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Overuse or Undertrained? Injuries in adolescences

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1 Overuse or Undertrained? Injuries in adolescences
Chris Peterson DO

2 Definition Repetition without Recovery Constant Vibration
Malpositioning of Limbs Psychological Under-Trained

3 The Statistics on Adolescent Injuries
30 Million kids in sports 1/3 of childhood injuries are d/t sports Athletic injuries are the most common reason for ER visits (4th for GP) Football has highest rate of injury

4 The Statistics on Adolescent Injuries
Soccer: 5.6 injuries/1000 player hours Risk of injury Increases with skill level Elite youth has highest Exposure (2 vs. 1 match/week) Games>Practice

5 Common Throwing Injuries
Youth Baseball: Injury Rates Increase of overall injury rate by 5% per year.

6 Population Poor Trunk Proprioception and Reflex Postural Sway
Trunk Displacement following Perturbation Weak Hamstrings Prior Injury

7 Shoulder at Risk Ill-defined symptoms-ignored
Posterior tightness or stiffness Inability to “get loose” Tries to “play through” “I rushed my warm up” Multiple teams


9 Overuse or Under-trained
Asymmetric pathology in the shoulder and elbow is prevalent and, with overuse, can progress to disabling injury. Joint injury occurs as a result of the body’s inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage.

10 Common Throwing Injuries
Traditional Thinking: Increasing arm strength by increasing pitching (different from throwing).

11 Comparing Injured vs Healthy Pitchers
There is little evidence to support current safety recommendations for adolescent pitchers.

12 Common Throwing Injuries
Where does the velocity come from? Historically-50% Arm/50% Body Current-20% Arm/80% Trunk “X-factor” What does this mean to me? Time to change my focus!!!

13 Posture Thoracic Kyphosis=Shoulder Killer
Tight Hips-Contra lateral Side

14 What to expect when you are expecting.
Shoulder Injuries: Growth Plate Changes (good and bad) Internal Impingement GIRD SICK Shoulder

15 Where’s the Data? Role of BMI in overuse injuries “Athletic BMI” 20-25
Lower rate of injuries

16 Overuse or Under-trained
The athletic build population has a lower tendency to suffer overuse soft tissue injuries Commencing physical activity at a younger age may have a positive effect in preventing overuse injuries


18 Preventing Throwing Injuries
Recommendation: Maintain throwing but limit pitching Work on entire kinetic chain 3 months of “active rest” per year Throw the curveball after you shave

19 Pitchers Report Card Mechanics Functional Strength Pitch Count

20 Preventing Throwing Injuries
Do not throw to warm up…….. Warm up to throw. Core

21 Bottom Line Biomechanics (Orthotics) Neuromuscular Training
Prevention Programs (PEP, F-MARC-11+) Compliance Unable to eliminate all Risk Need Full Rehab Prior to RTS

22 Overuse or Under-trained
Who is right? Darwin was right.

23 Overuse or Under-trained
Time to look away from the pathology and work on players anatomy. Prevention is now more important than ever.

24 Overuse or Under-trained
“Athletes are dysfunctional” Goal: “Health Dysfunctional Athlete”

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