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  • Field Hockey Injury Risks Go Back 4,000 Years
    its origins as ancient and unique field hockey Contrary to our belief in America this is a predominantly male sport for most of the world The sport has a long history perhaps 4 000 years of development with an evolution from a simple stick and ball activity into the complex game that is played today Yet most of that history is a male dominated activity that at times was quite brutal and at times was played on a field that was 750 feet long The modern game was an English design and spread to the commonwealth during the 19th century It was played so often in the British Empire that the early Olympic history of men s field hockey was dominated by India and Pakistan But in the U S the sport is predominantly a female sport Officially considered a non contact sport field hockey often results in injuries related to contact from another player the stick or the ball It is played in a semi crouched position that places certain body parts at risk to get injured Hand and wrist injuries from direct ball or stick contact are not uncommon often resulting in finger fractures The face is also at unique risk because of this body positioning and is often struck by the ball or an opponent s stick Many of these facial injuries are minor but facial fractures penetrating eye injuries and broken teeth have all been reported Furthermore concussions are not uncommon Seven percent of all injuries sustained during field hockey competitions are concussion related Concussions should be given special consideration due to the significance of the injury Dizziness and confusion are common symptoms but otherwise unexplained headache fatigue and difficulty concentrating may be symptoms of an unrecognized concussion The game is otherwise known for injuries to

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/field-hockey-injury-risks-go-back-4000-years/ (2015-03-26)
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  • Bones Develop in Distinctive Ways Depending on Gender
    present within the substance of a tendon where the tendon crosses over a joint The sesamoid bone is intended to hold the tendon slightly away from the joint in order to shift the mechanics and thereby improve the action of that tendon on the joint A few of these sesamoid bones develop predictably the most common and ubiquitous is the patella or kneecap Another common set of sesamoid bones are found under the big toe Due to the unique positioning of these bones and the high stress they experience they are at risk for developing problems often related to growing When a child grows it is actually their bones thigh and leg bones for example that are increasing in length The muscles and other surrounding structures have to be stretched out to accommodate this length change and it often results in muscle tightness This muscle tightness then increases the strain on the sesamoid bones When the child is somewhere between 2 and 6 years old their cartilage patella starts forming a center of bone Often the kneecap will start to form bone at multiple centers within the cartilage About 5 percent of the time some of these bone centers do not fuse together with the main bone center When this happens it is called a bipartite patella meaning a two part kneecap Whereas these are often not painful occasionally kids can develop pain at this nonfused site on the patella It can be preceded by an injury to the knee but often it is only due to growth of the child The sesamoid bones of the big toe are also at risk for the development of bipartite bones and can often experience pain When this happens in the foot regardless of the presence of a bipartite sesamoid it is called

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/bones-develop-in-distinctive-ways-depending-on-gender/ (2015-03-26)
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  • Kawasaki Disease Treatable but Cause Remains a Mystery
    San Diego County and the leading cause of acquired heart disease in children in the United States many parents have never heard of it That s why it is so important to know the symptoms Children with KD have a sudden onset of fever and develop a rash swelling of the hands and feet bloodshot eyes red lips and tongue and swollen glands in the neck The immediate effects of KD may not be serious but in some cases long term complications including damage to the blood vessels in the heart may result KD affects children almost exclusively most patients are under 5 years of age The disease is named after a Japanese pediatrician who described this particular pattern of signs and symptoms in 1967 In the United States the disease has been reported in all racial and ethnic groups but occurs most often among children of Asian American and African American background In San Diego 80 new KD cases are treated at Rady Children s each year To date the cause of KD remains a mystery Most experts agree that children are born with a genetic pattern that makes them susceptible to KD The illness is then triggered by exposure to an unknown agent such as a virus or bacteria There is no evidence that the disease is contagious A high dose of gamma globulin a protein fraction of human blood administered intravenously is the treatment of choice for patients with KD This treatment is most effective in reducing inflammation and preventing coronary artery damage if it is started within the first 10 days of illness High doses of aspirin are also given with gamma globulin during the acute phase of the illness until the fever subsides If your child exhibits the symptoms of KD he or she should

