1. Overuse or Undertrained? Injuries in adolescences
Chris Peterson DO
TheSportsMedicineClinic.com

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”