Price Transparency
Understanding Common Injuries in Youth Hockey

Understanding Common Injuries in Youth Hockey

by | Feb 3, 2025 | Sports Medicine

Ice hockey is becoming an increasingly popular team sport for many young athletes. However, with more participation comes a rise in hockey-related injuries. Physician assistant Cody Todesco, P.A.-C, M.M.S., is dedicated to helping young athletes, beginning with educating them about sports injury prevention. This passion is fueled by Todesco’s history as a young athlete

“I played both ice hockey and baseball from a young age,” Todesco says. “Because of a shoulder injury right before college, I underwent shoulder surgery, giving me an impactful perspective of youth hockey injuries and the field of sports medicine. I then went on to return to sports playing both collegiate hockey and baseball. This life changing experience fueled me to pursue an education that allows me to treat youth athletes in all sports, but I will always have a special love for hockey.”

It is important to equip young athletes with key strategies regarding youth hockey injuries, including how to prevent them and when to seek treatment. Continue reading to discover ways young athletes can protect themselves on and off the ice.

Common Injuries in Youth Hockey

The five most common injuries in youth hockey players are concussions, shoulder injuries, hip injuries, knee injuries and soft tissue injuries. Concussions can result from falls, collisions or impacts, like from a body check or a puck. Leagues that allow open-ice body checking often have higher rates of concussions.

The shoulder is a very mobile joint, and it is at risk of injury even with top-of-the-line padding and equipment. Injuries to the collarbone (clavicle) and shoulder, such as fractures, dislocations and separations, can occur from any collision or fall. Additionally, hip injuries, such as growth plate damage and muscle strains, are frequent due to the repetitive motion of skating. Goalies tend to experience femoroacetabular impingement, a condition caused by abnormal hip bone shaping.

Knee injuries, especially to ligaments like the medial collateral ligament, are common from skating motions and player collisions. These injuries often require medical evaluation before returning to play. Soft tissue injuries, including cuts and bruises from slashes, skates, or falls, are also prevalent. While minor injuries typically heal with basic treatment, more severe injuries that take longer to recover from should be assessed by a medical professional to prevent long-term complications.

“I think one of the hardest things as a sports medicine provider is balancing an athlete’s injury while also allowing them to recover to the ice both safely and quickly. ” Todesco says. “The importance of recovery along with nutrition and preparation is essential to preventing injuries and allowing a long athletic career.”

Reducing Injury Risk in Youth Hockey

To reduce injury risks, there are multiple steps young athletes should remember to protect themselves. Proper equipment is crucial, and gear should fit well and meet safety standards, with yearly fittings recommended. Off-ice warm-ups, including dynamic stretches and explosive movements, prepare the body for intense activity. Additionally, early sport specialization can increase injury risk, so a balanced approach to training, including rest and cross-training, is vital. A break between seasons and rest days during the season help avoid overtraining and support overall development.

By following these strategies, young athletes can protect themselves, ensuring they stay on the ice longer and healthier into adulthood. Read more about common hockey injuries here.

Preventing Overuse Injuries: An Overview with Dr. Henry Ellis & The National Council on Youth Sports

Preventing Overuse Injuries: An Overview with Dr. Henry Ellis & The National Council on Youth Sports

by | Jan 29, 2025 | Sports Medicine

Pediatric orthopedic surgeon and sports medicine expert Henry B. Ellis, M.D., spoke with the National Council on Youth Sports about Preventing Overuse Injuries in Youth Sports. Here are the key takeaways from his webinar:

 

What is an overuse injury?

Ellis: Overuse injury is defined as repetitive loading over a period of time. When an overuse injury occurs, it is the result of microtearing in tissues and cartilage while the body is unable to recover and heal. These injuries often occur around growth plates, which are the areas of cartilage that attach to muscles found in children and adolescents. Microtears and stress on the growth plates lead to an inflammatory process and an overuse injury. Inflammation causes pain, which is the body’s way of telling the athlete to slow down and give it time to heal.

