Thursday, February 14, 2002
"The number of professional and college athletes in this country totals only a few thousand, but more than one million American children participate in high school sports annually," said Dr. Bosco, an orthopaedic surgeon who practices in New York City and has worked with high school teams. "We haven't focused enough on these kids, despite strides in the prevention and treatment of injuries."
Dr. Bosco moderated an instructional course at the AAOS meeting entitled "Care of the High School Athlete: Issues and Controversies."
"The vast majority of orthopaedic surgeons will never treat a professional or elite college athlete, but almost all orthopedists routinely treat high school athletes," said Dr. Bosco. "Advances in treatment and prevention should be filtered down to the high school level sooner."
"High school athletes and professional athletes sustain roughly the same rates of injuries," noted Dr. Bosco, who serves as team physician for the Brooklyn Cyclones baseball team. However, the level of physical and emotional development among teenagers varies greatly, and the types of injuries between the two groups differ.
The bone structure of many teenagers has not fully matured. This immaturity makes adolescent players more susceptible to certain types of injuries and conditions than older athletes.
For example, areas of growing tissue near the end of children's long bones, known as growth plates, injure more easily than nearby tendons and ligaments. These growth plates mature by the end of adolescence. What would be a sprain in an adult could cause a serious injury in a high school player. Contact sports such as football and basketball, and overuse in sports such as gymnastics and baseball, can produce growth plate injuries.
Other conditions seen more commonly among high school than adult athletes include osteochondritis, an inflammation of the cartilage and underlying bone, and spondylolisthesis, the forward slippage of a vertebra on the vertebra below it.
Regardless of their nature, all sports injuries and complaints from young athletes need prompt medical attention. "Parents and coaches should not pressure the athlete to work through the pain because untreated injuries can lead to permanent damage and later disease, such as osteoarthritis," explained Dr. Bosco. "Young athletes are resilient, but parents and coaches should never assume kids will 'bounce back' from an injury because of their youth."
Dr. Bosco highlighted medical advances that have improved the long-term outlook for many injured athletes and allowed them to continue playing. Orthopaedic surgeons now know, for example, that the aggressive outpatient surgical treatment of dislocated shoulders can prevent many recurrences and allow athletes to stay in the game.
Insight into the origins of "stingers" and "burners," extremely painful nerve injuries common among football players caused by poor tackling techniques, has led to rule changes regarding tackling. Similarly, improvements in the identification of cognitive problems and memory loss due to recurrent concussions have triggered more stringent rules about when injured athletes can return to play.
Orthopaedic surgeons are finding themselves addressing emotional needs as well as medical issues, due in large part to the pressure our society places on young athletes to win at all costs and, in some cases, to turn professional. "Many kids go right from high school to the pros, and they're not emotionally ready for that. Orthopaedic surgeons often act as role models because they're educated and have the athlete's ear. In some cases, they may be the only adult role model the athlete has, stated Dr. Bosco.
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Last modified 15/February/2002