It’s early June and the pools, beaches and summer camps are on the minds of the parents and kids. The last thing that we are thinking about is our kids nagging pain in the knee. The high school and middle school athletes won’t need their per-season exams until early August, right. Wrong.
Nothing frustrates a Coach or a Sports Medicine Doc more than finding a "problem" at the beginning of fall sports. Most of these "chronic" injuries have been present since the previous year. Moms, dads, and the athlete have been hoping against all odds that the problem will just go-away with a summer of rest. Sorry, it’s not going to work.
Frequently during a pre-season exam in August I have found athletes in this condition. There is little to do except spend another season in pain or miss part of the season for treatment and rehab. The time to treat these "chronic" injuries is now, during the off-season.
Common chronic injuries in the high school and middle school athlete are shoulder, knee and ankle injuries. A common medical illness in the age group is exercise induced asthma. Treated early, these usually will not prevent participation in fall sports.
The most common shoulder problems are rotator cuff strains and shoulder instability. The rotator cuff is a group of tendons in the shoulder usually injured and overhead use of the arm. Shoulder instability can occur with rotator cuff injuries, after shoulder dislocations or without injury. Treatment for these conditions usually involves rehabilitation alone. Some more severe cases require surgery. Without treatment the pain, missed playing time, and poor performance will usually continue.
The knee can be affected by several chronic conditions, even in the young athlete. Ligament tears and knee instability do occur in these younger athletes. More commonly "Jumper’s knee" and Osgood-Schlatter’s disease (both an irritation of the kneecap tendon) will cause pain in front of the knee. In the female, irritation of the kneecap (chondromalacia) is a common complaint. These problems can be solved with rehab and sometimes bracing for sports. Rarely is surgery needed.
The most common finding in the pre-season exam is of "weak ankles". An athlete will describe multiple ankle requires exercise alone. More severe problems require added taping or bracing for sports. The most severe form may require surgery to prevent the recurrent ankle injury.
Exercise induced asthma is not uncommon in athletes. Symptoms of asthma include difficulty with breathing, wheezing and coughing. The symptoms may be mild to life-threatening. The cause of exercise induced asthma is not really known. Medications and the use of inhalants during sports allows continued competition in most cases.
A good off-season conditioning program is necessary for all serious athletes. I recommend checking with the head coach for a good program. These is no reason to miss playing time for chronic problems. For that nagging injury, check with your doctor or a certified athletic trainer.
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