Return to Weight Lifting: A Guide for Young Athletes After Injury

Return to Weight Lifting: A Guide for Young Athletes After Injury

by | Dec 14, 2021 | Sports Medicine

Patients in the Scottish Rite for Children sports medicine clinic may lift weights as part of their primary sport training or with a strength and conditioning coach to supplement sport-specific training. When an injured athlete is released back to activities that include weight lifting, Scottish Rite for Children athletic trainer Allen Tutton, M.S., L.A.T., A.T.C., C.E.S., provides systematic instructions to ensure a safe, progressive return to training. Tutton is uniquely qualified with skills as both an athletic trainer and a corrective exercise specialist (CES). A certification from the National Academy of Sports Medicine, the C.E.S., requires a solid understanding of the interrelationship of movement quality and exercise, a must for strength and conditioning advice for young athletes. Here are his tips for safe weight lifting:

Before You Start

  • Focus on form and technique instead of the amount of weight or number of repetitions.
  • Increase your working weight slowly after an injury or a long break from training.
    • Working weight (WW) is the repetition (not max) weight used in your workout on a normal day.

Warm-up and Lifting

  • A warm-up is necessary to help you perform your workout at your best.
  • An optimal, dynamic warm-up includes upper and lower body stretches as well as light jogging.
  • Have a spotter with you when you begin lifting.
  • If you feel any abnormal discomfort, you must stop and rest 48 hours before trying the step again.
  • If your working weight is too heavy, decrease the weight used.

Terms to Know

  • Repetitions (reps) = number of times you perform the exercise before a rest.
  • Set = number of times you repeat the exercise and rest.

Wrap It Up

  • Each workout should not last longer than one hour.
  • Stay hydrated and rest at least 24 hours between sessions.

Managing Load: Preventing Overuse Injuries
Load can be measured in several ways:

  • Total work or repetitions done in a day.
  • Total weight lifted in a day.
  • Collection of work throughout a period, such as a week or a month.

Rushi Patel, P.T., D.P.T., SCCE, says, “A combination of how much weight is lifted, how often and for how long can all play a role in potential overuse injuries in the weight room.”
Patel offers these tips to minimize the risk of injuries:

  • All sport-related training should be considered part of the overall load. Times to reduce the weight or intensity of a weight-lifting routine include:
    • Starting a new sport or returning to sport after a break.
    • Preseason sport-specific intense training.
    • Focused sport-specific training in a camp or when learning a new skill.
  • Monitor how you feel in the first 24-48 hours after a workout. Excessive joint pain or soreness that lingers might be a sign to modify some activities related to your workouts.

To learn how nutrition can play a role in safe and effective strength training programs, read this article.

Get to Know our Staff: Lindsey Ham, Therapy Services

Get to Know our Staff: Lindsey Ham, Therapy Services

by | Dec 13, 2021 | Therapy Services

What is your job title/your role at Scottish Rite for Children?  
I am an occupational therapist and certified hand therapist working primarily at the Frisco campus. 

What do you do on a daily basis or what sort of duties do you have at work? 
My primary role is an outpatient occupational therapist, specializing in pediatric hand conditions. While this sounds like a small subset, I assess and treat a wide range of diagnoses, including upper limb and hand differences, traumatic injuries and sport-related injuries involving hand, wrist, elbow and/or shoulder. In addition, I also see patients with cerebral palsy, arthrogryposis, arthritis and brachial plexus injuries. My job is to figure out what deficits are limiting their participation and independence with daily activities, such as dressing, bathing, toileting, school participation, sports and leisure participation and play. I then address these deficits through meaningful activities to get them back to doing what they love. Since we see all ages from newborn and up, every hour of my day looks different, ranging from playing a game of Connect 4 or Mancala to bear walks, push-ups and weight machines. We also fabricate custom orthoses (splints) for children who have fractures or surgeries that require immobilization.

What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
My first job was as a certified nursing assistant at a hospital while I was in college. I always knew that I wanted to be in the medical field. My high school had an amazing health careers program where we were able to shadow many different jobs across the medical field. It was then that I was able to shadow an OT and fell in love with the career! I have been an OT for 13 years and at Scottish Rite for almost three years. I moved from Nashville to Dallas just to work at Scottish Rite, and it was one of the best decisions I’ve made! 

What do you enjoy most about Scottish Rite?
I love the atmosphere and team here! It is such a positive place to work. I love the collaborative approach to treat every patient. There is an open line of communication between therapists and physicians and that creates great outcomes for our patients. I love that everyone here has the same mission — to give kids back their childhood. 

Tell us something about your job that others might not already know. 
Your hand strength is important! This is something that I preach daily. People know to go to the gym and workout, but no one really focuses on hand strengthening. So, grab a stress ball and keep your hands strong! 

What was the best vacation you ever took and why?
I love traveling, so it is hard to pick just one. I would have to say my favorite was the cruise I took to the Bahamas last month because I got engaged!!  

Do you collect anything? How did you start?
Shoes and sunglasses — I guess not a true collection, but I have a lot of both! 

Do you play any sports or instruments?
I was a competitive cheerleader in high school and then coached through college. My sister owns a cheer and tumbling gym, so I am still surrounded by it. I also belong to a kickboxing gym and love it. 