 

What is sports specialization?

Ellis: Sports specialization is associated with injuries and overuse. Some things that qualify as sports specialization include training in a specific sport year-round (more than eight months a year), quitting all other sports to focus on one sport, or choosing to focus on one main sport overall. Variety in sports is healthy all-around. All athletes need an off-season to do something different to avoid causing an overuse injury.

 

How do you tell the difference between typical soreness after activity versus an overuse injury? 

Ellis: A myth is that when you are not sore after training, you are not training hard enough. In children, the body is not meant to be sore or have discomfort after activities. When children are sore, it signals that they are doing too much and could have an overuse injury. Children’s bodies are growing and developing, and because of this, their healing capabilities are different than that of an adult.

 

What are some common overuse injuries?

Ellis: Many overuse injuries are related to growth plates around different bones in the body. Hamstring problems in a dancer are common due to repetitive movements such as high kicks causing an overuse injury known as apophysitis, which causes pain and inflammation around a growth plate. Another common overuse injury seen in basketball players is Osgood-Schlatter, which affects the growth plate at the top of the shinbone (tibia) just below the kneecap. This is often due to repetitive jumping and running. In runners and sprinters, it’s not uncommon to find overuse injuries around the growth plate near the hip flexor. In gymnasts and baseball pitchers, we see another condition called osteochondritis dissecans (OCD) of the elbow. This condition happens when a bone underneath cartilage no longer supports it, leading to pain and inflammation.

Stress Fractures are another common injury seen across all sports. They happen when repetitive loading in a bone creates tiny microfractures. The body normally heals these microfractures, but when an athlete is doing an action repeatedly, the body can’t keep up with healing. This could be due to lack of adequate rest or nutrition, and the body says enough is enough.

 

What could be the source behind an increase in overuse injuries in youth sports?

Ellis: We know that in the last 20 years, overuse injuries in youth sports are up at least 600%. As parents of a young athlete, it can be hard to pull in the reins on the amount of an activity they not only love, but that you love experiencing with them. We’re also seeing an increase in sports specialization and the commercialization of youth sports, leading to more pressure for young athletes to perform.

 

How can families prevent overuse injuries in their young athlete?

Ellis: Working as a family to monitor activity and staying involved with your child’s coach to keep an eye on training commitments can help prevent overuse injuries. Balancing multiple sports is beneficial, but extreme participation can lead to injuries. As a rule of thumb, try to balance the weekly hours of activity with a child’s age – less activity and training for younger children and more as they age. We’re not concerned about children being in sports all year-round, but those sports need to be different and allow for different activities in different seasons.

A good method to prevent overuse injuries is following the 70/30 rule. The 70/30 training rule helps prevent injuries by balancing sport-specific training and conditioning. For example, if you have a swimmer in the pool for seven hours one week, balance that with three hours of dry land training to avoid too much repetition in movements.

 

What are some other factors that contribute to overuse injuries in young athletes?

Ellis: Adequate sleep is crucial for recovery and performance, and a lack of sleep increases injury risk. Proper sleep and nutrition are probably two things we don’t talk enough about. If an athlete sleeps less than eight hours, they have a higher risk of becoming injured and may have delayed recovery from injuries.

Nutrition is also vital to preventing injuries such as stress fractures, a concerning overuse injuries. Proper fueling after training and competition help athletes recover and prepare for the next session or game.

 

To watch Dr. Ellis’ full webinar, please visit the National Council on Youth Sports on YouTube.

 

When Can I Return to Sports? Concussion Recovery for Athletes

When Can I Return to Sports? Concussion Recovery for Athletes

by | Jan 23, 2025 | Sports Medicine

Over 7 million teens play high school sports in the U.S., and millions more kids play in youth and recreational leagues. Athletics are a great way to make friends, stay active and learn life lessons. However, sports can also lead to dangerous concussions. Just like a sprained ankle, concussions take time to heal. Parents and young athletes need to understand how long concussion recovery takes and why returning to play takes time.

