Rest, stretch & strengthen, cross-train
Survey of injury sites

Knee Pain
– Patellar Tendonitis (Jumper’s Knee can
give rise to Osgood-Schlatter’s)



Repetitive micotrauma results from the
frequent use of the extensor mechanism
(jumping)
Rest, ice then stretch and strengthen
Infrapatellar strap, develop strong thigh
muscles
Survey of injury sites

Knee Pain:
– ACL Injuries:
ACL prevents front-back motion
 Injuries occur, cutting,
landing, stopping, side impact
 Girls 8x > boys
 Highest in basketball,
volleyball and soccer

Survey of injury sites

Knee Pain
– ACL Injuries:





Causes: weak quads: girls land with less knee flexion,
more valgus (inward) stress
Decrease H:Q muscle imbalance
Dynamic Warm-up, Plyometrics/Jump
Training, Speed and Agility Training,
High Intensity Strength Training,
Flexibility Training
Need to learn to absorb
landing with entire limb, “soft-land”
Cross-train
Survey of injury sites

Ankle Pain
– Ankle Sprain: Grade I, II or III
– 90% are lateral, inversion strain/sprains
Survey of injury sites

Ankle Pain
– Must seek medical attention if


Inability to bear weight for >1 day, or symptoms do
not improve x several days, or, numbness in toes
persist, or, pain above the ankle or in the foot
Causes: tight calfs, weakness in stabilizers
– Elastic wrap acutely to control
inflammation
– Prevention: calf stretching, strengthening,
ankle drills,
General Paradigms



Engage in appropriate conditioning program for 6
weeks prior to beginning daily practice routine
Appropriate warm-up/cool-down. Practices two
hours or less to avoid overuse injuries and medical
complications. Do not over-train
Make time for stretching and specific stretching
exercises. Be sure young athletes know it is
important to you that they stretch and strengthen;
they will take cues from you
General Paradigms



Overuse:
Cross training using other muscle groups to
manage or prevent overuse
Do not chose same muscle group crosstraining
– Ie., chose swimming for running athletes

2-3 months per year break, with alternate
conditioning
– “The American Academy of Pediatrics has issued
two policy statements on overuse injuries in
three years, the latest in 2007.”
General Paradigms

Make sure injured athletes have access to
medical assessments:
– “Team doctor” assessment
– Encourage player to seek out primary doc or
community sports medicine, orthopedist or
physiatrist or, require evaluation note from
player than an evaluation or treatment plan has
occurred. Close relationship with physical
therapy
Thank You

Michael Hatzakis Jr MD
– Rehab Options of Issaquah
 info@Rehabissaquah.com
 www.Rehabissaquah.com
(425) 394-1200

Nancy Mitrano PT
– Impact Physical Therapy

(425) 778-2325