HOLLI W. HAYNIE

With the school year underway, pediatricians and orthopedists are already experiencing an influx of sports-related injuries. Adolescent athletes are injured at nearly the same rates as college and pro athletes, but the types of injuries are quite different. The American Academy of Pediatrics' (AAP) Council on Sports Medicine and Fitness states that overuse injuries, overtraining, and burnout among child and adolescent athletes are a growing problem in the United States. Even though inactivity and obesity are on the rise, the number of children and adolescents who participate in athletics has grown significantly over the last 20 years.

A 2007 clinical report from the AAP estimated that 30 to 45 million youth, ages 6 to 18, participate in some form of athletics. The variety of available, organized sporting activities has also grown. Kids aren't just opting for traditional favorites like football, baseball , soccer and cheerleading, but have greater participation in rugby, lacrosse, field hockey and dance, all of which list their own sports medicine concerns.

"A lot of what we see is ankle injuries, but we also see a lot of low back pain injuries with kids that are doing improper technique or don't have the core strength to withstand a block," explained Matt Connell, MPT, ATC/L, sports medicine manager for Campbell Clinic.

Connell oversees the clinic's high school outreach program which provides athletic trainers to 12 area high schools. He said male high school athletes, for the most part, receive comprehensive training and care. But females and junior high age children, in particular, tend to be less conditioned because they have very little weight training experience, which equates to higher rates of overuse injuries. Low back injuries which tend to be common, he explained, are typically due to having weak core muscles, something that is often overlooked by parents and coaches.

"Some people equate their children being able to run three miles as being strong," said Connell. "They may be strong in some areas but not have adequate core strength which can lead to injuries."

Therapists and trainers address the issue by not only educating about proper technique, but by giving coaches an understanding that kids coming from junior high cannot be thrown into some of the more advanced plays, especially those that arch the back, until they've had adequate training.

"These days a lot of the junior high kids don't receive very good weight training programs," he added.

This school year, Campbell Clinic therapists have already seen a huge increase in stress fractures among female cross country runners. It comes as no surprise that overtraining is the main culprit, and the rehab team plans to publish literature in the community to promote proper conditioning. As part of their ongoing efforts to continually progress and improve the prevention programs, Campbell Clinic therapists are also addressing female knee injuries by developing an advanced jumping program for girls. Female athletes are more prone to ACL tears than males, explained Connell, and studies have shown it has to do with jumping technique and hamstring strength. They expect to start the program next summer.

"The jump training program is a big deal for us," maintained Connell, adding there are other efforts in the works to enhance the abilities of athletic trainers on campus. "We're also working on getting AEDs for all our trainers on the sidelines."

In addition therapists have utilized information from shoulder testing to develop better programs for baseball players. While the school year produces a lot of low back and knee injuries, summertime is when clinicians sees the majority of shoulder pain and injuries in adolescents. Summer leagues are not as overseen by athletic trainers and coaches may tend to let pitchers overdo it. Pitching 100 throws, three times a week, is a recipe for an overuse injury, said Connell.

Still, football injuries continue to lead the pack, with a rate of injury almost twice that of basketball, according to a 2006 report in the American Journal of Sports Medicine. The main priority for Campbell Clinic's outreach program is to have athletic trainers available at sporting events. When more than one event is occurring simultaneously on campus, trainers will stay with the sport that has the most contact, such as football. Schools contract with Campbell Clinic to have an athletic trainer on site either 20 hours or 40 hours per week. Trainers address injuries that occur during a game and refer to specialists or general practitioners as needed.

"Our trainers are on the front lines – on the field. After we assess an injury, if it's a minor scrape or strain and we know they are not going to hurt themselves by playing with some modification like taping or extra pads, we'll do that," Connell said. "If they need to sit out, they need to go to the doctor."

Campbell Clinic also offers annual physicals to junior and high school students. Clinic therapists evaluate 600 to 800 kids each May. Ultimately athletic trainers are there to provide care and play a vital role in preventing injury. They keep open communication between parents and coaches so young athletes can maintain their health and stay in the games they love to play.

"The coach's job is to coach," said Connell. "The trainer takes care of injuries, stays current on research and develops programs."