Vanderbilt Sports Medicine Injury Prevention in Youth Sports: What Works, What Doesn’t and What’s Next February 10, 2012 Alex B. Diamond, D.O., M.P.H. Assistant Professor of Orthopaedics and Rehabilitation Assistant Professor of Pediatrics Vanderbilt University Medical Center Co-Chair, Youth Sports Safety Taskforce Team Physician Vanderbilt & Belmont Universities Nashville Sounds & Nashville Predators 40th Annual Meeting heast Chapter of the American College of Sports Medicine (SEA
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Vanderbilt Sports Medicine Injury Prevention in Youth Sports: What Works, What Doesn’t and What’s Next February 10, 2012 Alex B. Diamond, D.O., M.P.H.
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Vanderbilt Sports Medicine
Injury Prevention in Youth Sports: What Works, What Doesn’t and What’s Next
February 10, 2012
Alex B. Diamond, D.O., M.P.H.Assistant Professor of Orthopaedics and Rehabilitation
Assistant Professor of PediatricsVanderbilt University Medical Center
40th Annual MeetingSoutheast Chapter of the American College of Sports Medicine (SEACSM)
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Disclosures• NO commercial relationships• Research & Educational funding
– NIH U54 Institutional Clinical & Translational Science Award
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Objectives• Review basic principles of injury prevention• Introduce key youth sports safety topics• Discuss strategies to prevent injuries in young
athletes• Empower you to create a safer sporting
environment and culture for youth athletes
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Injury Prevention is a Team Sport
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Injury Prevention 101
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Youth Sports: What We KnowThe Facts…• More than 38 million children and adolescents participate
in organized sports in the U.S. each year.– Another 10 million in some form of athletics
• Estimated 3.5 million children under age 14 receive medical treatment for a sports-related injury each year.– HS athletes account for additional 2 million injuries / 500,000
doctor visits / 30,000 hospitalization
Courtesy: Safe Kids USA & AOSSM
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ER Data: Sports & Recreation• Leading cause of presentation for injury among adolescents
– Emery CA. Epi Ped Sport Injur, 2005.• CDC data (Gilchrist J et al. MMWR, 2007.)
– 2.4 million visits/yr (age 5-18)– 29% of all unintentional injury visits– 48% of injuries that require hospitalization or transfer involve
age 5-18• NSW population health survey showed only 8.9% of sports
injuries treated in hospital setting. – Mitchell R. J Sci Med Sport, 2010.
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By the Numbers• Injury reported during sport among athletes age 5-14
– 28% of football players– 25% of baseball players– 22% of soccer players– 15% of basketball players– 12% of softball players
• Canadian study = more than 1 in 3 adolescents seek medical attention from a sport injury every year– Emery CA. CJSM, 2006.
AOSSM 2009 Annual Meeting Pre-Conference Program.
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Public Health Relevance:Sports Matter for (and to) Kids
• Organized vs rec, game vs practice, playoff vs regular season
Emery CA. Risk Factors for Injury in Child and Adolescent Sport: A Systematic Review of the Literature. CJSM, 2003. (LOE 2-4)
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Best Practice for Community and School Teams
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CONCUSSIONKey Sports Safety Topics
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Concussion Numbers• 1.6-3.8 million sports-related concussions/yr
– CDC MMWR, July 2007. • From 2001 to 2009, the number of sports and
recreation-related ED visits for TBI among persons aged ≤19 years increased 62% • CDC MMWR, October 2011.• TBI represents almost 9% of all injuries reported in HS
sports – National surveillance in 9 high school sports• Gessel LM et al. J Athl Train, 2007.
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Concussion Prevention: Equipment
• Football Helmets• Mouth Guards• Head Gear
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Football Helmet Ratings: STAR Evaluation System
• 5 Stars– Riddell Revolution Speed
• 4 Stars– Schutt ION 4D– Schutt DNA Pro +– Xenith X1– Ridell Revolution– Riddell Revolution IQ
• 3 Stars– Schutt Air XP
• 2 Stars– Schutt Air Advantage
• 1 Star– Riddell VSR4
• 0 Stars– Adams A2000 Pro Elite
Virginia Tech National Impact Database. May 2011.
Reduction in concussion risk
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Mouth Guards• Effects of mouth guards on dental
injuries and concussion in college basketball. – Labella et al. MSSE, 2002. (LOE 2)
• Findings:– No difference in concussion rate – Significantly lower rate of dental
trauma
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Head Gear in Soccer• Withnall et al. BJSM, 2005.
– Three equipment types tested– No attenuation of mechanical
forces due to heading ball– 33% reduction in acceleration
forces from direct head-to-head contact
– Further evidence needed for effect on injury or concussion prevention
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Navarro RR. Curr Sports Med Reports, 2011.
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Summary of Helmet Benefits in SportsMcIntosh AS et al. BJSM, 2011.
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Heading in Soccer• Straume-Naesheime et al. Br J Sports Med,
– Avoid playing for multiple teams at same time– 1-2 days/wk off from competitive sport or training– 2-3 months/yr away from same sport– Incorporate cross training– 10% Rule: Maximum 10% increase in training
program variables/week
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• 70% of kids participating in sports drop out by age 13- Lose benefits that sports provide
• Overtraining syndrome- Series of psychological, physiologic, and hormonal changes
that result in decreased sports performance
Parents and Coaches Beware!
“BURNOUT”
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Estimated Probability of Competing in AthleticsBeyond High School
Lace-Up Ankle Braces• McGuine TA et al. AJSM, 2011 (LOE 1)
– HS Football & Basketball (M & W)– Lower incidence of acute ankle injuries
• Degree of severity unchanged– No effect on other LE injuries– Benefit for both 1st time & prior sprain– Findings independent of shoe type, taping, field
surface
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Proprioception & Ankle Sprains• McGuine T et al. AJSM, 2006.
– Injury rate• 6.1% balance training program vs 9.9% control
– 50% risk reduction if prior sprain & perform intervention