| Ahead of the Game |
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Tackling Youth Sports-Injuries.... Excerpt from Therapy Times Ahead of the Game In the 18 years since the rainy afternoon when his car jumped a guardrail, severing both legs, Chipollini has undergone 15 surgeries to reattach both legs and ultimately lost one to a bone infection. His motto, “no excuses, no limits” and an upbeat, catching attitude are proof it’s possible to overcome the unthinkable. Chipollini, who works with patients at Norristown, Pa.-based Mercy Suburban Hospital, regularly plays golf and regularly runs 5k and 10k races, despite the challenge of running and bilking with a prosthetic leg. In addition, he has completed three full marathons, three half marathons and two triathlons to benefit his children’s charity, Generation Hope. The most important thing Chipollini learned from his near-death experience was “the importance of being compassionate and understanding.” For patients in recovery from an accident, trauma or life-threatening diagnosis, Chipollini says, “Don’t do the macho thing and say ‘I can handle this.’ Don’t be afraid to reach out because those close to you just want to help.” Pushing Past the Pain In the rehab, he inspires patients to push past the pain, keeping in mind their therapist’s directions and taking the time for rest and ice when needed. “Pain has a way of stopping us,” he says. “But the mind is strong enough to work through those moments of pain; you need to visualize where you want to be and break through those barriers.” Speaking from experience, Chipollini cautions, “Take it slow at the beginning. I’m not saying don’t push yourself; sometimes, people push it too fast and too hard at the beginning, and they don’t set the foundation.” For Lynne Yellenberg, MSPT, who works with Chipollini at Mercy Suburban, working with athletic patients is one of the highlights of her job. She says when working with athletes who have prosthesis, it is important to consider the patient’s gait, the shape and strength of the residual limb, skin condition, the prosthesis type and fit and the integrity of core muscles and the non-involved limb. After considering the above factors, therapists can begin exercises to restore balance and increase mobility to help patients enjoy life again. With prosthesis, balance exercises help patients relearn how to move and help them adapt to the new proprioception feel and kinesthetics. Yellenberg says it’s essential to help increase patients’ awareness of their body in space. In this process, she asks key questions, such as: “Where is my leg in space? How can I take off and land with efficiency, speed and accuracy?” She says, “The therapist needs to be creative and have fun with [his or her] patients.” Yellenberg says pacing and collaboration are particularly important when building a therapy regime. “As with most athletes, it is necessary to pace them; they are like horses coming out of the gate. Mostly, it is important to be creative, keep the PT's goals in mind and work as a team with the MD, PT and prosthestist.” Focusing on stretching and learning proper training techniques, Chipollini reminds patients not to underestimate the importance of building a foundation. “When I train with people that have not trained before, I often see mistakes that get them in trouble. It’s not about the weight; it’s about the proper form and staying active.” He often sees people push themselves too hard while forgetting the basics of proper hydration and nutrition. “You have to be smart,” he says. “Rest, nutrition and hydration are essential to have confidence you are doing your best.” Pediatric Sports-Related Injuries As a personal trainer and parent of two teenagers, Chipollini often sees coaches pushing child athletes too far, resulting in joint overuse injuries that could damage the growth plate, an area of cartilage located at the end of a bone which allows them to grow in length. Chipollini often works with pediatrics patients who have a prosthetic, encouraging them to try new activities and stay active. When training young athletes, who are not physically ready to lift weights until after reaching puberty, Chipollini refrains from pushing too hard because it can tax growing joints. At first, he says, “I don’t put weight on the bar and will have them do bar for 15 to 20 reps, just to get the blood flowing.” According to Raphael Longobardi, MD, FAAOS, physicians are seeing more and more children with sports-related injuries. “Statistically, there are a greater number of opportunities for injuries due to the increased numbers of participants.” He often sees pediatric sports-related injuries at his practice, University Orthopedic Center in Hackensack, N.J. Longobardi lists contact sports, such as football and hockey, as some of the most dangerous sports. He says soccer is also an at-risk sport, particularly for females because there is a four- to 10-fold increased risk of anterior cruciate ligament injuries in female soccer players. He says it’s important to ensure young athletes have the proper equipment, conditioning and strength training to prevent overuse injuries. According to Longobardi, youth sports leagues are often run by parents who do not always know proper warm-up techniques or how to size equipment, which often results in improper conditioning. Longobardi also says participating in multiple sports is better than specializing in one sport at a young age. Neuromuscular development is improved by cross training, which produces a better-conditioned athlete and reduces repetitive motion injuries. “Participating in different activities requires the individual to use different muscle groups in different ways,” he says. When an injury does occur, it is essential to visit a pediatric orthopedic specialist. Often, X-rays do not show a fracture at the growth plate because children’s bones are more malleable and may break in unexpected places or at angles that cannot be detected in an X-ray. In this case, the expertise of a pediatric specialist may detect a hairline fracture, which, if left untreated, could result in the limb growing at a wrong angle or create small deformity. Longobardi says a pediatric specialist should handle complicated cases or cases of swelling and pain with inconclusive X-rays. The Next Roger Clemens He says, “Pushing any child into a situation in which they are not comfortable can result in injury; their own apprehension can limit their judgment and slow their reaction time.” Youth sports are designed to be fun. Often, parents are unwittingly trying to live vicariously by raising the next Roger Clemens. “What they don’t realize is the extremely low percentage of individuals [who actually] become professional athletes,” Longobardi says. Reducing competition and emphasizing fun is one way to help reduce sports-related injuries. Longobardi says, “First and foremost, a child needs to be interested in and enjoy the sport [he/she is] playing.” Chipollini agrees, when speaking at schools across the country, he inspires children to “overcome adversity, accept diversity and to live their lives with 'no excuses, no limits!’” He emphasizes warm-ups, nutrition and hydration as essential for setting a lifelong foundation of health. He says, “If they are doing that now, they will do it through their lifetime and will have a healthy life and be very fit with minimal injuries.”
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