Department of Orthopedics and Sports Medicine, Children's National Medical Center, and The George Washington University School of Medicine and Health Sciences, Washington, D.C., U.S.A.
It is estimated that more than 30 million children in the United States participate in organized sports each year, with more than 7.5 million high school students playing competitive sports during the 2005/2006 school year. With the advent of year round recreational and competitive teams along with travel teams there are more and more opportunities for adolescents to participate in sports. Through Title IX, the first comprehensive federal law in the United States to prohibit sex discrimination against students and employees of educational institutions, girls have had an explosion in the number and variety of sports opportunities available to them. Along with this increase in sports participation has come the recognition that injuries do occur. In 2000-2001, there were more than 4.3 million visits to the ER for sports and recreation injuries with a majority of these injuries occurring in the 5- to 24-year-old age group. There are more than 10 million annual injury visits to pediatricians' offices with the number one reason being sports injuries and overexertion. More than 25% of adolescent injury visits are attributable to knee injuries. Overuse injuries have become more prevalent in this age of sports participation. This chapter will review some of the most common musculoskeletal injuries seen in this active adolescent age group.
Adolescent sport injuries are unique in that due to rapid growth, teenagers are more likely to injure a growth plate rather than the surrounding muscle-tendon unit. Apophyses (secondary centers of ossification where tendons attach) are frequently injured both acutely and chronically in adolescents. As these growth plates fuse at different ages, knowing the general patterns of ossification can help distinguish theses injuries.
Adolescents are sometimes hesitant to report injuries or pain because of peer pressure and their desire to participate in their sport. Close attention to the psychological impact injuries impart on adolescents is important in helping them fully recover and return to activity.
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