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Growth Plate Injuries: What Parents Should Know

Growth Plate Injuries: What Parents Should Know

boy-with-chocolate
boy-with-chocolate

For a child, falling down is almost inevitable and generally doesn’t result in a trip to the emergency room. However, even minor falls can sometimes cause serious injuries. If you hear a cracking sound or if your child has bruising, swelling, or a limb deformity, there’s a chance your child may have broken a bone and you should seek medical attention right away if you notice these symptoms. Most types of breaks are routine (for the medical staff if not for the parent), but those involving a growth plate can present complications and require extra attention.

There is a marked difference between the bones of an adult and those of a child. Children have what are called physes—that is, growth plates. These growth plates are located at the end of long bones in the arms and legs. The growth plates, made of soft, rubbery cartilage, cause the bone to grow in length. Growth plates are found near the shoulder joint, elbow joint, hip joint, knee joint, ankle joint and wrist joint. Of the six main locations the ankles and wrists are particularly vulnerable to harm.

Growth plate damage can lead to long term problems. When a growth plate is injured, the bone may stop or slow growing. This is why it is essential to seek qualified medical treatment immediately to avoid problems later in life. If injured, a child should under no circumstances “walk it off.”

It is imperative to get the child to a doctor as soon as possible if you suspect a growth plate break. Growth plates heal quite rapidly, which gives doctors only a very short window to do non- surgical manipulations in order to set broken bones correctly. If your child has a minor, non-displaced break, the doctor may treat it like a sprain and recommend a splint, cast, or walking boot to protect the area for four to six weeks. Usually, these types of fractures do not require long-term care. Preferably, a growth plate fracture should be set within a week of injury.

When a child’s bone has moved or been displaced, an orthopedist can set the bone back in place in the emergency room without the need to operate. The child will be anaesthetized in the emergency department, and the doctor will use X-rays to determine where to correctly move the bone. Once the bone has been set, the doctor will set a cast in order to keep the bone in place. Usually the child will be allowed to go home that night, but occasionally they will be admitted to ensure the swelling is not too severe. Proper care and follow up will likely involve physical therapy and doctor’s visits for the next half a year.

Most growth plate fractures heal properly and do not result in any long-term issues. Once in a while, the bone stops growing and winds up shorter than the other appendage. For example, a fractured leg might become shorter than the opposite leg. Early detection that growth is unequal between the two limbs is essential. However, this is a true minority of cases and most children heal just fine.

Proper Form for Football Tackles: Is Improved Technique Enough to Protect Youth Players?

Proper Form for Football Tackles: Is Improved Technique Enough to Protect Youth Players?

FootballThere is no question that football is a full-contact sport that has the potential to cause a variety of injuries, some of which can be very serious.  There is also no question that tackles are the most dangerous part of the game. Concussions and other head injuries, plus damage to the neck and spine can not only put a player out of commission, they may also lead to permanent injury or death.

Today’s professional football players are large, strong and fast. The traditional wraparound tackle places the head into harm’s way and increases the risk of injury. Football officials are promoting a method to change all this. To prevent or lessen this danger, the objective is to take the head out of play as much as possible. This is called the “heads-up” method of tackle. The experts say that you should not lead with your head down, as this can be dangerous not only for the tackler but also for the ball carrier.

Why has this become such an issue? The Washington Post reported in early 2013 that professional football injuries have risen between 2000 and 2011 from 2,640 to 4,473 injuries. In that same period, the average number of weeks a player spends on the NFL injury report has grown from 3.24 to 4.12 weeks. So, there are not only more injuries across the board, but longer lasting injuries as well.

The method recommended by professional football officials, including the NFL commissioner, and even the CDC, involves a specific form of stance and approach. With the head up and back, the chest forward and the arms extended slightly with elbows pointed down and knuckles pointed up, the tackler uses their leg muscles and hips to lunge upward, driving the chest and shoulders into the ball carrier. The tackler ends by throwing what looks like double uppercuts.

But not everyone agrees that the technique promoted by football officials is practical or that it’s likely to reduce the game’s inherent risks in any meaningful way. Matt Chaney, an analyst of football health issues, including catastrophic injuries, wrote a scathing critique of the method in a 2012 issue of Slate magazine. Chaney wrote, “As a former head-basher in NCAA football, I can say that this is a technique that I’ve seen precisely no one, ever, use on the field.” So, even though coaches may train and drill the technique, according to Matt Chaney, it isn’t used in the real world. Chaney explains, “To ask the body, while traveling at [football] speed, to crane the neck up and back, in defiance of physics, is a fool’s errand.”

At the same time, however, it is clear that some approaches to tackling—and being tackled—are safer than others. And the incentives to reduce serious injuries are beginning to grow for everyone in the broader football community, from team owners and coaches to the players themselves. Rule changes, improvements in protective gear and—yes—advances in tackling techniques all have a role to play. This is especially true in youth football programs.

Professional football players take their chances. After all, it’s part of their chosen career. However, juvenile players require more care and guidance. So what can be done to protect youth players? While some believe that better education and training (as well as better equipment) is the answer, others think that the nature of tackle football itself is the problem. Unlike baseball, which is sometimes described as men playing a boys’ game, tackle football is in some respects a man’s game being played by boys. This is the perspective taken by Matt Chaney. “If the NFL is truly serious about protecting kids,” wrote Chaney, “instead of building up the sport’s talent pool, then the league and the players’ union should start listening to the growing medical call to end tackle football for pre-adolescents.”

Can Joint Injuries Really Cause or Accelerate Arthritis?

Can Joint Injuries Really Cause or Accelerate Arthritis?

