Professional Documents
Culture Documents
BANGALORE, KARNATAKA
19-06- 2009
4 DATE OF ADMISSION
Assessment of effectiveness of
5 TITLE OF THE STUDY structured teaching programme on
knowledge regarding overuse
syndrome among Adolescents at
selected sports associations
Bangalore.
“We are fortunate to have so much talent on the mound. It is a luxury. We won't burn
kids out or overuse them.”1
The past decade has seen an explosion in the number of children participating
in team and solo sports. At a young age, sport is for enjoyment and for health and
personal development. This balance changes as a competitive element intervenes.
Subsequently, young athletes train harder and longer and participate in sport
throughout the whole year. As an undesired but inevitable consequence, sports-related
injuries have increased significantly. 2
Athletes are specializing in one sport at younger ages. Year-round training puts
more strain on muscle groups without providing the overused muscles sufficient
recovery time.3
One theory behind the increase in sport specialization at younger ages is the
highly competitive market for college scholarships. Young athletes are pushed harder
to be selected to prestigious club teams with the notion that they will have a better
chance of being seen by college coaches. The push results in harder and longer
training for younger and younger athletes. The price paid is a significant increase in
overuse injuries.3
Strain occur when body part is called on to work harder, stretch farther, impact
more directly or otherwise functions at a greater level then it is prepared for. The
immediate impact may be minute, but when it occurs repeatedly the constant straining
cause damage.3
The term overuse syndrome identifies a large group of conditions that result
from using the body in a repetitious way and causing injury by the amount it is done.3
These conditions are often focused on a joint and usually affect the muscle,
bone, tendon or bursa of the joint. However other anatomical features and areas can be
stressed and their response to that strain can be an injury.3
Some common examples of overuse syndrome are; carpel tunnel syndrome,
Tendonitis, Bursitis, Tennis Elbow, Trigger Finger, Blackberry Thumb, Shin Splints,
Calluses, Bunyan, Etc…3
Overuse injuries can be prevented through educating coaches and
parents as to the early warning signs of injury. Young athletes need to be monitored
closely for any signs of pain in the shoulder and elbow areas. If pain arises, the
athletes need to have an immediate reduction in the amount and intensity of throwing. 3
These types of injuries can also be prevented through providing the athletes
with a proper warm-up (including stretching the muscles that may be at risk for
injury), proper instruction in throwing mechanics, and a slow, gradual, warm-up for
each activity (throwing, pitching). Adding light rotator cuff exercises to the warm-up
can also help by strengthening the small muscles that can be at risk for chronic
injuries.6
Last, the amount that each athlete throws needs to be carefully monitored by
the coaching staff. The number of throws should be age appropriate with care taken to
decrease the number with young athletes and to gradually increase the number of
throws throughout the season. A slow progression of both distance and intensity
should ensure that athletes stay injury free.5
Overuse injuries can be prevented if caught early and managed properly through
the reduction of the activity that caused the initial pain. Athletes with persistent pain
should be referred for medical follow. The following guidelines are suggested to
prevent overtraining/burnout:
The variety of available, organized sporting activities has also grown typical,
such as football, baseball, and soccer, to include, field hockey, rugby, cheerleading,
and dance, each with its own list of sports medicine concerns. This report will assist
the clinician managing young athletes by first defining the medical, psychological, and
developmental concerns of intensive, focused athletic participation. In addition, it will
highlight specific overtraining issues such as participation in endurance events,
weekend athletic tournaments, year-round training on multiple teams, and the
multisport athlete. 7
The incidence of overuse injuries in the young athlete has paralleled the growth
of youth participation in sports. Up to 50% of all injuries seen in pediatric sports
medicine are related to overuse. Because training has become more sport-specific and
nearly continuous, overuse injuries are now common among young athletes recent
data indicat30% to 50% of all pediatric sports injuries are due to overuse . In a study
of children (aged 5 to 17) who presented to a sports injury clinic, 49.5% of 394 sports
injuries were classified as overuse, with boys and girls displaying a similar frequency.