 

Understanding Sport-Related Concussions

A concussion is a type of brain injury that happens after you are hit in the head or body by another person or an object. This blow can cause the brain to bounce around, leading to chemical changes in the brain. A concussion is a mild traumatic brain injury (TBI), and just like any TBI, it can be serious.

As soon as you suspect your child or teen has experienced a concussion, speak up. Learn the symptoms of concussion, and remove your athlete from a practice or game if you notice any of these signs after an injury:

  • Appearing confused, dazed or stunned
  • Balance problems
  • Changes in behavior
  • Losing consciousness
  • Memory issues, such as forgetting plays
  • Seizure, particularly with tension or stiffness in the arms or legs

 

Early Diagnosis for Successful Concussion Recovery

The first crucial step to healing after a concussion is getting athletes the medical care they need as soon as possible. Early intervention, and an accurate diagnosis from a physician who specializes in concussions, can help children and teens get back in the game sooner.

A pediatrician or concussion specialist can provide an assessment for treatment and may refer you to a neurologist or sports medicine expert, depending on symptoms. Young athletes may need neurocognitive testing to evaluate the extent of their injury.

 

Steps to Ease Healing

Concussion recovery can differ from athlete to athlete, but it typically takes weeks, not days, for the brain to heal. Taking the time needed to recover from a concussion is crucial to ensure proper healing.

Your young athlete’s medical provider will give you a treatment plan to help them gradually return to physical activities. It’s important to recognize that complete rest is no longer recommended. Concussion researchers, including those at Scottish Rite for Children, have found that returning to daily activities within two to three days helps children and teens feel better and recover faster than with total rest.

When your child or teen returns to school, talk to teachers and school administrators about the learning environment and any necessary schedule modifications.

Other steps to improve concussion recovery include:

  • Avoiding caffeinated drinks
  • Limiting screen time, which can worsen symptoms
  • Spending time with family members and friends to avoid isolation
  • Staying hydrated
  • Taking pain relievers such as acetaminophen or ibuprofen as recommended

Also, help your child or teen get sufficient sleep every night. Contrary to what many people think, sleep should not be avoided after a concussion. Our researchers have found that insufficient or poor-quality sleep slows recovery.

Athletes should get:

  • Nine to 12 hours of sleep per night if they are ages 6 to 12
  • Eight to 10 hours of sleep per night if they are ages 13 to 18

Most children and teens recover from a concussion within a few weeks. However, scheduling an appointment with an experienced doctor who has managed concussions is recommended if symptoms get worse instead of better. Some children develop post-concussive syndrome, a condition that can last months after the concussion.

 

Ready to Get Back in the Game?

Returning to play should be approached with caution for athletes of all ages. The University Interscholastic League recommends a health care provider with experience managing concussions should clear an athlete before he or she starts the progression to return to play. Your child’s school or coach may have additional protocols.

Typically, after an athlete is symptom-free, back in school and handling daily activities, he or she can start steps to return to sports, including:

  • Light aerobic exercise, such as riding a stationary bike or light jogging for 10 to 15 minutes
  • Sport-specific activity for 20 to 30 minutes with increased exertion, such as a running drill
  • Non-contact training drills with resistance training, such as ball handling or passing drills

Progression to the next step should occur only if no symptoms return during this activity or for 24 hours after. With a physician’s clearance, athletes can start full-contact practice, such as scrimmages. They may be cleared for competitive play after being symptom free for 24 hours after a vigorous practice.

Talk to a health care provider if symptoms return at any stage of these steps, either during training exercises or within 24 hours after.

Throughout your child’s or teen’s recovery, work closely with the school’s athletic trainer, if one is available, and ensure your athlete follows the provider’s directions closely before returning to sports, especially contact sports.