Woman wrapping her hand with a bandage on a white backgroundA U.S. Centers for Disease Control and Prevention (CDC) study performed from 2007-2009 showed that at least 22.2% of adult Americans suffered from arthritis. The actual number could be higher than the CDC estimate, though, because these were self-reported and doctor-diagnosed cases. Naturally, no one knows how many unreported cases there are. Still, it’s reasonable to believe that this percentage will only become higher as the population ages.

The short answer to the question asked in the title of this article is “Yes”.  Joint injuries really can cause or accelerate arthritis. The reason is simple. Arthritis is all about inflammation of the joint. Inflammation is a natural reaction of the body to injury, pathogens or irritants. Trauma or injury is a major cause of arthritic conditions. Various forms of arthritis, like osteoarthritis (the most common form), are degenerative—they get worse over time and with wear and tear. Once an arthritic condition is established, it will get worse unless the root cause is found and dealt with, or the symptoms are managed by drugs.

Dr. Joseph Borrelli Jr., chairman and professor of orthopedic surgery at the University of Texas Southwestern Medical Center, performed a study to see how post-traumatic arthritis (PTA) developed after an acute joint injury. Using an animal model, Borrelli found that trauma to the joint can lead to a range of acute lesions, including fractures to bones, ligament or meniscus tears and damage to the articular cartilage. These types of injury are often associated with bleeding in the area of the joint and cause post-traumatic joint inflammation. Despite the resolution of the acute symptoms, and the fact that some lesions could be surgically repaired, joint injury causes a chronic remodeling of the cartilage and other joint tissues that in a majority of cases eventually manifests as osteoarthritis.

The key seems to be in the chondrocytes. These are the cells present in healthy cartilage that help to produce and maintain it. When an acute injury occurs, these chondrocytes become inactive within a month, slowly reducing the structural integrity of the cartilage. Borelli said “In our PTA model, the cells became inactive almost immediately after injury and stopped producing these compounds [that maintain the cartilage]. He continued, “This may explain why PTA sometimes develops very quickly in patients after an injury, regardless of how successful we were in fixing the fracture. PTA can develop in just 6 months—unlike osteoarthritis, which may take up to 60 years to develop.”

PTA aside, serious joint injuries that are not addressed promptly can cause a range of problems down the road.  By healing incorrectly or incompletely, joints can become susceptible to instability and re-injury.  Weakened or unstable joints may also lead to other related injuries as the body changes its mechanics to compensate.

If you or someone you care about has recently suffered a back, neck or other joint injury, we can help!  Proper treatment can make a big difference!

Car Accidents and Delayed Symptoms: What You Need to Know

Car Accidents and Delayed Symptoms: What You Need to Know

rescue # 3Even if your recent fender bender didn’t seem too serious, there’s still a very real chance that you or your passengers may have been hurt. That’s because even the most minor car accidents can cause hidden injuries and delayed symptoms. And while damage to your car is likely obvious and easy to assess, evaluating damage to your body may be far more difficult. In fact, it’s not unusual for a driver or passenger to walk away from a collision with potentially serious musculoskeletal injuries (such as a concussion or whiplash), without knowing it.

Because of the stress response, right after an accident the body’s defenses are on high alert. Any pain may be masked by endorphins produced by the body during and shortly after this kind of traumatic event. Endorphins help the body manage pain and stress and can create a temporary euphoria or “high” feeling. When the threat of the accident is gone, endorphin production slowly disappears, allowing you to feel pain that may have remained hidden earlier.

Perhaps the most common delayed symptom is that of whiplash. Whiplash consists of soft tissue damage in the neck from the sudden acceleration and deceleration of the head, creating hyperflexion and hyperextension of the neck. This can not only cause damage to the muscles, tendons and ligaments of your neck, it can also occasionally fracture or dislocate vertebrae and cause any of the following symptoms to show up later:

  • Headaches
  • Reduced range of motion or difficulty moving
  • Slowed reflexes
  • Vertigo
  • Muscle spasms
  • Localized weakness or numbness
  • Stiffness in shoulders and arms

Every bit as serious as any broken bones or lacerations, a concussion can prove to be a grave threat to your health. Quite simply, a concussion is the result of the brain colliding with the inside of the skull from a rapid acceleration or deceleration. Not all concussions occur because of bumping the head. If the head is restrained in any way and the restraint suddenly stops or suddenly jerks into motion, a concussion may occur. Symptoms of concussion include the following:

  • Headaches
  • Bad temper
  • Nausea
  • Spasms
  • Loss of balance
  • Blurred or double vision
  • Disorientation
  • Confusion
  • Amnesia
  • Ringing in the ears
  • Difficulty concentrating or reasoning
  • Anxiety or depression
  • Tiredness, sleeplessness, or other problems with your ability to sleep

 

The key point with any of these symptoms is to know whether or not you had them before the accident. Someone who knows you or lives with you can help identify any changes in your behavior that may indicate a possible concussion. If you didn’t have a symptom that you’re now experiencing, see your doctor right away.

In addition to the health consequences of car accidents with delayed symptoms, there is also the insurance aspect to consider. Because many accident-related injuries don’t show up immediately, you may have to pay out-of-pocket for the medical expenses from any delayed symptoms if you settle with your insurance company right away. Therefore, consider waiting a few days before signing any release of liability so that any delayed symptoms have an opportunity to reveal themselves. Seeing a chiropractor for a medical evaluation as soon as possible after an accident is also a good idea, since he or she can help identify injuries and start treatment promptly. In many cases, seeking appropriate medical care soon after an accident can improve your chances of a more complete and more rapid recovery.