injuries in emerging sports leah concannon, md. case 1 competitive cheerleader pedicle stress...

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Injuries in Emerging Sports Leah Concannon, MD

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Injuries in Emerging Sports

Leah Concannon, MD

Case 1

• Competitive cheerleader• Pedicle stress fracture

LaBella CR, Mjaanes J; Council on Sports Medicine and Fitness. Cheerleading injuries: epidemiology and recommendations for prevention. Pediatrics. 2012 Nov;130(5):966-71.

Competitive Cheerleading

• Lower overall injury rate than gymnastics, but higher catastrophic injury rate• Approximately 66% of all catastrophic injuries in high school girl

athletes over the past 25 years were from cheerleading

Pedicle stress fractures

• Many cases of pedicle fracture are associated with osteoporosis, trauma or prior surgery• May be more common in cases with contralateral unilateral

spondylolysis, or may just have pedicle sclerosis

Imaging

• X-rays insensitive• Bone scan with SPECT is sensitive, but radiation concerns especially

for young athletes• MRI may be equally sensitive, and can identify bony edema• CT may be better to follow fracture healing, if needed

Treatment

• Similar to pars fracture, but even longer rest is likely required (up to 6 months)

Case 2

• Parkour• Hip flexor tendonitis

Parkour

• Free running, art of movement, urban gymnastics, obstacle coursing

Parkour

• Injuries• German survey: 70% skin abrasions, muscle injury 13%• Few case reports• Clavicle fx, bilat distal radius fx, distal tib/fib fracture, bilateral calcaneal

fracture, multiple midfoot fractures• C4/5 subluxation and locked facets resulting in death

• Beginners may try moves they have seen in videos, without proper training

Parkour

• Landings• Traditional: toe-heel landing• Parkour precision: forefoot only, arms counterbalance movement• Parkour roll: shoulder roll in the direction of travel

• Both parkour landings have shown decreased maximum ground reaction force, increased time to maximum force and lower landing rates than traditional landings• This may decrease risk for injury

Puddle DL, Maulder PS. Ground reaction forces and loading rates associated with parkour and traditional drop landing

techniques. J Sports Sci Med. 2013 Mar 1;12(1):122-9.

Traditional landing

Parkour precision technique

Parkour roll technique

Parkour

• Athletes should master moves in a controlled environment with padded landings before trialing outside• Many professionals have training in gymnastics or martial arts• Amateurs should not attempt high level acrobatics

• Fractures are the most common reported injury in the literature, but more serious injuries can occur