 

If your young athlete has recently experienced a concussion, Scottish Rite for Children sports medicine specialists are here to help. Request an appointment today.

Back on Beat: Alyson’s Determination to Heal Her Knees

Back on Beat: Alyson’s Determination to Heal Her Knees

by | Jan 16, 2025 | Sports Medicine

Alyson, a 17-year-old of Dallas, TX, has a passion for the fine arts! She has performed in her school’s musical productions, such as “Chicago” and “Mean Girls,” and even sings in the choir. Her most beloved hobby is dancing, but Alyson’s love for dance was threatened at age 9 when she began to feel frequent pain at dance practice.

Prior to visiting Scottish Rite for Children, Alyson was diagnosed with osteochondritis dissecans (OCD) in her knees. OCD causes the bone and cartilage at the joint surface to separate due to a lack of blood supply. It is common in young athletes, and may cause symptoms whensport requires running or jumping frequently. Alyson also has a condition called genu valgum, commonly known as knock-knees.

“I found myself needing frequent breaks from dance class, often icing my knees afterwards,” Alyson says. “In choir, I was often told, ‘Aly, stand with your knees straight.’ I physically could not.”

When Alyson’s paid did not improve, a pediatrician referred her to Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. Philip L. Wilson, M.D., assistant chief of staff, director of Sports Medicine and pediatric orthopedic surgeon, met Alyson and her family and recommended surgery as the best course of action to heal Alyson’s knees.   

“My world came to a standstill,” Alyson says. “My afternoons that I previously spent laughing with my friends or learning techniques from my dance teachers were now spent crying and feeling sick to my stomach with the dread of potentially not dancing again.”

Already familiar with Dr. Wilson from a fracture years before, Alyson decided to proceed with surgery. Dr. Wilson performed a double knee surgery, which involved placing plates and screws in both of her knees. The plates stabilized her knees and assisted in helping her knees grow straighter. The road to recovery required Alyson to stop dancing until she was fully healed.

“All of the doctors and nurses were so helpful,” Alyson says. “My determination to return to my sport fueled me through months and the challenging journey of learning how to walk again.”

Once the screws were removed, Alyson began working hard to heal her knees through physical therapy. What began as a painful setback has transformed into a triumphant comeback, and Alyson’s determination has led her to become her school’s drill team captain this year.

“When the ability to not move freely was taken away from me, I realized how much dance shaped me — not just on the stage and field, but in all areas of my life,” Alyson says. “Scottish Rite will always be remembered as an amazing environment for me. Not only were all of my nurses and doctors encouraging, but I also truly felt open to share what I was feeling with them.”

How Spotting Spondylolysis Early Helps Protect Your Child’s Spine

How Spotting Spondylolysis Early Helps Protect Your Child’s Spine

by | Jan 14, 2025 | Scoliosis & Spine, Sports Medicine

Back pain isn’t an adults-only problem. It also affects children, and spondylolysis — a break in a vertebra — is a common cause.

If your child tells you their low back hurts, especially during physical activity, have a medical provider check it out as quickly as possible. If spondylolysis is present, early diagnosis and treatment can prevent a more serious injury to the vertebra called spondylolisthesis. The sooner your child starts treatment, the sooner they can get back to enjoying an active childhood.

 

Spondylolysis vs. Spondylolisthesis: What’s the Difference?

Spondylolysis is a stress fracture that develops in a vertebra, one of a column of bones that protects the spinal cord. Along the spine, pairs of facet joints help stabilize the vertebrae. A thin piece of vertebra called the pars interarticularis links these joints. Spondylolysis affects this bony connector, most commonly in the vertebrae of the lumbar spine (lower spine).

Without treatment, spondylolysis can lead to spondylolisthesis, which is when the pars interarticularis splits. As a result, the vertebra slips out of position, potentially causing pain and nerve damage.

