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Ligament laxity: A Forgotten Entity in Children (Continued)
The traditional orthopedic sports medicine model of treating overuse syndromes, apophysitis, and epiphyseal injuries is to rest the area and modify sports training and activities. This is because the etiology of injuries such as these, generally, involves only three variables: mechanics, amount of sports activities, and genetic factors such as joint laxity. A good example of this is the Little League elbow. The risk factors for this condition are felt to be due to mechanics, workload, and joint laxity, as illustrated by the Venn diagram in Figure 24-19. Modifying throwing mechanics and workload (pitches/week) are helpful and do resolve the pain. This mode of treatment does not enhance athletic performance, however. Resting the area and modifying the playing of sports does not make the athlete stronger, just weaker. Summary Young athletes get the same types of strain and sprain injuries as older athletes. However, there are some significant differences in the type of injuries sustained by children and adolescents because of the differences in the structure of growing bone compared with adult bone. This growth is a central factor in the development of sports-related injuries in young athletes. Growth cartilage in the immature skeleton is found at the epiphyseal growth plate, the articular surface, and the apophyseal ligament/tendon insertions. When a young athlete gets hurt, injury to the growth plates and other areas of cartilage growth must be considered. As a result of these differences, a particular mechanism of injury may result in different conditions in the younger athlete compared with the mature adult. The younger athlete is more likely to injure cartilage and bone or completely avulse an apophysis than to have a significant ligament sprain. The ligament attachment is, relatively, stronger than the apophysis. The mainstay treatment for most athletic injuries in children and adolescents is RICE treatments, limitation of activities, and anti-inflammatory medications, according to traditional orthopedic sports medicine care. This goes for stable avulsion fractures, apophysitis, epiphyseal growth plate injuries, as well as for sprains/strains. This is usually frustrating for both the parents and the young athlete because athletics play an important role in the child's life. The problem with this approach is that the RICE protocol, immobility, and anti-inflammatories have a detrimental effect on healing cartilage. Studies have shown that exercise, activity, or at least joint movement is needed to adequately nourish the cartilage and have it heal. A much better approach for the young athlete to heal sports-related injuries, even injuries to the cartilage, is M.E.A.T. This stands for Movement, Exercise, Analgesics, and specific Treatments, including Prolotherapy. This protocol increases circulation to the area, which brings with it immune cells that heal the sports injury. An overlooked predisposing factor in athletic injuries in youth is ligament laxity. Ligaments are the main stabilizing forces to the joints and the growing articular cartilage in this age group. If the joint ligaments are loose and weakened, this makes the athlete more prone to injury. Since the ligaments are responsible for joint stability, it makes sense that ligament weakness will make apophyseal and epiphyseal cartilage injuries more frequent. The best approach for the young athlete who is injured is to get Prolotherapy and undergo the MEAT protocol. This not only heals young athletes' sports injuries faster, it prevents them from recurring because the underlying joint laxity has been cured. 1.Brukner, P. Clinical Sports Medicine. New York City, NY: McGraw-Hill Book Company, 1995, pp. 521-540. 2. Rowland, T. Preparticipation sports examination of the child and adolescent athlete: changing views of an old ritual. Pediatrician. 1986; 13:3-9. 3. Maffulli, N. Paediatric sports injuries in Hong Kong: a seven-year survey. British Journal of Sports Medicine. 1996; 30:218-221. 4. DeHaven, K. Athletic injuries: Comparison by age, sport, and gender. American Journal of Sports Medicine. 1986; 14:218-224. 5. Grahame, R. Clinical manifestations of the joint hypermobility syndrome. Reumatologia (USSR). 1986; 2:20-24. 6. McCarty, D. Arthritis and Allied Conditions. Twelfth Edition. Lea and Febiger, 1993. 7. Lysens, R. The predictability of sports injuries. Sports Medicine. 1984; 1:6-10. 8. Goldberg, B. Pre-participation sports assessmentùan objective evaluation. Pediatrics. 1980; 66:736-745. 9. Nicholas, J. Risk factors, sports medicine and the orthopedic system: an overview. Sports Medicine. 1976; 3:243-259. 10. Keller, C. The medical aspects of soccer injury epidemiology. American Journal of Sports Medicine. 1987; 15:230-237. 11. Crosby, E. Recurrent dislocation of the patella. Relation of treatment to osteoarthritis. Journal of Bone and Joint Surgery. 1976; 58:9-13. 12. Hughstone, J. Subluxation of the patella. Journal of Bone and Joint Surgery. 1968; 50:1003-1026. Back [ 1 | 2 | 3 | 4 ] |
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The information on this website is presented as information only and not a self-help guide. Never alter or change your health management or begin any new health plans without first consulting your personal health care provider. Some statements on this site regarding the value of nutritional supplements have not been evaluated by the FDA.
Prolotherapy may not be effective for every individual and there are risks involved, these risks should be discussed with your physician. Results achieved with some may not be typical of all. Please consult a physician.
There is no known cure for arthritis. Prolotherapy and nutritional supplements can help alleviate, reverse, or end arthritic pain by treating an underlying cause that contributes to degenerative disease, ligament laxity. Strengthening ligaments and other connective tissue can help prevent bone on bone arthritis from developing.
© 2011 Chicago Sports Medicine is part of Caring Medical & Rehabilitation Services Specializing in Chronic Pain Management and providing Prolotherapy in the Chicago area. For more info visit www.caringmedical.com. Learn More About: Alternatives to Knee Surgery, Cause of Knee Pain, Non Surgical Knee Pain Treatment and Chronic Knee Pain and Tendons. Also visit www.hauserdiet.com to optimize sports performance and www.benuts.com for Quality Natural Supplements. Find out more about Prolotherapy at www.prolotherapy.org. Subscribe to the Journal of Prolotherapy www.journalofprolotherapy.com.To learn more about Ross and Marion Hauser visit www.rosshauser.com and www.marionhauser.com.