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Common Youth Ice Hockey Injuries and How to Avoid Them

Common Youth Ice Hockey Injuries and How to Avoid Them

by | Oct 17, 2022 | Sports Medicine

Ice hockey is a contact sport that carries a higher risk of injury as the skill and competition level increase. Though ice hockey may not be as prevalent in North Texas as it is in other regions, Scottish Rite’s Sports Medicine team still takes care of injuries from this fast-paced and fast-growing sport.

Rules, such as delaying body checking, change an athlete’s risk of injury. We asked Jacob C. Jones, M.D., RMSK, and Madelyn White, P.T., D.P.T., to answer a few questions about pediatric sports medicine and physical therapy as it relates to ice hockey. Here’s what they had to say.

What do we know about ice hockey injuries?
Injuries occur quite frequently. Even though much of youth hockey prohibits checking and overt contact, that doesn’t entirely eliminate all contact in the sport. Both acute and chronic musculoskeletal injuries happen to hockey players. Concussions are also common in ice hockey players.

Are there different injuries in different age groups or skill levels?
Although many injuries are similar, younger hockey players may have more frequent injuries involving their growth plates since older adolescents may be near completion of growth. As a result, providers should be aware of how any injury may affect a growth plate. This can help provide the best treatment and avoid future complications.

Are there certain considerations when a player returns to the ice after an injury and rehabilitation?
It’s important to allow a gradual return to full participation in on-ice and off-ice training after injury. Be sure to warm up adequately prior to practice and games and avoid playing through pain.

Are ice hockey injuries preventable?
Yes, some of them may be preventable, especially the chronic injuries. Different youth leagues around the world have implemented rules changes regarding checking to help reduce the incidence of acute injuries.

What are tips for a skater to help prevent injuries?
Wearing proper gear, continuing to build flexibility and core strength. Some common injuries include ankle and shoulder injuries. Focusing regularly on exercises that help with the strength and mobility of these areas could help prevent injuries. Many overuse injuries and burnout can be prevented by trying to find at least three months out of the year to do a non-hockey sport or activity.

What should parents know about concussions in ice hockey?
Like other contact sports, these happen even with appropriate protective equipment and rules to avoid contact. Given the unique nature of the sport of hockey compared to other field sports, a treatment plan and return to play program should be tailored to hockey players. Seeing a medical provider familiar with sport-related concussions and hockey can help determine when it is safe to return to the ice, then safe to return to full hockey participation.

Are there exercises to help prevent back pain in ice hockey skaters?
Exercises to maintain hip mobility can help maintain good skating form and avoid back pain during hockey. It’s also important to build up abdominal and glutes strength. Exercises such as planks, banded side steps and crab walks can help prevent low back pain.

What is a Bridge Program?

What is a Bridge Program?

by | Dec 22, 2021 | Sports Medicine

Getting back to sports after an injury or surgery can be a long road. From the beginning of rehabilitation, the team is actively considering the best path for the athlete to get back to play safely with the lowest risk of re-injury. Depending on the condition and treatment, the natural course of recovery may take as long as 12 months. Formal physical therapy may last three to six months, but when that is over, what’s next? There are several options to “bridge” the gap between discharge from therapy and safe return to sports. The idea is to continue training in an environment where the instructor is familiar with young athletes and aware of the challenges associated to returning to sports after an injury. For some, a high school athletic trainer may be well-suited to collaborate with the athletic program’s strength and conditioning coach. The best option is to stay with a program that understands your child’s history and goals. One that is led by a qualified professional familiar with post-injury and post-surgical recovery timeframes. We are pleased to introduce this option to our current and former patients. Keep reading to learn more about this program at Scottish Rite for Children Orthopedic and  Center.

Sports Medicine 

Top Things to Know About the Bridge Program 

What is it?    The Bridge Program is specially designed for the young athlete who has completed their physical therapy sessions but is still needing focused training to help them return safely to their sport. Why was the program created?  When therapy ends, patients are often not ready to return to sport, but do not know where to turn. The purpose of the program is to offer additional resources to the patient who completes therapy and is in search of continued training with returning to sports as their main goal. Our team is well-equipped to direct the program development and care in this stage of recovery. What is the difference between physical therapy and performance training?  In therapy, physical and occupational therapists are movement experts who optimize quality of life through prescribed exercise, hands-on care and patient education. Once the patient is pain free and exhibits quality movement, performance training is the natural next stage.  Performance training can be offered in a small class setting under the direction of a certified strength and conditioning specialist (CSCS). It is not covered by insurance, but some guarantors have HSA/FSA funds that may qualify for this program. Learn more about this kind of coach in an earlier blog [here]. Who can participate in the Bridge Program?  This program is open to athletes that do not have an injury or have been cleared from all restrictions except the final clearance by their physical therapist or doctor to return to sport and to be considered for this program. How will the program help an athlete in their sport?  With an overall focus on where your child is in his growth pattern, our coaches can address each athlete individually and customize programs that work on weaknesses which may protect him from injuries in the future. We look to provide a starting baseline, progress and discharge summary for the athlete and family to view results throughout our eight-week programs. How do you sign-up?   Call 469-515-7150 or email BridgeProgram@tsrh.org to request more information. Classes are offered with rolling admission.
Return to Weight Lifting: A Guide for Young Athletes After Injury