 

Who’s at Risk for Stress Fractures of the Spine

Repeatedly overstretching the spine stresses the vertebrae, which are especially vulnerable to stress fractures during childhood because they’re still growing. Your child may have a higher risk of spondylolysis and spondylolisthesis if they participate in sports or activities that involve frequently leaning back and moving the lumbar spine, including:

  • Ballet
  • Football
  • Golf
  • Gymnastics
  • Soccer
  • Volleyball
  • Cheerleading
  • Weightlifting
  • Wrestling

 

When Back Pain Is a Red Flag

Sometimes, stress fractures of the vertebrae develop silently, without causing symptoms. In other cases, however, these bone breaks provide clues to their presence. Back pain is the main one.

Spondylolysis in a lumbar vertebra can cause low back pain that feels like a muscle strain. Your child’s discomfort may get worse with activity and improve with rest. Other symptoms of spondylolysis include pain in the legs and buttocks, which may be a sign the pain has spread from the back. Spasms from the stress fracture can cause your child’s hamstrings to tighten.

 

Diagnosing and Treating Spondylolysis

If you notice symptoms of spondylolysis, take your child to their primary care provider, who will ask about medical history and sports participation. The medical provider will also perform a physical exam to look for signs of a stress fracture in the low back and legs. He or she may press on your child’s back to identify tender areas or ask your child to bend backward to see if the movement causes discomfort.

Imaging tests, such as X-rays and CT scans, can show stress fractures in the vertebrae and help your child’s medical provider confirm a spondylolysis diagnosis. MRI scans can show whether a stress fracture has led to tissue damage.

Your child’s primary care provider may refer you to a pediatric orthopedic specialist for further evaluation and treatment. If found early, spondylolysis usually heals with nonsurgical treatment.

Your child may need to take a temporary break from sports that put repetitive stress on the low back to give the fracture time to heal. To help the process, they may need to wear a back brace to limit the spine’s movement.

While the injury heals, your child may take over-the-counter pain-relieving medications to stay comfortable. Working with a physical therapist can also help reduce pain and improve strength and flexibility in the lumbar spine.

Surgery isn’t usually necessary. However, if spondylolysis leads to severe spondylolisthesis, spinal fusion may be the most appropriate treatment. During this operation, a surgeon connects two damaged vertebrae using a bone graft so the vertebrae heal into a single, stable bone.

 

How to Reduce Your Child’s Risk of Spondylolysis

You can help protect your child’s spine and keep him or her on the field or court by encouraging simple steps to reduce the risk of spondylolysis, including:

  • Build strength in the middle. Encourage your child to strengthen his or her core to help support the lower back.
  • Focus on one sport at a time to prevent overuse injuries. Don’t let your child play more than one sport that increases the risk of a spinal stress fracture per season.
  • Play it smart. Ensure your child uses the proper equipment and technique for his or her sport.
  • Rest up. Your child should take at least one day off from practice or training each week.
  • Eat a balanced diet. Maintain a healthy diet with adequate calcium and protein intake. Vitamin D supplementation is especially necessary for those missing key nutrients in their diet.

 

Need an expert who can treat your child’s low back pain? Schedule an appointment with a pediatric orthopedic specialist at Scottish Rite for Children.

Can You Sleep With a Concussion? A Common Question, Answered

Can You Sleep With a Concussion? A Common Question, Answered

by | Jan 13, 2025 | Sports Medicine

A concussion is a type of traumatic brain injury, and if your child has experienced one, there are many ways you can support their recovery process. One of the most important ways you can help is by ensuring your child gets plenty of rest. For many years, it was thought that sleeping with a concussion was unsafe. Current evidence encourages parents to promote and protect rest, as it helps the child’s brain recover.

“We now know that it is safe to sleep after a child has been medically diagnosed with a concussion by a medical provider,”pediatric sports medicine physician Jane S. Chung, M.D., says. “Unless your child’s provider says otherwise, let your child sleep without interruption.”

