Bilateral Knee Pain in a High-Level Gymnast

Blatnik, Terra; Briskin, Susannah

doi:10.1097/jsm.0b013e31825c464d

Cited by 9 publications

(3 citation statements)

References 3 publications

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“…13 19 Physeal injury of the knee has been described in the distal femur and proximal tibia of young athletes with knee pain. [163][164][165][166] This abnormality may be visible on X-ray or T2-weighted MRI. In a retrospective review of the largest case series of six athletes, five were treated with 3-5 weeks rest and immobilisation and had resolution of their pain and physeal widening at 1-3 months.…”

Section: Physeal Stress Injurymentioning

confidence: 99%

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

DiFiori¹,

et al. 2014

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BackgroundYouth sport participation offers many benefits including the development of self-esteem, peer socialisation and general fitness. However, an emphasis on competitive success, often driven by goals of elite-level travel team selection, collegiate scholarships, Olympic and National team membership and even professional contracts, has seemingly become widespread. This has resulted in an increased pressure to begin high-intensity training at young ages. Such an excessive focus on early intensive training and competition at young ages rather than skill development can lead to overuse injury and burnout. PurposeTo provide a systematic, evidenced-based review that will (1) assist clinicians in recognising young athletes at risk for overuse injuries and burnout; (2) delineate the risk factors and injuries that are unique to the skeletally immature young athlete; (3) describe specific high-risk overuse injuries that present management challenges and/or can lead to long-term health consequences; (4) summarise the risk factors and symptoms associated with burnout in young athletes; (5)provide recommendations on overuse injury prevention. MethodologyMedical Subject Headings (MeSHs) and text words were searched on 26 March 2012 from MEDLINE, CINAHL and PsycINFO. The search yielded 953 unique articles. Additional articles were found using cross-referencing. The process was repeated on 10 July 2013 to review any new articles since the original search. Screening by the authors yielded a total of 208 relevant sources that were used for this article. Recommendations were classified using the Strength of Recommendation Taxonomy (SORT) grading system. Definition of overuse injuryOveruse injuries occur due to repetitive submaximal loading of the musculoskeletal system when rest is not adequate to allow for structural adaptation to take place. Injury can involve the muscletendon unit, bone, bursa, neurovascular structures and the physis. Overuse injuries unique to young athletes include apophyseal injuries and physeal stress injuries. EpidemiologyIt is estimated that 27 million US youth between 6 and 18 years of age participate in team sports. The National Council of Youth Sports survey found that 60 million children aged 6-18 years participate in some form of organised athletics, with 44 million participating in more than one sport. There is very little research specifically on the incidence and prevalence of overuse injuries in children and adolescents. Overall estimates of overuse injuries versus acute injuries range from 45.9% to 54%. The prevalence of overuse injury varies by the specific sport, ranging from 37% (skiing and handball) to 68% (running). Overuse injuries are underestimated in the literature because most of the epidemiological studies define injury as requiring a time loss from participation. Risk factorsPrior injury is a strong predictor of future overuse injury. Overuse injuries may be more likely to occur during the adolescent growth spurt. The physes, apophyses and articular surfaces in skeletally immat...

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Section: Physeal Stress Injurymentioning

confidence: 99%

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

DiFiori¹,

et al. 2014

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“…Overall, there were 13 case reports/series describing 26 patients, including 17 males and 9 females, ages 8-15, with PPSIs involving the distal femur, proximal tibia, or proximal fibula [21,88,[110][111][112][113][114][115][116][117][118][119][120][121]. These injuries are believed to result from repeated compression, rotational, shearing, valgus, or varus forces on the knee ensuing from repetitive trauma during sports activities [110,118,120,121].…”

Section: Kneementioning

confidence: 99%

“…These injuries are believed to result from repeated compression, rotational, shearing, valgus, or varus forces on the knee ensuing from repetitive trauma during sports activities [110,118,120,121]. Patients represented a wide range of youth sports including baseball [88], basketball [21,110,111], football [21], gymnastics [11,21,113], rugby [118], softball, running [119], soccer [21,120], tennis [21,121], as well as engagement in multiple sports [114][115][116]. There was also a report of one patient who participated in recreational sports only [117].…”

Section: Kneementioning

confidence: 99%

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

et al. 2021

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Background Overuse injuries are common in sporting children and adolescents. These injuries are a particular concern when they involve the epiphyseal-physeal-metaphyseal (EPM) complex given their potential to disturb skeletal growth. Specifically, the limits of mechanical tolerance of the EPM complex to repetitive stress may be exceeded by the intense and continuous training characteristic of many youth sports today. Objective This article describes the present status of knowledge on the occurrence and outcome of primary periphyseal stress injuries (PPSIs) affecting the EPM complex in the extremities of children and adolescents involved in youth sports. Methods A comprehensive review of the sports medicine literature was conducted to determine the nature and extent of PPSIs affecting the EPM complex of the extremities among youth sports participants and the potential for consequent skeletal growth disturbance and resultant limb deformity associated with these injuries. Results Our initial search uncovered 128 original published scientific articles reporting relevant data on PPSIs. There were 101 case reports/series, 19 cross-sectional, 1 case-control, and 7 cohort studies with relevant data. The case reports/series studies reported 448 patients with PPSIs involving the extremities. Children and adolescents representing a variety of high impact repetitive youth sports activities-including baseball, badminton, climbing, cricket, dance, gymnastics, rugby, soccer, swimming, tennis, and volleyball-may sustain PPSIs involving the shoulder, elbow, hand and wrist, knee, and ankle and foot. Although incidence data from prospective cohort studies are lacking, data arising from cross-sectional studies suggest that PPSIs may be common in select groups of youth athletes-including the shoulder in baseball players (0-36.6%), wrist in gymnasts (10-83%) and platform divers (52.6%), and fingers in rock climbers (5-58%). Notably, not all stress-related skeletal changes detected on imaging were symptomatic in these studies. When diagnosed and treated with an appropriate period of rest and rehabilitation, most patients studied were able to return to their sport activities. However, our data also show that 57/448 PPSIs (12.7%) produced growth disturbance, and that 28/448 patients (6.2%) underwent surgery for their injuries. Absence of treatment, delayed presentation and diagnosis, and non-compliance with a rest regimen were common in cases that produced growth disturbance. Conclusions PPSIs may affect the extremities of children and adolescents engaged in a variety of youth sports, especially at advanced levels of training and competition. Most skeletally immature patients with PPSIs respond well to timely treatment; however, in extreme cases, PPSIs can progress to produce skeletal growth disruption which may necessitate surgical intervention. Clearly, establishing the early diagnosis of PPSIs and providing timely treatment of these injuries are needed to ensure the skeletal health of youth sports participants. Rigorous prospective lo...

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Treatment and Rehabilitation of Common Lower Extremity Injuries

Lim¹

2013

Gymnastics

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Bilateral Knee Pain in a High-Level Gymnast

Cited by 9 publications

References 3 publications

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine

Primary Periphyseal Stress Injuries in Young Athletes: A Systematic Review

Treatment and Rehabilitation of Common Lower Extremity Injuries

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