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Monthly Archives: October 2016

Basketball and Volleyball

Acute and overuse injuries are common in jumping sports likebasketball and volleyball. Acute injuries include bruises(contusions); cuts and scrapes (lacerations); ankle, knee, or finger sprains or fractures; shoulder dislocations; eye injuries; and concussions. Overuse injuries include patellar tendonitis (also called jumper’s knee) or Osgood-Schlatter disease, spondylolysis (stress fracture of the spine), rotator cuff tendinopathy, stress fractures, and shin splints.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent basketball and volleyball injuries. Also included is an overview of common basketball and volleyball injuries.

Injury prevention and safety tips

  • Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for regular health well-child checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes should be in good condition, appropriate for the surface and laces tied.
    • Ankle braces or tape applied by a certified athletic trainer can prevent or reduce the frequency of ankle sprains.
    • Knee pads have been shown to reduce knee abrasions and contusions (bruises).
    • Buddy tape (tape around the injured finger and the one beside it) can prevent reinjury to an injured finger. X-rays should be obtained in all “jammed” fingers.
    • Mouth guards prevent dental injuries.
    • Protective eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials.
  • Environment. A safe playing area is clean and clear. Goalposts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle sprains

Ankle sprains, one of the most common injuries in jumping sports, can prevent athletes from being able to play. They often happen when a player lands from a jump onto another player’s foot, causing the ankle to roll in (invert). They are more likely to happen if a player had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays are often needed to look for a fracture.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains. Tape and an ankle brace can also support the ankle, enabling an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays are often needed to look for a fracture. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs (NSAIDs), and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury or knee cap dislocation. Anterior cruciate ligament (ACL) tears are more common in females than males.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Athletes who return to play with a torn ACL risk further joint damage. Athletes with an ACL tear are usually unable to return to their sport until after reconstruction and rehabilitation.

Patellar tendonitis (jumper’s knee) is a common overuse injury seen from repetitive jumping and landing from jumps. It causes pain in the front of the knee with jumping, sometimes associated with a bump, and can be severe. It is treated with ice, stretching, NSAIDs, and relative rest.

Shoulder injuries

Shoulder injuries in volleyball can occur from repetitive hitting (spiking) or serving. Shoulder injuries in basketball can occur from diving or rebounding.

Athletes usually feel the shoulder pop out of joint when their shoulders are dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called a dislocation. Risk of dislocation recurrence is high for youth participating in these sports. Shoulder strengthening exercises, braces and, in some cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in volleyball, usually due to weak muscles of the shoulder blade and trunk. Often rehabilitation exercises and rest from excessive hitting or serving are all that is needed.

Eye injuries

Eye injuries commonly occur in sports that involve balls but can also result from a finger or another object in the eye. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Head injuries

Concussions can occur after an injury to the head or neck contacting the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion may be more susceptible to another injury than an athlete with no history of concussion.

About Diving

 Competitive springboard and platform divers start training and competing at an early age. Many Olympic and world champions are 18 years of age and younger.

Diving is considered a collision sport because of the impact with the water on entry. A diver entering the water from the 10-meter platform is traveling almost 40 miles per hour. These forces are enough to break bones and dislocate joints. Divers are also at risk of injuries from hitting the board or platform as well as overuse injuries similar to gymnasts from frequent jumping, back arching, trunk flexion, and back twisting. Injuries can also occur from training on “dry land.” This type of training usually includes weight lifting and the use of spotting belts, trampolines, and springboards.

While injuries do occur in competitive diving, unsupervised or recreational diving is associated with a far greater risk of serious injury or even death. The following is information from the American Academy of Pediatrics (AAP) about how to prevent diving injuries. Also included is an overview of common diving injuries.

Injury prevention and safety tips

  • Rules. Swimmers should follow pool rules at all times, including
    • Never swim alone. The pool should be supervised.
    • Don’t run on pool decks and wet areas. Abrasions and contusions (bruises) commonly occur from careless falls.
    • Don’t dive in shallow water or any water where the depth is not known.Swimmers should know how deep the pool is and avoid diving into shallow pools less than 3 feet deep. This will help prevent serious head and neck injuries.
  • Equipment. Safety gear includes
    • Swim caps
    • Sun protection (sunscreen, lip balm with sunblock) when outdoors
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations in or out of the water. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Shoulder injuries

Shoulder injuries typically occur during water entry when arms extended overhead get forced back. Athletes usually feel the shoulder pop out of joint when their shoulders are dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called a dislocation. Risk of dislocation recurrence is high for youth participating in these sports. Shoulder strengthening exercises, braces and, in some cases, surgery may be recommended to prevent recurrence.

Chronic shoulder pain is usually due to a pinching of the rotator cuff (the tendons around the top of the shoulder). This is more common in athletes with weak shoulder blade muscles. Symptoms include a dull pain or achiness over the front or side of the shoulder that worsens when the arm is overhead. Treatment involves exercises to strengthen the shoulder blade muscles and the rotator cuff.