CBS DFW: Scottish Rite for Children Patient Cedric Has Found His Niche With Sports

CBS DFW: Scottish Rite for Children Patient Cedric Has Found His Niche With Sports

by | Dec 11, 2021 | Events, Press Coverage

Since 2007, the Patient Champion program has enlisted Scottish Rite for Children patients to help encourage and cheer on runners in the BMW Dallas Marathon. This program helps us highlight some of the wonderful kids the marathon generously supports each year. We’re excited to introduce you to Cedric, one of our Patient Champions!  
 
Watch the full story. 

CBS DFW: BMW Dallas Marathon Benefits Scottish Rite for Children

CBS DFW: BMW Dallas Marathon Benefits Scottish Rite for Children

by | Dec 11, 2021 | Events, Press Coverage

The BMW Dallas Marathon named Scottish Rite for Children their primary beneficiary in 1997, and since then has raised more than $5 million for the world-class institution. This year, Scottish Rite is celebrating its centennial, which means for 100 years it has been providing excellent pediatric care for orthopedic, related neurodevelopmental and musculoskeletal conditions, as well as for specific learning disorders, such as dyslexia.
 
“Because of the long-standing relationship and support from the BMW Dallas Marathon, Scottish Rite for Children can continue to provide life-changing, expert care to children with pediatric orthopedic conditions and help give kids back their childhood,” said Bob Walker, president and CEO of Scottish Rite for Children.
 
Watch the full story.

Stress Fractures in the Spine: Spondylolysis

Stress Fractures in the Spine: Spondylolysis

by | Dec 7, 2021 | Research & Innovation

Pediatric orthopedic surgeon Jaysson T. Brooks, M.D., presented this as part of Coffee, Kids and Orthopedics education series. Brooks provided a detailed discussion of evaluating stress fractures in the spines of adolescents.

You can  and print the pdf.

watch the full lecture -What is Spondylolysis?

The facet joints in the back of the spine are connected by small segments of bone called pars interarticularis. Since this portion of the spine doesn’t get a great blood supply, it is at risk for stress fractures. This condition is called spondylolysis. Spondylolysis occurs more commonly at the L5 level and less commonly at the L4 level.

Most kids aren’t born with spondylolysis; it is caused by overuse and repetitive mechanical stress or forces. Activities or sports with repetitive hyperextension can cause a stress fracture of the spine. We see a higher incidence of spondylolysis in adolescents – as many as 47% of those with back pain. This is typically higher during growth spurts. The condition is much less frequent in adults. Some estimate 5% of adults with low back pain have spondylolysis.

In some cases, the stress fracture occurs bilaterally and the vertebra can slip forward, which is called spondylolisthesis. If a slipped vertebra presses on a nerve, it might cause severe shooting pain down the leg, and surgery may be required. However, if it breaks and doesn’t slip forward, surgery might not be necessary.

Spondylolysis: Genetic Predisposition?

  • Spondylolysis occurs in 15-70% of first-degree relatives
  • Prevalence
    • White: 6%
    • Black: 2-3%
    • Indigenous American (Inuit): as high as 40%

History Matters

There is a higher prevalence of spondylolysis in elite athletes who report playing sports with repetitive hyperextension/rotation of the lumbar spine. Back pain should raise suspicion in these athletes:

  • Football lineman
  • Cheerleaders
  • Gymnasts
  • Weightlifters
  • Divers / Swimmers

Back pain without a history of injury or repetitive activities is less likely to be caused by a stress fracture. In cases with shooting or decentralized pain, disc herniation should be considered.

Exam

The physical exam to assess for a stress fracture begins with palpation, and pain should be centralized around L5-S1 area. Active extension and hyperextension will be more painful than flexion. Coordination and strength should not be affected unless there is some nerve involvement, but pain may impact their ability to perform activities like heel walking and single leg hopping.

Imaging

In most cases, especially if the patient heard a “pop” and has acute low back pain, a standing anterior-posterior (AP) and lateral X-ray of the lower lumbar spine is recommended.

A study published in the Journal of Pediatric Orthopaedics looked at 2,846 patients with a median age of 14.6 years that were seen for back pain. 76% had no clear cause for their back pain, and less than 61% had two or fewer follow-up visits. This is a good reminder that not every patient with back pain has a stress fracture.
X-rays may not show early signs of spondylolysis. Rather than automatically ordering advanced imaging, a pediatric sports or spine referral may be the best next step because MRIs may also be inconclusive.

Treatment

Treat conservatively first.

  • Activity Modification: 3 – 6 months
  • Physical Therapy: 3 – 6 months
    • Focus on core strengthening to improve lumbar stability
  • Non-steroidal anti-inflammatory drugs (NSAIDS)
    • Meloxicam and/or diclofenac cream
    • Naproxen
  • Bracing may provide comfort but does not affect return to activities.

Often patients only want to do one of these, but that may make extend their recovery by several months.
It is acceptable if a fracture never heals on an X-ray as long as the symptoms go away. If six months of conservative treatments only show slight improvements, a pars injection may help their symptoms. Some patients are injected every six months.

Surgery should always be a last resort.
If the gap is not too wide, a screw is used for a direct pars interarticularis repair. A fusion of the surrounding vertebra may be considered if a loss of motion is acceptable.

Check out our latest on-demand lectures available for medical professionals.