The relative percentage of overuse injuries varies by sport, however. In a 2-year study
of 453 young elite athletes, 60% of swimmers' injuries were due to overuse, compared
to 15% of soccer players' injuries. Athletes who had overuse injuries lost 54% more
time from training and competition than those who had acute injuries.5
Overuse injuries occur when a tissue is injured due to repetitive
submaximal loading. The process starts when repetitive activity fatigues a
specific structure such as tendon or bone. With sufficient recovery, the tissue
adapts to the demand and is able to undergo further loading without injury.
Without adequate recovery, microtrauma develops and stimulates the body's
inflammatory response, causing the release of vasoactive substances,
inflammatory cells, and enzymes that damage local tissue. Cumulative
microtrauma from further repetitive activity ultimately causes clinical injury.
In chronic or recurrent cases, continued loading produces degenerative
changes leading to weakness, loss of flexibility, and chronic pain. Thus, in
overuse injuries the problem is often not acute tissue inflammation, but
chronic degeneration (ie, tendinosis instead of tendinitis). 5
6
children may be too small for protective equipment, growing cartilage may be
more vulnerable to stresses and children may not have the complex motor
skills needed for certain sports until after puberty.6
The most commonly injured areas of the body include the ankle and
knee followed by the hand, wrist, elbow, shin and calf, head, neck and
clavicle. Contusions and strains are the most common injuries sustained by
young athletes. In early adolescence, apophysitis or strains at the apophyses
are common. The most common sites are at the knee (Osgood-Schlatter
disease), at the heel (Sever's disease) and at the elbow (Little League Elbow).
Non-traumatic knee pain is one of the most common complaints in the young
athlete. Patellar Femoral Pain Syndrome (PFPS) has a constellation of causes
that include6
7
sports are considered, sports involving contact and jumping have the highest
injury levels, Among girls, soccer had the highest injury rate, followed by
basketball, field hockey, softball and volleyball. Elite athletes, however, have
lower injury rates than the general sporting populations. In general, the
incidence of sports injuries seems to increase with age, approaching the
incidence rate of senior players in the older children. 7
Time spent in learning how to prevent overuse injuries before they set
in is good training for both parents and coaches. In youth sports, the focus
should be on preventing shoulder and elbow injuries. These injuries include
rotator cuff and biceps tendinitis, medial epicondylitis, and instability of the
medial collateral ligament of the elbow.
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3. Encourage the athlete to take at least 2 to 3 months away from a
specific sport during the year.
4. Emphasize that the focus of sports participation should be on fun, skill
acquisition, safety, and sportsmanship.
5. Encourage the athlete to participate on only 1 team during a season. If
the athlete is also a member of a traveling or select team, then that
participation time should be incorporated into the aforementioned
guidelines.
6. If the athlete complains of nonspecific muscle or joint problems,
fatigue, or poor academic performance, be alert for possible burnout.
Questions pertaining to sport motivation may be appropriate.
7. Advocate for the development of a medical advisory board for
weekend athletic tournaments to educate athletes about heat or cold
illness, over participation, associated overuse injuries, and/or burnout.
8. Encourage the development of educational opportunities for athletes,
parents, and coaches to provide information about appropriate
nutrition and fluids, sport safety, and the avoidance of overtraining to
achieve optimal performance and good health. 6
9
In light of above facts with the personal experience of the investigator
working as staff in caring adolescents have encountered many injuries
specially sports persons complaints of various injuries. So this has created
interest in investigator to provide a structured teaching programme on
overuse syndrome among Adolescents
6.4 OBJECTIVES
1. Knowledge:
It refers to level of understanding regarding overuse syndrome among
Adolescents
2. Effectiveness:
It refers to the improvement in knowledge on Overuse syndrome among
Adolescents.
