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29 Cards in this Set
- Front
- Back
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2 categories of athletic injury types
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- ACUTE (MACROTRAUMA) - contact sports
- OVERUSE (MICROTRAUMA) - non contact sports |
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Highest % of severe injuries and highest % of reportable injuries
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FEMALE GYMNASTICS
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Most common site of injuries in both men and women in sports
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KNEE AND ANKLE INJURIES
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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 |
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TYPES OF CLEARANCE
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- CLEARED WITHOUT RESTRICTION
- CLEARED AFTER COMPLETING ADDITIONAL EVALUATION OR REHAB FOR SPECIFIC INJURY OR ILLNESS - NOT CLEARED FOR PARTICIPATION IN SPECIFIC SPORT |
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DHEA
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- 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 |
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ANDROSTENDIONE
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increases endogenous testosterone (300 mg/day) - BANNED
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CREATINE
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increases formation of ATP, increases muscle mass and delays fatigue - BANNED
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BETA-HYDROXY OR BETA-METHYLBUTYRATE
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nutritional supplement that is a metabolite of leucine and increases muscle mass and rate of recovery after strenuous exercise - BANNED
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Name restricted drugs in athletes
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- human growth hormone - increases type II fast acting muscle fibers and decreases body fat
- diuretics - beta blockers - reduce anxiety and reduce tremors |
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Erythropoietin and blood doping
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EPO - natural hormone secreted by kidney - increases RBC mass
Darbepoietin - similar action but greater half life BANNED |
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RESULTS OF INCREASED FEMALE PARTICIPATION IN SPORTS
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- 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 |
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PHYSICAL GENDER DIFFERENCES AFTER AGE 12
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- 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 |
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GENDER DIFFERENCES OF INJURY RATES
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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 |
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EATING DISORDERS
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- 1O TIMES GREATER IN FEMALES
- 60% OF PARTICIPANTS - depending on sport - POOR PROGNOSIS - increased mortality rate - PREDISPOSING FACTORS - driveto excel, subjective judges, revealing clothing |
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ANOREXIA NERVOSA
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- 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 |
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BULIMIA NERVOSA
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- 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 |
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FEMALE ATHLETE TRIAD
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AMENORRHEA
DISORDERS OF EATING OSTEOPOROSIS |
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SIGNIFICANCE OF AMENORRHEA
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- SKELETAL DIMENIRALIZAITON PREDISPOSING TO STRESS FRACTURES
- INFERTILITY - INCREASED RISK OF UTERINE CA |
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2 GROUPS OF RISK FACTORS IN IMMATURE AND ADOLESCENT ATHLETES
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- 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 |
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PEDIATRIC SHOULDER IN SPORTS
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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 |
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PEDIATRIC ELBOW IN SPORTS
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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
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PEDIATRIC WRIST IN SPORTS
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- 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)
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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 |
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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 |
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PEDIATRIC KNEE IN SPORTS
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- 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 |
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PEDIATRIC ANKLE IN SPORTS
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- 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 |
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PEDIATRIC FOOT IN SPORTS
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- Accessory navicular bone
- KOHLERS DISEASE - avascular necrosis of navicular bone - FRIEBERGS - avascular necrosis of 2nd metatarsal head - Juvenile bunions |
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MUSCLE STRAINS
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- 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 |