Return to Weight Lifting: A Guide for Young Athletes After Injury

by | Dec 14, 2021 | Sports Medicine

Patients in the Scottish Rite for Children sports medicine clinic may lift weights as part of their primary sport training or with a strength and conditioning coach to supplement sport-specific training. When an injured athlete is released back to activities that include weight lifting, Scottish Rite for Children athletic trainer Allen Tutton, M.S., L.A.T., A.T.C., C.E.S., provides systematic instructions to ensure a safe, progressive return to training. Tutton is uniquely qualified with skills as both an athletic trainer and a corrective exercise specialist (CES). A certification from the National Academy of Sports Medicine, the C.E.S., requires a solid understanding of the interrelationship of movement quality and exercise, a must for strength and conditioning advice for young athletes. Here are his tips for safe weight lifting:

Before You Start

  • Focus on form and technique instead of the amount of weight or number of repetitions.
  • Increase your working weight slowly after an injury or a long break from training.
    • Working weight (WW) is the repetition (not max) weight used in your workout on a normal day.

Warm-up and Lifting

  • A warm-up is necessary to help you perform your workout at your best.
  • An optimal, dynamic warm-up includes upper and lower body stretches as well as light jogging.
  • Have a spotter with you when you begin lifting.
  • If you feel any abnormal discomfort, you must stop and rest 48 hours before trying the step again.
  • If your working weight is too heavy, decrease the weight used.

Terms to Know

  • Repetitions (reps) = number of times you perform the exercise before a rest.
  • Set = number of times you repeat the exercise and rest.

Wrap It Up

  • Each workout should not last longer than one hour.
  • Stay hydrated and rest at least 24 hours between sessions.

Managing Load: Preventing Overuse Injuries
Load can be measured in several ways:

  • Total work or repetitions done in a day.
  • Total weight lifted in a day.
  • Collection of work throughout a period, such as a week or a month.

Rushi Patel, P.T., D.P.T., SCCE, says, “A combination of how much weight is lifted, how often and for how long can all play a role in potential overuse injuries in the weight room.”
Patel offers these tips to minimize the risk of injuries:

  • All sport-related training should be considered part of the overall load. Times to reduce the weight or intensity of a weight-lifting routine include:
    • Starting a new sport or returning to sport after a break.
    • Preseason sport-specific intense training.
    • Focused sport-specific training in a camp or when learning a new skill.
  • Monitor how you feel in the first 24-48 hours after a workout. Excessive joint pain or soreness that lingers might be a sign to modify some activities related to your workouts.

To learn how nutrition can play a role in safe and effective strength training programs, read this article.

Nutrition Tips for Young Athletes in Stop-and-Go Sports

Nutrition Tips for Young Athletes in Stop-and-Go Sports

by | Jul 9, 2021 | Sports Medicine

A stop-and-go sport, also known as a high-intensity interval exercise, includes baseball, softball, football, volleyball, basketball, ice hockey, soccer and tennis. These sports require coordination, agility and concentration. Quick reactions in these sports demand bursts of energy, speed and power.

Alternating periods of intense power and speed, with short or long periods of rest, involve all of the major energy systems in the body. Therefore, meals and snacks throughout the day for these athletes should include appropriate mix of all foods and nutrients.

“It’s easy for busy young athletes to not make food a priority, showing up for practices and games under fueled and thinking they can power through”, says certified sports dietitian Taylor Morrison, M.S., R.D., CSSD, L.D. “However, the reality is that food and nutrition are very important components to optimal performance and injury prevention. The good news is that this food and nutrition doesn’t have to be complicated. An athlete can incorporate simple meals, snacks and fluids throughout the day using some general guidelines thereby reducing concerns and optimizing health and performance”.

CONCERNS FOR THE YOUNG ATHLETE IN STOP-AND-GO SPORTS
Burning Out Early 
Because of the intensity of some stop-and-go sports (like basketball, soccer, tennis and hockey) and because of the length of some games (like baseball or football) and tournaments (like basketball, soccer, tennis and volleyball), young athletes can use up their energy stores before the event is over. This especially becomes a problem if the athlete has not eaten a proper meal or snack earlier in the day or prior to the event and does not bring appropriate snacks for during the event.

End of the Season Injury
If this pattern of burnout continues, the constant fatigue during events can put the athlete at increased risk of injury due to decreased motor skills and performance. Poor nutrition or under-fueling can also lead to a lack of important nutrients like protein, fat, iron, calcium and vitamin D, which can also increase an athlete’s risk of injuries like stress fractures.