First Steps to Recovery After a Concussion

If your child has a head injury and displays symptoms of a concussion, immediately remove them from activities that put them at risk for a repeat head injury, such as athletic practices or games. You should take your child to see a provider with experience in concussion management. In addition to concussion testing, these providers are experienced at evaluating brain function and the consequences of the injury.

Signs of a concussion observed by others can include:

    • Appearing dazed or stunned
    • Confusion
    • Forgetting plays
    • Being unsure of game, score or opponent
    • Exhibiting unsteadiness
    • Moving clumsily
    • Answering questions slowly
    • Losing consciousness (getting knocked out)
    • Memory loss
    • Being more sleepy or tired than usual
    • Seeming sad, nervous or anxious
    • Being irritable, easily frustrated or upset
    • Having problems with academic performance
    • Slow to get up after a fall, collision or blow to the head
    • Clutching the head after an injury
    • Sleep problems

     

    Concussion symptoms felt by the athlete can include:

    • Headaches
    • Concentration or memory problems
    • Nausea
    • Balance problems or dizziness
    • Double or blurred vision
    • Feelings of being “in a fog” or slowed down
    • Sensitivity to light or noise
    • Confusion
    • Just “not feeling right” or “feeling down”

     

    A concussion evaluation includes a variety of physical exams, tests and computerized neurocognitive testing, as needed. If your child is diagnosed with a concussion, their provider will give you advice about what your child can and can’t do in the days immediately following the injury. Most importantly, your child should avoid activities, practices and games that increase their risk for a repeat head injury until cleared by their medical provider.

    Your child’s doctor will work with you to determine when your child can progressively return to school, practices and games. Returning to activities too early can cause worsening symptoms and delayed recovery.

     

    How Much Sleep Your Child Needs

    Your child’s doctor will encourage you to make sure sleep is part of the recovery plan. “Sleep plays an important role in a child’s growth and development,” Dr. Chung says. “Following a concussion, sleep is even more important to allow brain healing and recovery. We encourage at least 9 to 10 hours of sleep every night during concussion recovery in our teenage patients.”

    As your child recovers, take the steps to help them get good-quality sleep. You can improve your child’s sleep habits with these tips:

    • Help them create a wind-down routine. Your child should avoid energy drinks and caffeine, especially close to bedtime. If your child has a hard time falling asleep, develop a sleep routine that helps prepare your child to sleep. They can try taking a warm bath or shower, you can read them a story or help them find other relaxing activities to signal their brain and body that it’s time for bed.
    • Create a sleep-friendly environment. Your child’s bedroom should be quiet and comfortable. If the room gets lots of sunlight, you can use blackout curtains and keep the room cooler.
    • Stick to a sleep schedule. You should ensure your child goes to bed and wakes up around the same time every day. Avoid long naps during the day. They may take brief short naps during the day, no more than 30 minutes, if needed. However, we encourage kids to go to bed earlier if they are feeling tired, rather than taking prolonged naps during the day, as it can negatively affect their circadian rhythm.
    • Turn off electronics. Computers, televisions and other screens produce a blue light that can keep kids awake. Your child should avoid electronics at least one to two hours before bedtime.

    In addition to ensuring good-quality sleep, keep an eye out for sleep problems. In research conducted at Scottish Rite for Children with patients who had a sport-related concussion, experts learned poor sleep quality can be associated with prolonged concussion recovery and delayed return to sport compared to those athletes who had good sleep quality.

     

    Talk with your provider if your child experiences:

    • Difficulty sleeping at night. Frequent naps can make it hard for your child to sleep at night.
    • Lack of improvement in symptoms. A normal concussion resolves within two to four weeks.

    Another study published in the Journal of Clinical Sleep Medicine by our sports medicine team suggests that after a concussion, sleep quality may be affected.

     

    Does your child need help recovering from a concussion? Call 469-515-7100 to schedule an appointment with a sports medicine specialist at Scottish Rite for Children Orthopedic and Sports Medicine Center.