Tuesday, September 21, 2010

Childhood Sport Injuries

Does your middle or high school aged child play organized sports?  Now that school has officially begun, school sports have begun as well.  If your child plays on a school team, you might have already been to coach's night and /or have signed waivers for your child to participate.  But, how does the school know that your child is fit enough to play a particular sport?  Yes, I know that all sports require a medical exam prior to a child starting, but...

Do you know what is actually being checked in the pre-season exam?

This exam is, in most cases, simply a basic body systems' exam (eyes, ears, nose, throat, etc..) with a minimal scoliosis evaluation called "Adam's Test", which  happens to be very vague and unreliable test.  If a scoliosis is suspected on the exam, it is reported as either positive or negative on the exam form.  From there, you are notified to follow up with your child's doctor and if its not "severe"  then your child is on a "wait and see" status to see if the scoliosis worsens.  There is so much I could write about scoliosis, but I will have to it for another blog.  Realize for today that scoliosis is not the only structural test worthy of being tested.  There are many other structural abnormalities that are left unchecked that can affect your child's injury status.

So basically, this pre-season exam provides almost no biomechanical information on your child's structure.  Most potential sports injuries are biomechanical or structural in nature, and much can be done before the season begins to reduce the likelihood of injury.  When a professional athlete is being considered by a franchise, that franchise puts the athlete through a battery of tests that also include speed, strength, flexibility, endurance, body composition, and structural integrity.   They are not going to invest money for a player if they can't pass their exhaustive physical exam. Now I realize your child is not a professional athlete, but the point is that most of the tests that are performed by a professional franchise are for preventative measures.  They are not going to sign an athlete that is going to be prone to injury.

A structural exam detects imbalances, weakness, and sites of potential injury.  A detailed, customized corrective program is then designed to balance and strengthen these defecits before injury occurs.  This is true preventative care!

I want to point out that I am not referring to serious traumas like broken bones, concussions, severe cuts and lacerations.  Those are obviously traumas that happen no matter what condition your child is in.  Again, most injuries that occur are biomechanical or structural in nature and are not addressed or corrected.    In these cases, when a child is injured he/she is seen by a doctor, trainer, therapist, etc...   A little rest and maybe some therapy is usually prescribed to address the injury, but the weak link in the child's structure was not addressed.

To you give you an example from our office, a high school sophomore came in with knee pain.  The parents had already seen the athletic trainer and their primary medical doctor.  Wraps, rubs, stretches, and medications were not solving this child's problem.  We did a structural exam and found abnormal shifts in the child's spine, hips, knees, and feet.  These are findings that are significant to allowing the child's joints to work normally without excessive wear and tear and undue stress.  Just like if a mechanic found that the front end of your car is out of alignment, then the tires are going to wear down unevenly (arthritis) and the steering performance will be affected (muscles). Your child's structure is just like an automobile (metaphorically speaking), except that replacing your child's "parts" is not an option. 

The patient was put on a structural correction program which addressed all of his issues.  This patient is now in college and playing competitive sports without any relapse of knee pain.

Short term fixes are just that, short term.  Long term fixes require a blue print and plan to correct structural problems to allow the body to be resilient to the stress put upon it whether it's from sports or just living life.

Have a great Day,
Dr. Deane


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