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Thursday, June 27, 2013

Don't let your Dentist do brain surgery

I love training young athletes. Its a challenge that I feel we do better than ANYBODY in this business. Training professional athletes is a breeze, but getting a 10 year old to make a travel team is where our skills as sports performance specialist really shine. Kids have unique developmental bench marks to attain to be great athletes and we provide a safe, progressive training environment to ensure they reach those benchmarks. And just because they are adolescence don't think it's easy. Just come in anytime and watch to see what I mean!

 In fact, I find it interesting that the only time you here about youth and exercise is when  juvenile obesity is being discussed, YET the fitness commercials NEVER show kids training.  Its kinda like, at Thanksgiving dinner, when we were kids, when all the adults sat at one table, and the kids were assigned their 'own' table. Don't act like I'm the only one.

It bothers me that there are incompetent practitioners of our craft training youth athletes and doing a very bad job of it. This is prominent in coaching. Coaches: YOU ARE NOT GOOD AT THIS! LET THE PROFESSIONALS HANDLE IT! Great coaches. Lousy trainers.  A professional is someone like me who has studied, researched and published and was 'born' into this profession. My skills were not 'adopted' at a workshop or  through a video series. Sports performance is a science and we don't take it lightly. Coaches mantra: "Hey I coach em I train'em".
Hey, my dentist is great, but I wouldn't let him do my brain surgery!

So what follows is my continuing crusade to get parents to hire REAL training professionals that specialize in sports performance for all ages, and to provide parents with some knowledge on how to keep your young athlete safe from poor training practices.

 DO NOT SUBSTITUTE THIS (blog) FOR MEDICAL ADVICE. See a physician:  A REAL ONE!  NOT WEB MD! or Dr. Oz! Preferably one who specializes in sports medicine or an athletic trainer who is qualified to treat, assess and management sport related injuries
  • This article addresses injuries in a unique population: Adolescent athletes
  • Don't rely on ' sports camps' to teach proper training and conditioning. They don't!
  • If your child tells you they 'hurt' especially after hours of practice and playing don't say. "its just growing pains. Man up" Most likely it is a legitimate injury and you are a terrible parent (just kidding)
This is a common site where rookie assessments are made as 'growing pains'! Often hip pain can be referred to the knee. Because these young athletes have not structurally matured, there are injuries to the growth plates that are quite common. Osgood-Shlatters is one of those 'injuries' that can manifest with increased joint stress: especially running and jumping sports. The patella (kneecap) tendon attaches to bone below the knee joint. That bone does not completely harden, so as the the muscle contracts, that force is transferred to this incomplete ossification which can cause pain.

Along with knee pain is the dreaded ACL tear. Now the difference with an adolescent ACL is that when it tears it usually takes a hunk of bone with it! With the increase in kids participating in sports these are becoming more common. This is the one injury where gender plays a big role. Females for example have certain orthopedic predispositions to ACL injuries. One, oddly enough, is too much flexibility at the wrong time. Second is poor hamstring and calf strength. You thought I was going to say quadriceps! Not so. The ability of the female to change direction or decelerate a landing requires a co-contraction(same time)  from the quadriceps and a strong hamstring. Another unique feature is valgus syndrome. Its where the knees 'collapse' inward after landing from a jump. This is bad and should be detrained. Again this is where a trained professional in sports performance should be sought out to fix this early in a young females budding sports pursuits.

Shoulder pain in young athletes is common among overhead sport athletes. The shoulder is inherently unstable, thus making it one of the most vexing of body parts to protect. Nevertheless, the rotator cuff is by far the most popular BUT it is not the primary culprit. When we evaluate a rotator cuff we evaluate mechanics of how the shoulder moves with respect to sport. Often times there are weaknesses that predisposes the RC to injury. In adolescent the offending activity is overuse and poor preseason, and in season conditioning.

Rotator cuff injuries are not as common in this age group as shoulder separation. This is not to be confused with shoulder dislocation. They are NOT the same. Shoulder separation involves the top of the shoulder where the end of the clavicle (collar bone) and scapula (shoulder blade) meet. You can place your index finger directly on top of this joint. Its boney and connected by a series of ligaments. Pain here can be mistaken for rotator cuff pain. Shoulder dislocation is when the humerus bone is displace out of it's socket. This is very painful and causes disability. There is a distinct look to a dislocated shoulder. A normal looking shoulder has a nice 'cap' or mound to it when you look at it from the side, front and back. Image that mound looking 'sunk' in from the side!
Get to a hospital right away if there is not someone on site who can reduce (put back in place) it.


Shin splints is the most annoying of all sport related injuries and the most misunderstood among coaches who actually think it is acceptable to get these pains as part of the sport! And its this mentality that causes unnecessary and preventable injuries such as shin splints. Shin splints is a 'waste basket' term for Anterior tibiaitis. This simply means that the muscle in front of the leg, anterior tibialis is inflamed! It gets inflamed due to it's inability to 'decelerate' foot 'slap'(when the foot lands to the ground after heel strike). This is the easiest to prevent when taught properly. Harder to treat when its full blown during in-season training. The symptoms are innocuous at first during preseason training and this is when it should be treated promptly.

saved the best for last! Who HASN'T had one of the most common rite of passage injuries of all time? The most misunderstood injury in terms of treatment and prevention. There are many degrees of ankle sprains. The most common that puts athletes out for awhile is a grade 2 ankle sprain. This is swelling with some disability and mild to moderate ligament damage. Grade 3 is severe swelling, disability, and possible fracture combined with severe  ligament damage. Its what sportscasters erroneously call a 'high ankle sprain. This is an inappropriate term because the ankle sprains only occur at the ankle and BELOW it!

Now the key, is aggressive treatment to prevent what can lead to a functional instability from not addressing stability during the healing phase. I'm still shocked at the conservative approach to ankle sprains since we understand them better and the implications it has in providing stability as far up as the lumbar spine!

 Always ice ankle sprains. Epsom salt in warm water does not work! Ice compression and elevation are key and early calibrated weight bearing and balance training. CAUTION: this should only be done by a trained professional! We have our proprietary technique to reducing ankle sprains as well as treatment protocols. Coaches would do themselves and their athletes justice by coming in and learning how to reduce the risk of this common problem.

-Margaret Fuller