Treating Young Athletes: Q&A With Sports Medicine Specialist Dr. Patrick Wupperman

Orthopedic Sports Medicine

In many communities, sports medicine practices are seeing an increasing number of youth athletes with sports-related injuries. For physicians, this means considering different types of treatment based on growth-plate and muscle development, as well as new strategies for communicating with younger patients. Patrick Wupperman, MD, a surgeon with a special interest in sports medicine at Azalea Orthopedics in Texas, discusses best practices for physicians when approaching young patients. As part of his training, Dr. Wupperman completed a fellowship at the American Sports Medicine Institute in Birmingham, Ala., where Dr. James Andrews served as his mentor.

Q: What are the most common injuries among young athletes?

Patrick Wupperman:
The most common injuries we see with all athletes are contusions, bruises, strains and some ACL tears and elbow and shoulder injuries. With children playing competitive sports at an earlier age orthopedists are seeing an increase in injuries because younger players’ bodies are still changing rapidly. Their tendons are still growing and their muscles are a little weaker. For children, bones grow first and their muscles have to catch up. This makes them more susceptible to injuries to the growth plate, in areas like the shoulder or elbow from throwing and other overuse injuries.

Q: What is the best treatment for these injuries?

Prevention is always the best treatment. Prevention means that children should not focus on one sport year around like, over-pitching, year-round gymnastics, playing both indoor and outdoor soccer, bottom line: avoid overuse. Ten years ago, a young child with an ACL tear would not have surgery because it was thought to cause damage and growth arrest. With the increase of injury in youth if you don't have an ACL surgery, the knee is too unstable. With each movement there is a shift, this movement can cause damage to the meniscus. Unlike the past, orthopedic surgeons are forced to be more aggressive in pursuing surgery for these patients. We do alter the normal fixation devices, graph choice and angle of the drilling but prevention is the key.

Q: What is the primary reason for injuries among young athletes and how do physicians advise they prevent it?

PW: Because of today's ultra specialization in sports, young athletes are turning into one-sport athletes doing their sport all year round. This ultra specialization leads to the same muscles, joints and bones are used too often and this leads to more injuries. They are not being encouraged to cross train. As a result, they put strain on the same muscles over and over again. If they take a few months off to do another sport, they relieve the stress from the primary muscles used for their skill.

Q: How can physicians effectively communicate treatment plans with young athletes?

I believe in utilizing diagrams and models with parents and the child. If somebody has an ACL tear, I use the model of an ACL tear and show them how the graph goes over the site. For damaged elbows, I show the elbow model for overuse with the growth plate and explain how the elbow can be injured and the stresses that are placed on it by the injury.

Q: How can physicians help their younger patients deal with the psychology related to their injury?

Children remember what caused them to have the injury in the first place and they can get scared to do that again, especially if it's a significant injury. First we do surgery and then we do rehabilitation and physical therapy to rebuild their strength. Finally, we give them a thorough program that is highly structured to help the kids slowly build confidence. The program begins with the basics and uses "baby steps" to bring them back up to where they were. In the program, the children do everything in intervals instead of immediately returning to the team situation. You don't want them going back full time and see them struggling because of the injury. Our goal is to help them gain confidence. If they return to soon they may very well lose even more of their confidence.

Learn more about Azalea Orthopedics.

Read other coverage on sports medicine practices:

- 4 Ways to Improve Profits at Sports Medicine Practices

- 5 Tips for Building a Successful Sports Medicine Practice

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