1. Examination, Diagnosis, Treatment, and Prevention of Sports Injuries Unique to the child Athlete

2. Injuries unique to the Child Athlete Macro trauma Microtrauma Broken Radius Ligament Injuries Avulsion Fractures Overuse Injuries Severs Osgoods- Schlatters Salter-Harris Fractures

3. Increase in overuse injuries: Due to increase emphasis and participation in organized sports Inappropriate Coaching Lay people giving medical advise

4. Growth Spurts Growth cartilage: Injuries has different effects and requires different diagnosis and treatments Psychological vulnerability Susceptible to inappropriate coaching and training

5. Salter- Harris Fracture Growth Cartilage Injury May cause arrest of the growth process Limb length discrepancy

6. History: Trauma or Overuse

7. Observation Inspection Rang of Motion

8. Provocative Tests: Kemps, Adams, Stork. Determine if it’s the Anterior or Posterior Elements a. Pars Interarticularis, Facet Joint, Pedicle, SI Joint.

9. Must begin at the Hip and end at the foot. Observation in standing posture: a. Frontal, Lateral, posterior Eval of posture, symetry and alignment Sitting Examination: Check patellar alignment, ACL integrity, Muscle imbalance. Joint line pain in heel to knee check.

10. Supine Exam: Lachmans, McMurrays, Varus/valgus Stress Look for ligamentous Injuries: If hemarthrosis strong indication of cruciate injury Cross Leg: Lateral Ligament, cartilage, popliteal tendon

11. Apleys Hip Extensors: Ely’s, Internal/external rotation. Internal rotation in flexed position: Slipped Capital Epiphysis

12. Sitting: Look for swelling Palpation medial, anterior talus, lateral ligaments( 85% ) ROM: Inversion, Eversion, Plantar Flexion, Dorsi Flexion Tests: Drawers, Varus stress

13. Check for syndesmosis sprain Kneeling: Achilles, calcanius,metatarsalgia

14. Check for Navicular, 2 nd metatarsal fracture Liz- Frank fracture Interosseus sprain Plantar fascitis

15. Examine in relation to spine: Range of Motion standing Provocative Tests: sitting, prone for stability.

16. Reactive sympathetic Dystrophy Clinical syndrome of excessive pain following surgery or injury A. Most common in individual sports: Gymnastics, ice skating B. Disorder of Autonomic Nervous System C. Etiology unclear D. Multiple Psychological complex

17. Injury Prevention Early detection key to overuse injuries Growth spurts: Decrease training demands Exercise programs: Resistance Training most important: Wayne Wescot