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/kawasaki-disease-treatable-but-cause-remains-a-mystery/ (2015-03-26)
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  • Adverse Food Reaction is Not Always an Allergy
    mediated or by immune cells non IgE mediated The IgE mediated food allergies are the kind that may result in immediate hives and swelling or anaphylaxis a potentially life threatening reaction with multiple symptoms Common food allergies in children include allergies to egg milk peanut tree nuts fish shellfish soy and wheat however children can develop an allergy to almost any food Symptoms develop typically within 30 minutes but can occur up to two hours after ingestion and may include hives lip and or eye swelling mouth itching throat discomfort coughing wheezing difficulty breathing vomiting diarrhea and a drop in blood pressure which may be lead to dizziness or fainting These symptoms are the result of chemicals such as histamine which are released in the body when IgE binds to a particular food protein Non IgE mediated food allergies typically cause gastrointestinal symptoms These symptoms may include repetitive vomiting chronic diarrhea blood in the stool weight loss or difficulty swallowing These gastrointestinal food allergies are often diagnosed either by history alone or with endoscopy by a gastroenterologist Food intolerance is a more accurate term when referring to adverse food reactions that do not involve the immune system and are typically not a result of food protein For example lactose intolerance is a metabolic disorder where the body does not have the enzyme called lactase to digest the sugar lactose present in cow s milk This condition results in bloating abdominal discomfort and diarrhea Lactose intolerance is diagnosed by history alone or with a breath test performed by a gastroenterologist Treatment includes replacement of the enzyme lactase Other foods may have a pharmacologic effect due to certain chemicals This includes sensitivities to chemicals in chocolate tyramine aspartame MSG nitrates nitrites alcohol and caffeine which may trigger migraines or symptoms such as

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/adverse-food-reaction-is-not-always-an-allergy/ (2015-03-26)
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  • Pitch Count, Mechanics Can Keep Elbow Healthy
    the inside of the elbow and has the potential to cripple a throwing athlete Q What exactly is youth leaguer s elbow A This term has evolved to indicate a childhood elbow injury related to throwing It can represent a broken bone or a ligament injury but traditionally indicates a stress fracture of the growth plate on the inner side of the elbow Q Why did my kid get this problem A Stress fractures are caused by overuse We see it in kids who are pitching too much kids who are growing stronger and throwing harder without sufficient practice or those with poor throwing mechanics The force of throwing a ball places significant stress at the inner portion of the elbow This overload results in the injury that can be immediate or worsen with time Q How do I prevent this from happening A Limit the amount of throwing especially pitching Take time off from baseball Consider cross training to become a better all around athlete When in season remember to monitor the pitch count and add up all pitches if your child is in multiple leagues Pitch count recommendations based on age can be found at www asmi org asmiweb usabaseball htm Young pitchers should stick with fastballs and change ups and not throw curves screwballs or other specialized pitches until high school Even subtle poor throwing mechanics will increase the force across the elbow with these types of pitches Teach good throwing mechanics at an early age Do not let them rely on arm strength to throw teach them to use their core muscles to throw Q But what if my son already has elbow pain A If your young athlete is experiencing pain then have them stop the painful activity Rest is always a wise course For