Neck injuries

Repetitive extension of the neck on water entry can cause an irritation of the neck joints. This results in muscle spasms and stiffness when rotating the neck or looking up. Athletes with tingling or burning down the arm may have a cervical disc herniation or “stinger” and should see a doctor. Stingers are stretch injuries to the nerves in the neck and spine. Because the force of impact is greater with 10-meter platform diving, there are more complaints of neck problems with tower divers.

Elbow injuries

Elbow pain can occur when an athlete’s elbow hyperextends on entry into the water. The ulnar nerve (“funny bone”) can be stretched and cause pain, numbness, or burning down the arm into the fingers. If the ligament of the elbow is stretched, it can cause pain, weakness, and instability of the elbow. Athletes with pain on the outside of the elbow may have a condition called osteochondritis dissecans. This condition can cause an inability to straighten the elbow and locking, catching, or swelling of the elbow. X-rays may beneeded to confirm diagnosis.

Wrist/hand injuries

When divers enter the water, they grasp their hands one on top of the other with the palm facing toward the water. As they try to “punch” a hole in the water, thewrist gets bent backward. Doing this repetitively causes pain, swelling, stiffness, and irritation of the wrist joint. This can be treated with rest, ice, and nonsteroidal antiinflammatory drugs. Taping or bracing the wrist can also prevent further injury.

When divers reach for the water and attempt to grasp their hands for entry, they occasionally hyperextend the thumb. This causes a sprain to the base of the thumb. Symptoms include pain, swelling, instability, and weakness of the thumb. This can be treated, and may be prevented, by taping the thumb while diving. Occasionally, a custom thumb splint or even surgery is necessary to stabilize the thumb.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from arching or extending of the back. Symptoms include low back pain that feels worse with back extension activities. Back or reverse dives are often more painful. Treatment of spondylolysis includes rest from diving, physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Disc injury may cause low back pain that occurs with flexion—including pike and tuck dives. The pain is usually worse on one side, extends into the buttock, and occasionally down the leg. Disc-related pain can also occur with sitting, lifting, jumping, and twisting. Successful treatment requires early recognition of the problem and timely treatment.

Knee injuries

There are thousands of jumps in practice for each dive seen in competition. Jumping causes pressure on the kneecap and can result in pain in the front of the knee. Patellar tendonitis (also called jumper’s knee) causes pain
just below the kneecap. Treatment requires identifying and addressing the causes of the pain.

The number of dives performed; dry land training; poor flexibility; strength imbalances; and malalignment of the hips, knees, and feet can also contribute to knee pain. Because corrective shoes, orthotics, and knee braces aren’t practical while diving, physical therapy, patellar taping, and training modifications are the mainstays of therapy.

Other medical issues

Divers are at risk for a variety of medical concerns as well, including

  • Swimmer’s ear and sinusitis from too much water in the ear
  • Ruptured eardrums from impact in the water and acute pressure changes
  • Cuts, scrapes, bruises, fractures, and head or facial injuries from hitting the board, platform, or pool deck
  • Sunburn or rashes from the sun

Aerobic Training for Beginer

 Aerobic training strengthens the heart and lungs and improves muscle function. One goal of aerobic training is to enhance sports performance and to improve training response. The following is information from the American Academy of Pediatrics (AAP) about aerobic training exercises.

What are aerobic training exercises?

Aerobic training exercises are any activities that raise heart rate and make breathing somewhat harder. The activity you are doing must be constant and continuous. Examples of aerobic activities are

  • Walking or hiking
  • Jogging or running
  • Biking
  • Swimming
  • Rowing
  • In-line skating
  • Cross-country skiing
  • Exercising on a stair-climber or elliptical machine

Other activities, when done in a constant and continuous way, can be aerobic, such as tennis, racquetball, squash, and the martial arts. Weight training, however, is not aerobic because it is done in short bursts of a few minutes at a time.

How does aerobic training improve endurance?

Aerobic training increases the rate at which oxygen inhaled is passed on from the lungs and heart to the bloodstream to be used by the muscles. Aerobically fit athletes can exercise longer and harder before feeling tired. During exercise they have a slower heart rate, slower breathing rate, less muscle fatigue, and more energy. After exercise, recovery happens more quickly. Aerobic fitness can be measured in a laboratory setting while exercising on a treadmill or bicycle. This is called maximal oxygen uptake or VO2 max.

How often and how long should athletes train?

To achieve a training response, athletes should exercise 3 to 5 times per week for at least 20 to 60 minutes. Fitness level can be improved with as little as 10 minutes of exercise if done 2 to 3 times per day. If the goal is also to lose body fat, athletes should exercise for at least 30 to 60 minutes. Athletes who are not fit will need to start with lesser amounts of exercise. They can slowly add more time as their endurance improves. Increasing the level of exercise at about 10% per week is a good goal to prevent overuse injury.

Cross-training can help reduce the risk of overuse injuries. This is done by alternating different kinds of activities. To avoid putting too much stress on the body and help prevent injuries, it is wise to alternate high-impact activities, like running, with low-impact exercises, like walking, cycling, and swimming.

