Adolescents in Sport Symposium

More course information now available.
Please see below for lecture and workshop summaries:

Dr Loretta O’Sullivan Pippia
Lecture 1: Injury profile in adolescent athletes and the impacts of injury in adolescents.
This lecture will discuss the literature surrounding injury in adolescents including injury related to gender, sports and body region.  Injuries that are unique to adolescents, that peak in adolescents and/or have greater impact in adolescents will be discussed.  The impact of injury in adolescents will be addressed, in particular, relating to biopyschosocial issues and long term implications of injury.

Lecture 2: Knee pain and injury in adolescent females.
Both patellofemoral pain syndrome and anterior cruciate ligament injury have peak incidence and prevalence in active adolescent females.  Similar potential mechanisms have been proposed for both patellofemoral pain syndrome and anterior cruciate ligament.  These potential mechanisms may be due, in part, to normal maturational changes and appear to be modifiable with neuromuscular training.  Pain and injury occurring during adolescence has been shown to have significant long term health impacts and does not simply ‘resolve’ with age.

This presentation will discuss:  potential mechanisms that contribute to anterior cruciate ligament injury and to the development and maintenance of patellofemoral pain syndrome in adolescent females; normal physical maturational changes in female adolescents; potential screening protocol for adolescent females; and potential injury prevention programs for adolescent females.

Workshop: In small groups participants will have the opportunity to complete an athlete screening and to design one aspect of an injury prevention program.

David Spurrier
Lecture: How bone development and physical adaptation drives bone response to loading.

Bone sustains repeated loading cycles that include occasional large deformations, at varying rates rarely breaking down though an athlete’s lifetime.  Bone tissue is able to meet the physical demands of use by adapting structural characteristics of organisation and composition and physiological characteristics of cellular repair.  Bone adapts structure to be strong enough for the activities of use whilst maintaining minimal amount of material.  However, structural adaptation is both loading and activity specific and is also affected by periods of disuse, nutritional and endocrine factors. Understanding how bone develops and responds to load is important to injury management.Bone cell mechanosensitivity reduces with constant stimulation and the osteogenic effects of mechanical loading also diminish with repeated loading events. By understanding the energy absorption and osteogenic response of bone to repeated loading cycles, including rates of loading and resting cycles, the clinician may develop management plans that significantly effect the response of bone to load in bone stress reaction and stress fracture repair.

This presentation investigates the growth and pathophysiology of bone and the response to physical loading.  It highlights new concepts in bone stress science and highlights the muscle-tendon-bone continuum in sport injury management.

Workshop: Loading and mechanotransduction in bone: Options for repair? …“ A frolic with the skeleton!”
This workshop is aimed at developing the clinicians ability to design and manage physical loading programs with relation to bone pathophysiology.Practical application of current concepts in bone science related to enthesopathy, trabecular and cortical bone injury, including stress reaction and stress fracture will be examined.

Leanne Rath
Lecture: The way in which the hip joint develops has inherent risk for abnormal development at critical times in adolescence. In particular the femoral capital epiphysis and the acetabular component are predisposed to consequences of sporting load application which may impact on the long term health of the hip. Along with this, the adolescent pelvic and hip region has many active sites of growth which are susceptible to both acute and chronic overload.

During this lecture, critical development features of the hip joint will be explained in relation to typical clinical presentations of hip disorders in the active adolescent. Specifically, Slipped Upper Femoral Epiphysis, Cam Morphology Development, and Acetabular Dysplasia will be considered. The Apophyseal regions at risk of injury in the pelvic area will be identified and management features will be included.  Subtle Hip instability presentations and their management will  be discussed in relation to long term hip health. Interpretation of an AP Xray of the pelvis in the clinical reasoning process will be integrated throughout the lecture. In the absence of significant bony morphological abnormalities and apophyseal “stress”, a framework to reduce dynamic hip overload and facilitate the development of the adolescent athletic facility will be proposed.

Workshop: The aim of this workshop is to present assessment techniques  for Clinical Hip Instability, screen for clinical signs of significant hip pathology in this age group and to diagnose the hip that needs referral on to a Physician.

Dr Matthieu Sailly
Lecture 1: Diagnosis, staging and management of Osgood Schlatter’s disease using ultrasound imaging.
This lecture will discuss the various presentations of OSD and the role that ultrasound imaging plays in prognosis and management of the injured adolescent athlete.

Lecture 2: Pubic Apophysitis.
Chronic groin pain is commonplace in the Australian adolescent population. This lecture reviews the anatomy of the groin and pelvis and discusses the development and bony maturation of the pubis  and the role that the pubic apophysis plays in chronic groin pain. Discussion will include injury staging based on ultrasound findings, as well as management and prognosis.

Workshop:  This workshop will be a live demonstration of ultrasound imaging of the apophyses of an adolescent. The aim of the workshop is to help practitioners develop skills in interpreting results of ultrasound imaging in this population.