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/pitch-count-mechanics-can-keep-elbow-healthy/ (2015-03-26)
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  • Ankle Most Commonly Injured Joint in Basketball
    century Currently there are over 1 6 million injuries attributed to basketball per year in North America including about 500 000 children Most injuries are very minimal and require no medical attention and in fact may not even get reported to parents Some experts suggest that one in four high school players sustain an injury yearly boys and girls Elementary school kids sustain a large percentage of arm and head injuries while playing basketball This is likely secondary to developing coordination skills These injuries are difficult to prevent unless children are restricted from participation until developmentally appropriate Adolescents sustain a totally different set of injuries related to basketball When it comes to the arm shoulder elbow and wrist basketball is relatively safe While injuries can and do occur especially at the hand and fingers the mechanism of throwing and shooting the ball is much more in tune with human development than the overhead throwing seen in baseball softball and water polo Our shoulders were designed to utilize a dart throw mechanism and the pushing type throw seen in basketball is very similar Therefore it is relatively uncommon to see throwing injuries in basketball The legs are not so lucky when it comes to the game of basketball Some NCAA data suggest that most of the injuries are contact injuries The ankle is by far the most commonly injured joint usually a sprain or ligament injury Many coaches will actually create a rule that all team members must wear ankle braces in order to play It does appear that scientific research would support these coaches in their attempts to prevent ankle injury Taping and high top shoes may also help decrease ankle sprains But it is important to understand that none of these methods are foolproof The knee is another area

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/ankle-most-commonly-injured-joint-in-basketball/ (2015-03-26)
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  • Linemen, Gymnasts at Highest Risk of Spondylolysis
    Linemen Gymnasts at Highest Risk of Spondylolysis Health Safety Health Library Ask Your Nurse Videos Safety Store at Rady Children s Rethink Your Drink Injury Prevention Growing Up Columns Community Health Needs Assessment Flu Information Whooping Cough Information Linemen Gymnasts at Highest Risk of Spondylolysis By Dr Eric W Edmonds Low back pain occurs in children but it is relatively uncommon compared to the frequency of pain identified in the adult population There are multiple causes of back pain but one that is seen with increased incidence in young football linemen gymnasts dancers and martial artists is spondylolysis Spondylolysis is a disorder related to the development of a stress fracture in the lower vertebrae This stress fracture develops most commonly in adolescents 10 to 15 year olds Although it can be a cause of low back pain the majority of adolescents with spondylolysis do not have symptoms or their symptoms are mild and are often overlooked Spondylolysis is seen more often in athletes than in children who do not actively participate in sports Approximately 3 percent to 7 percent of the general population is thought to have one of these stress fractures The reason that the previously mentioned group of teenagers football linemen and gymnasts are at higher risk for at least having symptomatic stress fractures is due to the repeated hyperextension of the lower back seen in those sports The primary symptom of a spondylolysis includes pain in the lower back especially when bending backward The diagnosis can be made based on the clinical story as well as physical exam Besides location of pain most teenagers will demonstrate tight hamstrings during the examination Treatment is a period of rest from the offending activities and enrollment into physical therapy Occasionally surgery is indicated when conservative management fails to improve symptoms

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/linemen-gymnasts-at-highest-risk-of-spondylolysis/ (2015-03-26)
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  • OCD of the Knee May Require Rest or Surgery
    persist Most areas of scientific inquiry concerning the knee revolve around the major ligaments and our knowledge of these injuries is so far advanced that often the remaining questions are minor fine tuning However even though it was first described in 1888 by German surgeon Franz König osteochondritis dissecans OCD of the knee remains an enigma The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones such as the femur or thigh bone When for example repetitive trauma results in a blood supply injury or blunt injury to this growth cartilage then the bone can either fail to develop from the original cartilage or the maturing bone dies softens and collapses It is a process that evolves over a few years The risk with an OCD is that the compromised segment of bone and cartilage may come loose break away from the femur and float around inside the joint Although many surgeons feel that surgery is the more conservative treatment with less risk and improved outcomes it is not universally accepted as the initial treatment The savviest of surgeons will take into consideration the age of the child activity level and the radiographic findings Once your treating physician confirms that an OCD is present on X ray and that there is no evidence to suggest a second diagnosis as the source of pain treatment should begin with further diagnostic evaluation and rest The next test is a magnetic resonance imaging MRI The MRI will tell us the true size of the lesion location of the lesion and demonstrate evidence of potential looseness The summation of these MRI findings may be predictive of OCD progression or ability to heal without surgery The MRI findings and child age

    Original URL path: http://www.rchsd.org/health-safety/growing-up-columns/ocd-of-the-knee-may-require-rest-or-surgery/ (2015-03-26)
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