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3. Structured teaching programme:
It refers to systematically organized teaching strategy for duration of 45 mins
to one hour on Overuse syndrome, its definition, causes, injuries and
prevention among Adolescents, by verbal interaction with the use of flash
cards.
4. Overuse syndrome:
It is a condition where a part of the body is injured by repeatedly overusing or
exerting too much strain on that body part.
5. Adolescents:
Adolescents are undergoing training in sports association of age group
between thirteen to nineteen years.
.
ASSUMPTIONS
H : There is a significant difference between mean pre test and post test
1
11
H : There is a significant association between the knowledge of the
2
12
level basketball players aged 14 to 18 years. Results showed that athletes who
specifically sustained overuse injuries (p = 0.01) participated in a greater
amount of basketball refereeing than uninjured athletes. 10
13
improve outcome and compliance. The goals of this article are to familiarize
the reader with the diagnosis and management of swimming injuries and to
improve the physician's effectiveness in dealing with swimmers through a
thorough understanding of technique and psychology. 13
14
matches, respectively. The risk of injury was greater in the youngest (under
age 15) group compared with the oldest (under 19) group and 83 (13.4%)
were overuse injuries. There were 51.9% minor injuries, 35.7% moderate
injuries, and 12.4% major injuries.16
15
injury such as exercise-associated amenorrhea and chronic fatigue or
depression are reviewed. That running may promulgate osteoarthritis is still
controversial. However, the preponderance of data gives insufficient credence
to the idea of osteoarthritis as a complication of long-distance running. With
regard to treatment, nonsteroidal anti-inflammatory drugs appear to play little
or no effective role in the management of running injuries19
iii. Setting
The study will be conducted at selected sports associations Bangalore.
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iv. Population
All the Adolescents of age group between thirteen to eighteen years in
selected sports associations Bangalore.
v. Sample
Adolescents who fulfill inclusion criteria and the sample size will be 60.
Exclusion criteria:
The study will exclude:
Section A:
Demographic variable such as age, sex, education, type of sports,
religion, occupation of parents, duration of practice, food pattern
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Section B:
Structured questionnaire is used to assess the knowledge on Adolescents
regarding Overuse syndrome.
Descriptive statistics:
Frequency and percentage distribution of demographic variables will be
analyzed. Mean, and standard deviation will be used to assess the level of
knowledge of Adolescents regarding Overuse syndrome.
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Inferential statistics:
Paired-'t' test will be used to compare the pretest and posttest knowledge
regarding Overuse syndrome among Adolescents; chi-square test will be used
to associate posttest knowledge on Overuse syndrome of Adolescents with
selected demographic variable.
List of references:
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3. Terry, Zeigler Preventing Overuse Injuries in Youth Sports Mar 28, 2009
Available from: URL: http://how-to play.com.
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11. Chezhiyan Shanmugam and Nicola Maffulli, Sports injuries in
children
.Department of Trauma and Orthopaedic Surgery, Keele University School
of Medicine
14. Lyle J. Micheli, Robert Wood. Back Pain in Young Athletes Significant
Differences From Adults in Causes and Patterns, Arch Pediatric Adolescence
Med. 1995;149(1):15-18.
15. Omey, Monica l.; Micheli, Lyle J. Foot and ankle problems in the young
athlete, Clinical Supplement: Foot and Ankle; Medicine & Science in Sports
& Exercise: July 2009; 31 (7) S470-S486
17.Alan Ivković, Miljenko Franić, Ivan Bojanić, and Marko Pećina , Overuse
Injuries in Female Athletes; 2007 December; Medical journal,767–778.
18. Nadler, Scott F, Karen D, Galski, Thomas, Feinberg, Joseph H. Low Back
Pain in College Athletes Health Services Research; April 1998 ; 23(7) 828-
833.
19. Paty, John G. Jr. Sports-related injuries, and related conditions: Running
injuries, Lippincott-Raven Publishers.
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