Growth spurts in young athletes can lead to an increased incidence of injury. The long bones (femur, tib/fib) grow in length before the muscles elongate and develop enough strength to counteract the sudden increase in lever lengths. Imagine a young soccer/gaelic player who suddenly has a longer leg but not the muscles to generate the force required to move that heavier and now longer leg. Something will break down, usually the proximal muscles, such as the abdominals and groin.
We Chartered physios tend to work on the understanding that the bones grow about a year before the muscles develop length and strength. And this forms the basis of injuries sustained by growing young bodies. If the bones grow longer but the muscles remain the same length, then the muscle will have a relative tightness. The structure most susceptible to overload in this situation is where the muscle, via the attaching tendons, joins the bones. At these sites, we have growth plates.
The injuries we see in young athletes that are growth related and influence the growth plates are called ‘traction apophysitis’ injuries. The areas most vulnerable are the Achilles tendon insertion (Severs disease), the patella tendon on the tibia (Osgood Schlatters disease), the quads tendon into the knee cap (Sindling Larsen disease) and the attachment of the hip flexors onto the anterior pelvis.
The really interesting thing is that injuries tend to occur in predictable time sequences. They work from south to north. The Severs disease usually occurs first (in boys around 12), then Osgood Schlatters at about 14 and then the hip traction problems around 16 and 17.
The biggest causative factor in these injuries is overload of the tendon attachment due to doing too much. It is not uncommon for young athletes to train for multiple sports at the same time. Sports specialisation tends to come later in the teenage years. So it is not rare to see a 14-year-old training and competing in sports such as cross country running, basketball, soocer and different age groups in Gaelic football. They rarely get a day off during the week where they are not training.
In terms of what we do about these injuries, most of them are self-limiting. This means that they generally improve with time as the muscles catch up to the bones. If they are too sore, they back off training. When they feel good, they return to training.
However, there are some interventions that may help a young athlete nurse themselves through these injuries. Local interventions such as anti-inflammatory creams and ice tend to calm down the symptoms. Regular stretching is also needed to kick start the muscle elongation process. As a general rule strengthening exercises don’t help, as the issue is to do with flexibility and not strength. But at the end of the day, if the tendon attachment is still painful then unfortunately they need to rest, or at least modify what they are doing to incorporate rest days or training that involves no impact.
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如果说,我开玩笑的说我喜欢某个人,那么,最后那可能变成真的。所以,爱情不允许开玩笑。
这个城市没有草长莺飞的传说,它永远活在现实里面,快速的鼓点,匆忙的身影,麻木的眼神,虚假的笑容,而我正在被同化。
不是所有玩笑都可以开,也不是所有人都可以和我开玩笑,更不是所有人都经得起开,所以,别拿我们在意的开玩笑,后果,不可预料
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我的幽默你不懂你的玩笑我也不懂这大概是心与心之间最远的距离了更难过的是我还要装作愉悦的语气向你解释“嘿刚刚我是开玩笑的别生气”
如果我从没遇见你,如果我从没爱上你,如果我一开始没坚信,也许我就不会是现在的这个自己。
相遇是错、认识是错、在一起更是错、对你动心是错,和你恋爱还是错、爱上你更是一个错、全部都是错。
珍惜经常和你开玩笑的人,说明你在这个人的心中肯定有一定的分量。
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小时候总把无数的玩笑当成梦想,认为开玩笑不会付出什么代价。到了现在才发现从这些玩笑中我们失去了一个又一个信任我们的人
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想要放弃吗?别开玩笑,你必须为这一切负责。坚持下去,即使根本不可能获胜!
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