How hard should athletes train?

Training at low to moderate intensity levels is enough to improve endurance. In general, this level of intensity is more enjoyable and less likely to lead to injuries than high-intensity training.

However, aerobic training programs should be designed to match each athlete’s fitness level. There are 3 ways to measure aerobic training intensity.

1. The “talk test.” During a workout, athletes should be able to say a few words comfortably, catch their breath, and resume talking. If it is difficult to say a few words, then athletes should probably slow down. If athletes can talk easily without getting out of breath, then they are probably not training hard enough.

2. Heart rate. Aerobic training occurs when heart rate during exercise is between 60% to 90% of maximal heart rate. Athletes can figure out their maximal heart rate by subtracting their age from 220.

3. Level of difficulty. Athletes can determine how hard the exercise feels on a scale of 1 to 10 using the Borg Scale of perceived exertion. The ideal range for aerobic training is between 2 to 7.

Other factors affecting aerobic training response

  • Baseline fitness level. The more unfit athletes are, the greater the training response. However, as athletes become more fit, it will take higher levels of training to improve further.
  • Genetics. Genetics play a large role in an athlete’s natural fitness level as well as how much he will improve as a result of training.
  • Growth. As children grow, they are able to respond more to aerobic training. However, before puberty, the aerobic training response is much less than during and after puberty. This is why aerobic training is of limited value for improving endurance in young children. Activities should focus more on other goals, such as skill development and fun.

Soccer Safety Tips

 Soccer (known as football outside the United States) is one of the most popular team sports in the world. Soccer also can be a way to encourage children to be physically active while they learn about teamwork and sportsmanship.

With the growing popularity of soccer comes a greater number of injuries. However, the risk of injury can be reduced.

Tips to Help Prevent Soccer Injuries

  • Equipment. Players should use the right equipment.
    • Protective Mouthguards
    • Protective Eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials (ASTM).
    • Shoes. Cleats should provide sufficient heel/arch support and grip.
    • Balls. Soccer balls should be water-resistant, the right size based on age, and properly inflated.
    • Preseason Training. There is growing evidence that preseason conditioning and balance training may reduce the risk of anterior cruciate ligament (ACL) injury.
  • Fair Play. Violent behavior and aggressive play increase the risk of injury and should be strongly discouraged. Parents and coaches should encourage good sportsmanship and fair play.
  • Field Conditions. Uneven playing surfaces can increase risk of injury, especially in outdoor soccer. The field should be checked for holes or irregularities. Goal posts should be secured to the ground at all times even when not in use. Follow installation guidelines from the manufacturers and Consumer Product Safety Commission.
  • Heading Technique. The risk of a head injury is comparable to other contact/collision sports, though evidence does not support repeated heading as a risk for short- or long-term cognitive issues. However, to reduce the risk of injury from heading the soccer ball, players should be taught proper heading technique at the appropriate age and with an appropriate-sized ball.
    Excessive heading drills should be discouraged until more is known about the effects on the brain. Also, no recommendations regarding the use of helmets or cushioned pads to reduce head injury in soccer can be made at this time. More research and established safety standards and regulations are needed.

Common Soccer Injuries

Soccer injuries in general occur when players collide with each other or when players collide with the ground, ball, or goalpost. They also may result from nonbody contact, such as from running, twisting/turning, shooting, and landing. The most common types of injuries in youth soccer are sprains and strains, followed by contusions (bruises). Most injuries are minor, requiring basic first aid or a maximum of 1 week’s rest from playing soccer.

  • Ankle & Knee Injuries. Most ankle and knee injuries do not result from contact with another player. Ankle injuries are more common in male players and knee injuries are more common in female players. ACL injuries are relatively common knee injuries. Most of these injuries happen not from coming in contact with another player, but from sudden stops and pivots. ACL injury risk-reduction programs are recommended for female adolescents.
  • Heel Pain. Irritation of the growth plate of the heel bone (Sever’s Disease) is common in youth soccer. This can be treated with calf stretching, activity modification (avoid extra running), heel cups or arch supports, ice, and antiinflammatory medicine.
  • Head Injuries. Concussions are common in soccer. They usually occur when a player’s head collides with another player’s head, shoulder, or arm, or the ground. Females tend to have a slightly higher concussion risk than males. Concussions temporarily affect brain function, although loss of consciousness or blackout may or may not happen. All concussions are serious and need to be evaluated by a doctor before players can return to play. The signs and symptoms of a concussion range from mild to severe and usually happen right after the injury, but may take hours to days to show up. With most concussions, the player is not knocked out or unconscious.
  • Mouth, Face & Teeth Injuries. Soccer is one of the leading causes of mouth, facial, anddental injuries in sports (second only to basketball). Use of protective mouthguards may help reduce the number of injuries.
  • Eye Injuries. Eye injuries are rare, but when they occur they are often severe, resulting in damage to the eye globe or blowout fractures of the eye socket. Protective eyewear is recommended for all soccer players.