Youth Sports and Sports Medicine

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1 Youth Sports and Sports Medicine Lyle J. Micheli, MD Director, Division of Sports Medicine O Donnell Family Professor of Orthopaedic Sports Medicine Children s Hospital Boston Clinical Professor of Orthopaedic Surgery Harvard Medical School Secretary General International Federation of Sports Medicine 1. Work Sources of Exercise 2. Play 3. Physical education 4. Recreational sports/exercise 5. Organized sports: school 6. Organized sports: community 1 2 Child = Growth 3 4 1

2

3 Growth and Chronic Exercise Stimulus: Adams, E. H., 1983 Joki, 1941 Australia, 1983 Retardant: Kato & Ishiko, Goals of Sports for Children Health/fitness Enjoyment Sportsmanship Psych/soc: child Psych/soc: parents The Game Money

4 Children in Organized Sports Risks vs. Benefits Organized Sports for Children: Benefits Emotional and social growth Fitness Safety Advanced skills Facilities Organized Sports for Children: Concerns Emotional stress Endurance / heat stress Injury

5 Sports Medicine: What Is It? Pediatric / Adolescent Sports Medicine The field of medicine concerned with injuries sustained in athletics, including their prevention, diagnosis and treatment (Dorland s Medical Dictionary, 1989) OR Sports medicine is the study of the physiological, biomechanical, psychosocial and pathologic phenomena associated with exercise and athletics (Oxford Dictionary of Sports Science and Medicine, 1998) Sports Medicine USA: The Players 1. Physicians orthopaedic, medical 2. Chiropractors 3. Podiatrists 4. Athletic trainers NATA, epidemiology 5. Physical therapists 6. Clinical exercise physiologists 7. Sports/fitness gurus Sports Medicine USA: The Playing Field 1. American Osteopathic Academy for Sports Medicine Certification CAQ in Sports Medicine. Board Family Practice, Internal Medicine, Pediatrics, Emergency Medicine, Fellowship, Physical Medicine 3. CASM Exam Sports Physician 4. Sub-Specialty Licensure in Orthopaedic Sports Medicine Orthopaedic Board and Fellowship (2007) (Europe: 5 spec. 7 sub spec.)

6 Clinical Sports Medicine: Young Athlete Acute trauma: musculoskeletal Overuse injury: musculoskeletal Sports specific Risk factors Head, neck Injury; concussion Medical conditions/athlete Equipment Training Cardiovascular Musculoskeletal Nutrition; performance enhancement Field side: team physician, emergencies, return to play Mass participation events Who Speaks for the Growing Athlete? 1. American Academy of Pediatrics (AAP) Sports, exercise section Position stands 2. ACSM Position stands 3. AOSSM 4. POSNA?

7 Pediatric Adolescent Sports Medicine: The Future 1. Organization? AOSSM, POSNA, ACSM 2. Double fellowship? 3. Combined fellowship? Proximal humerus physeal fx. Same Room vs. Anatomic

8 Shin Splints compartment syndrome

9 Sports Tumors 11.Concussion: ding, double ding

10 Neuropsych Exam: ImPACT Pre-season testing: psychologist Memory, reaction time, processing speed Sequential post concussion testing Lovell M. R., Collins M. W., Iverson G. L., Johnston K. M., Bradley J. P. Grade 1 or ding concussions in high school athletes. Am J Sports Med. 2004;32(1): Prevention of Sports Injuries in Children Participation match Conditioning Training Rules Equipment Prevention of Sports Injuries in Children Participation match Conditioning Training Rules Equipment

11 41 42 Prevention of Sports Injuries in Children Participation match Conditioning Training Rules Equipment

12 School-Age Athletes: The Medical Care Team Team physician Athletic trainer Coach School nurse Primary care physician Medical consultants Parents Sports Training: The Young Athlete 1. Cardiovascular 2. Musculoskeletal Strength Flexibility 3. Nutrition 4. Skills 5. Psychological Prevention of Sports Injuries in Children Participation match Conditioning Training Rules Equipment

13 49 50 Prevention of Sports Injuries in Children Participation match Conditioning Training Rules Equipment

14 THANK YOU!! Lyle J. Micheli, MD 53 14

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