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29 Cards in this Set

  • Front
  • Back
2 categories of athletic injury types
- ACUTE (MACROTRAUMA) - contact sports

- OVERUSE (MICROTRAUMA) - non contact sports
Highest % of severe injuries and highest % of reportable injuries
FEMALE GYMNASTICS
Most common site of injuries in both men and women in sports
KNEE AND ANKLE INJURIES
PPP - PREPARTICIPATION PHYSICALS

OBJECTIVES - ?

FORMAT- ?

TIMING - ?

MOST IMPORTANT PURPOSE - ?
OBJECTIVES - determine any underlying conditions and would restrict participation, identify and evaluate potential problems, fulfill legal and insurance requirements, establish rapport, provide counseling to athlete and establish baseline medical record
FORMAT - single physician or team approach with stations
TIMING - 4-6 weeks before competition, annual exam
MOST IMPORTANT PURPOSE - determination of clearance to play
TYPES OF CLEARANCE
- CLEARED WITHOUT RESTRICTION

- CLEARED AFTER COMPLETING ADDITIONAL EVALUATION OR REHAB FOR SPECIFIC INJURY OR ILLNESS

- NOT CLEARED FOR PARTICIPATION IN SPECIFIC SPORT
DHEA
- Anti- aging, anti - obesity
- removed by FDA in 1985 because of liver disease
- 1994 - introduced as nutritional supplement
- significantly increase androgenic serum plasma levels
- increase physical and psychological well being
- may increase risk of prostate and uterine CA (also can increase gynecomastia, hirsutism, liver disease, etc) - BANNED
ANDROSTENDIONE
increases endogenous testosterone (300 mg/day) - BANNED
CREATINE
increases formation of ATP, increases muscle mass and delays fatigue - BANNED
BETA-HYDROXY OR BETA-METHYLBUTYRATE
nutritional supplement that is a metabolite of leucine and increases muscle mass and rate of recovery after strenuous exercise - BANNED
Name restricted drugs in athletes
- human growth hormone - increases type II fast acting muscle fibers and decreases body fat
- diuretics
- beta blockers - reduce anxiety and reduce tremors
Erythropoietin and blood doping
EPO - natural hormone secreted by kidney - increases RBC mass
Darbepoietin - similar action but greater half life
BANNED
RESULTS OF INCREASED FEMALE PARTICIPATION IN SPORTS
- GIRLS LESS LIKELY TO BECOME PREGNANT AS TEENAGERS
- WOMEN LESS LIKELY TO BECOME INVOLVED IN ABUSIVE RELATIONSHIP
- WOMEN MORE LIKELY TO FINISH HIGH SCHOOL AND GO TO COLLEGE
PHYSICAL GENDER DIFFERENCES AFTER AGE 12
- FEMALES HAVE INCREASED % BODY FAT
- 30-50% LESS UPPER BODY STRENGTH
- MEN HAVE HIGHER RBC COUNTS
- LOWER EXTREMITY PAIRITY
- WOMEN HAVE WIDER PELVIS AND EXTERNAL ROTATION ALLIGNMENT OF LOWER EXTREMITIES (> Q ANGLE)
- WOMEN MORE FLEXIBLE
GENDER DIFFERENCES OF INJURY RATES
KNEE IS MOST DRAMATIC DIFFERENCE - ACL 5 higher in women, collateral ligament 2.5 higher, meniscus injury 2 times higher, also patellofemoral syndromes and ligamentous laxity are more common in women
STRESS FRACTURES - more common in women, poor nutrition and eating disorders, menstrual irregularities, hormonal - estrogen increases osteoblastic activity
EATING DISORDERS
- 1O TIMES GREATER IN FEMALES
- 60% OF PARTICIPANTS - depending on sport
- POOR PROGNOSIS - increased mortality rate
- PREDISPOSING FACTORS - driveto excel, subjective judges, revealing clothing
ANOREXIA NERVOSA
- REFUSAL TO MAINTAIN MINIMAL BODY WEIGHT FOR HEIGHT
- INTENSE FEAR OF WEIGHT GAIN
- DISTURBED BODY IMAGE
- THREE CONSECUIVE MONTHS OF AMENORRHEA
- FAILURE TO BEGIN MENSTRUATING AT 16
- SIGNS AND SYMPTOMS- amenorrhea, weight loss, fat loss, muscle loss, dry hair, lanugo, cold discolored extremities, decreased body temp, dizziness, bradycardia
BULIMIA NERVOSA
- RECURRENT BINGE EATING WITH ANY 2 HOUR PERIOD
- OVER EATING - SENSE OF LOSS OF CONTROL
- RECURRENT COMPENSATORY VOMITTING OR ABUSE OF LAXATIVES
- FASTING AND OVER EXERCISE
- NEGATIVE SELF IMAGE
FEMALE ATHLETE TRIAD
AMENORRHEA

