Abstract des Autors

Maintaining proper flexibility in the young athlete is an essential part of injury prevention. This is most crucial during the adolescent growth spurt. Most commonly, this growth phase occurs with the onset of puberty. Females generally reach their peak growing phase at the age of 12, whereas males will reach their peak at the age of 14. During this growth phase, girls can add 6 to 11 cm in height, while boys may grow 7 to 12 cm. Rapid increase in bone length can bring with it a possibility of overuse injury at one of the bone's growth centers. The apophysis is a cartilaginous structure where the muscle/tendon unit attaches to the bone. These centers are placed under stress by tensile forces exerted on them by the muscle/tendon units. Repetitive stress to these growth centers can cause the young athlete to develop an apophysitis, or overuse-related inflammatory reaction. Because these growth centers ossify with age, these same stresses in the adult would commonly lead to a tendinitis of the inserting soft tissues. Apophyseal centers are located throughout the body. Frequently, it is the centers within the hips, knees, and calcaneus that are affected by rapid bone growth. It is often as though the bones are outgrowing the muscles' ability to lengthen in proportion to the associated bone growth. This rapid bone growth, combined with repetitive traction forces on the cartilaginous growth center, can lead to considerable pain that limits or inhibits the young athlete's ability to practice or compete. Upon presentation to the medical clinic, many of the athletes with these conditions are found to have significant flexibility deficits in the corresponding muscle groups. In the hip, it is often the sartorius muscle and its attachment to the anterior superior iliac spine, the rectus femoris' attachment to the anterior inferior iliac spine, and the hamstrings' attachment to the ischial tuberosity. The knee is also a common site of lower-extremity pain in the young athlete. Osgood-Schlatter's disease is an apophysis of the tibial tubercle, while Sinding-Larsen-Johannsson syndrome is a similar condition affecting the inferior pole of the patella. These sites become subject to stress from tensile forces placed on them by the extensor mechanism of the knee. Sever's disease is found at the Achilles tendon's insertion into the posterior portion of the calcaneus. While no definitive cause of these conditions has been determined, they all are usually associated with athletes involved in running and jumping activities. Verf.-Referat