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Pediatric Orthopedic Lecture

6/25/2014

5 Comments

 
Picture
At the Harris Health system we only see a small percentage of pediatric cases so our clinical experiences are limited in this area. To compensate for the lack of clinical hours, our residency director, Dana Tew, PT, DPT, FAAOMPT organized a lecture with a local pediatric orthopedic expert. In this post, I want to summarize a few key points regarding pediatric- especially sport related- injuries and management.

1. If a child presents to your clinic with pain near the bone, you should almost always order an X-ray. Since muscles attach at or near the apophysis (growth plate) it is easy to see how repetitive stresses to the muscle can create undue forces across growth plate. Combined with rapid growth, adolescents are at risk for apophysitis. Apophysitis commonly occurs at the knee (Osgood Schlatter Disease), heel (Sever Disease) and medial elbow (little league elbow). Since the apophysis is skeletally immature, this area is a common site for avulsion fractures as well. The patient will likely present similar to a tendinosis patient. They will have pain near the muscle insertion and describe their symptoms as achy or throbbing. Due to the osseous immaturity, obtaining films is necessary to rule out a fracture or apophyseal injury. 

2. Pediatric patients can have muscle shortness AND joint hypermobility.
This is an important concept when choosing appropriate treatment options in the pediatric population. For example, a young thrower may have short Lats and Pectoralis muscles, but the glenohumeral joint is hypermobile. Many times people assume muscle shortness coincides with joint hypomobility. This may be true in older adult joints where arthritis and synovial changes have occurred, but not always the case in children. When performing a pediatric evaluation, be sure to perform a thorough joint assessment in addition to checking muscle length. 

3. Parents are equally competitive about their child's athletic career as the child. 
Every parent dreams there child will become the next Lebron James or Aaron Rodgers, so missing this weekends little league tournament seems out of the question. It sounds ridiculous, but it is not far from the truth. Parents and children alike need education regarding tissue healing following an injury, return to sport, the importance of playing multiple sports throughout the year to avoid overuse injuries. 

4. As a population, we need to do a better job preventing pediatric injuries from (re)occurring.
In today's society, we have the knowledge to know what stresses will cause injury to a child. We know that factors such as pitch count, dehydration, the psychological effects of being in a sport are extremely important. However, this information is not being relayed to coaches, trainers, and parents. Despite the abundance of knowledge, rates of injury are increasing among young athletes. A recent article from Advances in Pediatrics states "the incidence of medial epicondyle apophysitis is increasing as the number and intensity of organized youth sports have increased (Hoang 2012)." As healthcare professionals specializing in movement and exercise prescription, we need to be taking a more firm approach regarding prevention, management, and discharge criteria of pediatric injuries.       

-Jim 

References: 
Hoang, Quynh B., and Mohammed Mortazavi. "Pediatric Overuse Injuries in Sports." Advances in Pediatrics 59.1 (2012): 359-83. Web.
5 Comments
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9/21/2021 01:03:07 am

The student physical therapist has a forum about their orthopedic lecture. They are offering the clinical experiences seats that are limited in the given area. You can also get a lecture with a local pediatric orthopedic expert. Join in for more.

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6/7/2022 02:45:10 am

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10/11/2022 01:09:16 am

Pediatric orthopedic lecture is an area of specialty that deals with specific needs of pediatric patients. There are many aspects to consider for a pediatric orthopedic lecture, including the development process, age and growth rates, different types of joints and bones and how to treat each of these conditions

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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test