DISORDERS OF EATING

OSTEOPOROSIS
SIGNIFICANCE OF AMENORRHEA
- SKELETAL DIMENIRALIZAITON PREDISPOSING TO STRESS FRACTURES

- INFERTILITY

- INCREASED RISK OF UTERINE CA
2 GROUPS OF RISK FACTORS IN IMMATURE AND ADOLESCENT ATHLETES
- HOST RELATED - growth of tissues, growth spurts, gender, anatomical malalignment, conditioning, psychological, preexisting medical conditions

ENVIRONMENTAL - training error, technique error, coaching, equipment, playing surface, drugs and supplements, nutrition, weather, parents
PEDIATRIC SHOULDER IN SPORTS
LITTLE LEAGUE SHOULDER - stress reaction to proximal humeral epiphysis (microfracture and widening)

DISLOCATION - rare under 12, fracture more common

MICRO INSTABILITY - leads to labral tears
PEDIATRIC ELBOW IN SPORTS
LITTLE LEAGUE ELBOW - excessive acceleration, decceleration - medial epicondylar apophysitis, lateral joint compression, OCD of capitulum, ulno-humeral chondromalacia - MAY PROGRESS TO AVULSION OF MEDIAL EPICONDYLE
PEDIATRIC WRIST IN SPORTS
- GYMNASTS AND/OR WEIGHT LIFTERS - dorsal impaction of radiocarpal joint (due to excessive dorsiflexion under load), can cause Madelungs deformity (shortened and deformed distal radius)
PEDIATRIC SPINE IN SPORTS

SPONDYLOLYSIS

JUVENILE HNP
SPONDYLOLYSIS - 50% OF ALL LOW BACK PAIN IN YOUNG ATHLETE (EXCESSIVE HYPEREXTENSION) - usually L5, diving, volleyball, soccer, dance, skating and gymnastics

JUVENILE HERNIATED DISK - as likely to herniate into endplate as well as posteriolateral
PEDIATRIC HIP IN SPORTS

SNAPPING HIP

SNAPPING ILIOTIBIAL TRACT
SNAPPING HIP - tight iliopsoas, bursitis, inflammation - painful snapping with external rotation
SNAPPING ILIOTIBIAL TRACT - painful snapping at greater trochanter
PEDIATRIC KNEE IN SPORTS
- Meniscal tear
- Discoid meniscus
- ACL tears
- Tibial spine avulsion
- Tibial tubercle avulsion
- Patellofemoral syndrome
- Patellar instability
- OSGOOD SCHLATTERS SYNDROME- pain over tibial tubercle, painful, hot, swollen knee, gets worse with activity, can lead to calcifications and non-union of apophysis, self limiting - goes away when growth stops
- JUMPERS KNEE - patellar tendonitis
- OSTEOCHONDRITIS DISSECANS 0 medial femoral condyle
PEDIATRIC ANKLE IN SPORTS
- POSTERIOR HEEL PAIN - Sever's apophysitis, Achilles tendonitis, plantar fasciitis
- OCD of talus
- TILLAUX - in kids anterior lateral tubercle of tibia avulses instead of ATF ligament that tears more often in adults
- TRIPLANE INJURIES - asymmetrical closure with S-H II component - need surgery with screws
PEDIATRIC FOOT IN SPORTS
- Accessory navicular bone
- KOHLERS DISEASE - avascular necrosis of navicular bone
- FRIEBERGS - avascular necrosis of 2nd metatarsal head
- Juvenile bunions
MUSCLE STRAINS
- STRETCH INDUCED INJURY, 30% OF CASES IN SPORTS MEDICINE
- DIAGNOSIS - acute onset of muscle soreness, usually during unaccustomed exercise, accompanied by weakness and easy fatiguebillity, most occur at MT junction, increased incidence when fatigued
PATHOGENESIS - pronounced local inflammatory response - 1-2 days post injury, fibrous tissue replacement of injured tissue (by 7th day)
PROPHYLAXIS - warm up with flexibility exercises, pre-exercise stretching
TREATMENT - RICE - rest, ice, compression, elevation, NSAIDS