In Young Athletes,
It’s Not Always a Muscle Strain.
wellness
by Erin McLaughlin, MS, ATC, PES | Nemours Center for Sports Medicine | Nemours/Alfred I. duPont Hospital for Children
At her appointment, Shannon explained
that her nagging hip pain was located
on the outside of her hips. The pain
was moderate, and waxed and waned
between sharp and dull in quality. She
was frustrated that she was unable to play
the sport she loved. Following a thorough
evaluation, Dr. O’Brien diagnosed Shannon
with an overuse injury of the hip. She
recommended that Shannon begin the
Next Steps Program, a personalized fitness
program offered at the Center for Sports
Medicine. The program is supervised by
a certified athletic trainer and includes a
baseline functional movement screen which
is a one-on-one assessment so that the
program can be modified and customized
as needed. The goal of the program is to
foster independence and confidence with
sport and exercise activities.
Most readers might think Shannon’s
story is unique. It is not. Her injury is
relatively common among pediatric and
adolescent athletes. Overuse or chronic
injuries are becoming more common in
young athletes because of early sport
specialization and participation in
multiple year-round sports. Hip and core
weakness can contribute to the onset of
pain, resulting in poor mechanics—where
athletes compensate physically for their
pain. In young athletes, a hip pain that
persists without resolution is often a
result of an apophysitis. An apophysitis
injury occurs at the attachment site of the
muscle tendon and in growing athletes;
this muscle-tendon-bone attachment is
subject to injury from repetitive stress. This
combination of hip and core weakness
coupled with poor mechanics can make an
athlete susceptible to more serious injuries
such as an ACL tear, especially, if they
continue to play while injured.
In recent years, more attention has been
focused on the importance of strength and
conditioning in youth sports, particularly,
as it relates to injury prevention. Those
who play "cutting" sports such as
field hockey that feature swift, abrupt
movements such as pivoting, stopping, or
turning are more likely to develop hip and
or knee pain as a result. An appropriate,
research-based lower body injury
prevention program, like “Jump Smart”
offered at the Center for Sports Medicine,
aims to improve stability,
strength, and body awareness.
While Shannon did not enroll
formally in Jump Smart, her
exercise program for Next
Steps mimicked the instruction
offered in the class.
For the next 3 months, the Center
for Sports Medicine became Shannon’s
home away from home. Her work
began with addressing deficits in
flexibility of her hamstrings, gluteal muscles,
and hip flexors. Shannon learned the basics
of core stability and hip strengthening. At
program completion, Shannon, her mother,
and the Athletic Trainer reviewed, step by
step, how to maximize her time in practice
and minimize her risk of injury.
Shannon worked very hard to recover
fully from her injury. Along the way,
she learned how to avoid future injury
recurrence. After t