Dehydration
Dehydration is another contributor to fatigue, but also a cause of headaches and muscle cramps in the young athlete. Either of these can lead to decreased performance and injury. Of special concern are those young athletes playing in the heat or with extra gear like football, softball and hockey. Dehydration in these young athletes can lead to heat illness if it is not properly recognized and addressed.

NUTRITION SOLUTIONS FOR THE YOUNG ATHLETE IN STOP-AND-GO SPORTS
Proper Fueling Before and During Events
Eat a balanced meal at least three to four hours prior to the event and a small snack just before. Make sure to offer easy-to-digest carbohydrates to keep energy levels up until the very end of games and tournaments. More popular suggestions are fruit slices, dried fruit, crackers, pretzels, fig bars or sports drinks.

Balanced Meals Throughout the Day
Remember that the exact amount of food and nutrients needed vary depending on gender, height, weight, stage of development, sweat rate, sport played and position played. However, overall a young athlete’s plate should consist of:

  • Variety of Carbohydrates – Mix it up with sources like milk and yogurt, whole grains, fruits and starchy vegetables. Carbohydrates provide short and long-term energy to fuel for a practice, game or tournament.
  • Lean protein – Protein is important to repair any torn muscles and build tissue.
  • Healthy fats – Fat is important for the growing brain and has potential anti-inflammatory benefits.
    • Healthy fats, such as mono- and polyunsaturated fats, are important for brain development and function, aid in the absorption of vitamins A, D, E, and K and may have anti-inflammatory benefits. Learn more about healthy fats for the young athlete.

Getting carbohydrates, protein and fat from a variety of sources ensures that the athlete is also getting proper amounts of other nutrients like calcium, vitamin D and iron, among many others. Eating enough calories from carbohydrates, protein, fats and these nutrients helps promote optimal recovery and prevents injuries.

Hydrate
Drink fluid consistently throughout the day. Most of the time, an athlete should choose water and milk. Make sure to bring plenty of water to events adding a sports drink (for electrolytes and carbohydrates), if needed and encourage sips during timeouts, breaks and halftime. For heavy sweaters, salt can be added to drinks or salty snacks can be incorporated into breaks and halftimes.

Visit our sports hydration page to learn more about nutrition and fueling the young athlete.

Young Athletes and Heel Pain

Young Athletes and Heel Pain

by | May 18, 2021 | Sports Medicine

Skeletally immature athletes, those that are still growing, have unique conditions that occur in the growth centers of the bones. Heel pain in adults is caused by different issues because their growth centers are closed. Sports medicine physician Jacob C. Jones, M.D., RMSK, says, “This is one of the most common conditions we see in the developing athlete. Though it is a condition that does not have lasting problems or require aggressive treatment, it can really disrupt an athlete’s training and competition. Following guidance for rest, cross-training, improving ankle mobility and delaying specialization can help to keep the heels game-ready.”

What are growth centers? 
The medical term for a growth center is a physis. The physis is an area of the bone that has soft tissue called cartilage that is later replaced by new bone cells. Some are areas where bone growth makes bones longer. Others, called apophyses, give the bones a unique shape. These growth centers are found in the elbow, pelvis, heel and other areas. The apophyses are attachment sites for tendons.

What growth center is in the heel?
The calcaneal apophysis is in the calcaneus (heel bone). The apophysis is the attachment site for the very strong tendon from the calf muscle, called the Achilles tendon.

What causes heel pain in the calcaneal apophysis?
Children become more committed to sports around 8-12 years old. With running, or repetitive jumping, the Achilles tendon pulls on the cartilage in the heel. This, accompanied by the impact on the ground with running and jumping, can lead to irritation in this area. Because this has a gradual onset, this is referred to as an overuse injury and is often referred to as Sever’s disease.

What is Sever’s Disease?
Sever’s disease, or calcaneal apophysitis, is a type of overuse injury and the most common cause of heel pain in active children ages 8-12. It is caused by repetitive movements, like running and jumping and may occur in only one or both sides. The pain is usually not related to a specific injury and comes on gradually.

What is the treatment for Sever’s disease?
Changing shoes or adding heel cups may be recommended to help with comfort during recovery. Simple ankle stretching exercises may also be helpful. Other treatments are available and should be considered on an individual basis, but rest is the most common prescription for this condition. Returning to a sport and other physical activity may gradually prevent recurrence. Pain may last months to years and may come back or worsen with increased sport or activity.

How long does Sever’s disease last?
Sever’s disease will resolve with completion of growth in this area. Because the growth plate is soft until it is closed, this problem can happen again in this age group. Pain in this area typically resolves by the mid-teenage years.

What factors may increase risk of initial or recurrent Sever’s Disease?

  • Playing sports on a hard surface or barefoot.
  • Footwear with poor cushioning, such as soccer cleats.
  • Year-round sports participation.
  • Sudden increase in training intensity.
  • Increase in duration or frequency of activity, such as tournaments and camps.
  • Tight Achilles tendon or calf muscle.

Learn more about Sever’s disease in this popular short lecture featuring sports medicine physician Jane S. Chung, M.D.