Sports Medicine Archives

It’s a Whole New Game: Bridge Program Helps Young Baseball Players

by Lexie.Feikema@tsrh.org | Feb 5, 2021 | Sports Medicine

When a child or adolescent baseball player completes physical therapy for an elbow or other injury, his needs still look different from those of their peers. Bridge Program Coordinator Ian Wright, P.T., D.P.T., CSCS, USAW, answered the five “W’s” about what a bridge program can do for these athletes.

Who should participate in a bridge program?
Growing muscles, joints, and bones in boys and girls are at an increased risk of injuries from improper training and repetitive activities that occur in baseball and other sports. After recovery from an injury and discharge from physical therapy, all athletes would benefit from a strength and conditioning program to balance sport-specific training sessions. An athlete with a current injury should not start a bridge program without activity clearance from the medical provider.

What is a bridge program?
A bridge program is a series of group training classes led by a certified strength and conditioning coach. The coach evaluates the athlete’s movement patterns and provides instruction while supervising specific exercises with proper repetitions, resistance, and rest. Activities range from general strength and conditioning to sport simulation activities that are age- and task appropriate for each athletes. Education to complement the physical activities includes nutrition and hydration information for young athletes.

When is a bridge program appropriate?
A bridge program is most effective when it closely follows rehabilitation closely. Because poor movement patterns are associated with growth and increased injury risk, an ongoing or periodic conditioning program provides value to the young athlete at any point. The instructor must have a solid understanding and commitment to off-season periodization. Periodization is selecting the appropriate type of intensity of training based on the sports season.

For example, for baseball players, three seasons are considered:

Off-Season: August – November
Pre-Season: December – February
In-Season: March – July

Periodization becomes more difficult when athletes participate in a single sport year-round which is also associated with an increased risk of injury.

Where can an athlete participate in a bridge program?
The program should be implemented in a setting where there is access to equipment for the young athlete to train in a safe environment. For example, an at-home exercise program may have limitations for the athlete because they do not have enough space to perform their activities with the needed equipment. Additionally, proper supervision is important, both the ratio of participants to instructors and the qualifications of the instructors must be considered.

Why should young baseball players participate in a strength and conditioning program?
Physical therapy typically focuses on the specific impairment or limitations caused by the injury or condition. Though sports-focused therapists integrate total body treatment throughout, the sessions may end long before the body is back to normal. Most home exercise programs revolve around continued, supervised resistance training. Young athletes have limited access to well-trained instructors that consider total body conditioning, growth and development, skill acquisition, seasonal periodization, and individualized effective strengthening prescription. When left on their own, athletes are at an increased risk of a new injury or re-injury when they return to sport specific regimens of practice, games, tournaments, coaching clinics, and self-guided training.

Scottish Rite for Children in Frisco is offering training classes to former patients, Contact our Therapy Services team at 469-515-7150 or bridgeprogram@tsrh.org.

Learn more about Osteochondritis Dissecans (OCD) in the Elbow.

Rising Elite Gymnast

by Lexie.Feikema@tsrh.org | Feb 4, 2021 | Sports Medicine

When 12-year-old Julia began gymnastics eight years ago, her coaches immediately recognized her strength, focused attention and determination. They knew she could be great. Julia continues to prove them right and has earned her spot on the Hopes team at Plano’s World Olympic Gymnastics Academy (WOGA). Hopes is a pre-elite program for gymnasts under the age of 14 to begin their journey through the Elite Program, where National Team coaches look to find the next generation of Olympians.

While preparing for the Hopes Competition season, Julia was practicing new gymnastic skills progressions, which required her to land on her left leg repeatedly. She began experiencing soreness in her hip, and her coach could tell that something was wrong by the way she was moving. She suggested that Julia get it checked out to prevent further injury. Her mom, Heather, brought Julia to the Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco, Texas. She was seen by sports medicine physician Shane M. Miller, M.D., who is very familiar with the demands of gymnastics.

Miller recognized that Julia had an injury to a growth center where the hamstring tendon attaches to the pelvis, called the apophysis. The apophysis is made of soft cells called cartilage that will later be replaced by bone. In growing athletes Iike Julia, the apophysis is vulnerable to injury from repetitive activity. Until Julia finishes growing, this activity-related inflammation called pelvic apophysitis could continue to be a problem.

Fortunately, surgery is not required to treat the condition, so the Scottish Rite team developed a care plan focused on physical therapy to get Julia back in the gym for the USA Gymnastics (USAG) Development Camp. Physical therapist Lorenzo Vite, who frequently works with elite and pre-elite gymnasts, worked closely with Julia to help her achieve her goal. “We began by assessing musculoskeletal dysfunctions. Once dysfunctions were identified, we started low-impact movement skills and then we put her into our brand new Hydroworx® underwater treadmill to allow the muscles to work without too much stress,” says Vite. “From there, we progressed her to strengthening programs, monitoring her all the time to make sure that we didn’t exacerbate the hip pain.”

Julia enjoyed the variety of exercises that she did with Lorenzo. “At first, physical therapy was hard, but after a little bit, it all started getting easier,” she says. Over the course of eight sessions, Vite carefully managed and monitored Julia’s progress until they believed that she was able to perform. After she passed a rigorous functional test with flying colors, they knew that she was ready. Julia performed well in the USAG Development Camp in October and is continuing to compete pain-free!

Although COVID-19 slowed everything down for a while, it did show young athletes how taking time off can be beneficial. “In the gymnastics culture, people always think that you shouldn’t take any time off, but the pandemic showed us that if you miss some time and if you do it right, you can come right back and avoid injury,” says Heather. “In some cases, girls came back stronger in their core, which made them stronger gymnasts.”

Young athletes often feel like they have to play through the pain, so they don’t let their team or coaches down. Both Julia and Heather encourage other young athletes to speak up when something doesn’t feel right. “Talk to your coaches about it and tell them what’s happening,” says Julia. “Make sure that they know, so they don’t push too hard because you don’t want to hurt yourself.” Injuries may be treated quickly early on, but if athletes continue to practice and compete at a high level, it may become much worse, taking them out of their sport much longer. “Missing practice to go to Physical Therapy, does not mean you are falling behind or not getting stronger,” says Heather. “You are actually getting even stronger by going through physical therapy.”

Today, Julia continues her exercises to help prevent future injuries, and she is using everything that she has learned through this experience to help her fulfill her dream of competing in the Olympics!

Rising Elite Gymnast

by Lexie.Feikema@tsrh.org | Feb 4, 2021 | Sports Medicine