Not Children, But Not Yet Adults: Special Concerns of Teen Athletes
Sep 2009
The dividing line between childhood and adulthood can be foggy during adolescence. Teens who look and feel “grown-up” often feel out of place in a pediatric waiting room filled with children playing with wooden puzzles and coloring books.
But adolescents, especially those who are athletes, face heightened health risks unique to their age. Because they are still growing, teens who are active in sports risk injuring their bones, ligaments and tendons—injuries best treated by pediatric sports medicine specialists.
The following are some conditions that occur at a higher rate among adolescents than children and are seen more often in gifted athletes who spend especially long spells on the playing field.
“Little League” Shoulder and Elbow
Many a pitching career has been derailed by injuries that result from throwing too many balls without using the proper mechanics. These injuries are especially common when a talented pitcher spends too much time on the mound. Pitchers who specialize in curve balls and sliders are at greatest risk.
Little league shoulder—normally defined as a strain in the rotator cuff (a network of muscles and tendons that connects the upper arm to the shoulder joint)—can also cause a tear in the labrum (a ring of cartilage in the shoulder joint) as well as damage to the growth plate (a piece of cartilage found at the ends of long bones during the developmental years). As the athlete’s shoulder begins to hurt, his or her athletic performance will decline and he or she may feel a need to push harder, making the injury worse. Little league elbow is also caused by overuse and poor mechanics, placing enormous stress on the elbow joint and forearm. It’s an injury that can cause chronic, debilitating pain.
Any pitcher, quarterback or other athlete whose sport requires rapid, repeated overhead arm movement (this includes swimmers) should consult a specialist in adolescent sports medicine at the first sign of tenderness. Among other things, the sports medicine specialist can help correct mechanical errors to reduce stress on the elbow and shoulder joints. An adolescent sports medicine physician can also design a plan to help the athlete build up certain muscles to support the affected joint and prevent future injuries.
Athlete’s Knee
While any adolescent athlete can suffer a knee injury, female athletes face special risk as their hips widen during adolescence, causing skeletal imbalance that can lead to a catastrophic tear in the ligaments that hold the knee joints together. Again, these injuries are more common among the most talented athletes who may be asked to spend more time on the field or court.
In far too many cases, athletes can rupture or snap the anterior cruciate ligament or ACL. The ACL crisscrosses inside the knee and surgery to repair it can sideline an athlete for months. After surgery, there is no guarantee that an athlete with such an injury will fully return to his or her previous level of activity.
Teen athletes, especially females, should consult a sports medicine specialist to learn exercises that can help increase the stability in the knee joints to prevent ACL tears or other knee injuries. At Children’s Hospital of the King’s Daughters, for example, sports physical therapists regularly offer classes that may reduce the risk of ACL injuries in female athletes by as much as 80 percent by teaching strengthening, stretching and balance techniques as well as core stabilization exercises. The classes also provide guidance on specific moves used in various sports, including proper jumping and landing.
Spondylolysis
Spondylolysis, or stress fracture of the spine, is the most frequent injury among teen athletes who suffer from lower back pain. While the condition can be treated without surgery, if ignored it can grow worse with each growth spurt. This condition rarely occurs in adults.
As a general rule, young athletes should consult a physician—preferably one certified in both sports medicine and pediatrics or adolescent medicine—at the earliest sign of muscle tenderness. Treating injuries early can allow children and teens to further develop their sports abilities and enjoy long, healthy and pain-free athletic careers.
Editor’s Note: See our Health Directory in this issue for pediatric sports medicine practitioners and physical therapy offices near you.