Body Image (02:14)
Dr. David Kruse welcomes the audience and explains the talks will focus on a pediatric perspective to sports injuries. Dr. Amanda Weiss Kelly's will begin the session with a talk on adolescent body image in female athletes. Body image is the mental image a person possesses about his or her physical appearance.
Body Image Disturbances (03:33)
Body image disturbances include dissatisfaction, perceptual distortion, and functional body image. The eating disorder inventory diagnoses the scale of dysfunction, but concentrates on butt, thigh, and abdomen regions. Dr. Weiss Kelly provides two examples of dysfunction in adolescent athletes.
Not Just For Girls (03:09)
Teenage adolescent body image dysfunction occurs in boys as well, but has not been studied as frequently as girls. Males tend to want to gain muscle rather than lose weight. Dr. Weiss Kelly describes general risk factors including transitioning to new schools and social influences.
The Media (02:59)
The more exposure kids obtain to the "perfect body" in TV and magazines, more likely they will possess body image dysfunction. Sports can protect a teenager if they enjoy the activity. Athletes tend to pick larger more muscular ideal body types than non-athletes.
Risk Factors for Sports (02:13)
Elite and lean-sport athletes tend to believe that being thinner will improve their performance and are at an increased risk for eating disorders. Coach pressure made a group of Dutch gymnasts diet, because "thin wins." Teenagers with body image dissatisfaction tend to use pathogenic weight control and are at risk for depression and low self-esteem.
Preventing Low Body Image (02:55)
Successful programs include obesity prevention, ATLAS, Everybody's Different, Happy Being Me, and ATHENA. A good school based program should be interactive, provide media literacy, include self-esteem building, problem solving, and stress management.
Pharmacologic Therapies for Pediatric Concussions (04:01)
Dr. Mark Halstead will examine when a concussion warrants medication in a pediatric athlete and different options. Medications should be implemented if it reduces the severity of symptoms or shortens the return to learn time frame. Studies have shown taking omega three prior to a concussion benefited rats.
What Meds Are Used? (02:47)
Dr. Halstead alerts his patients that he prescribes medications for off-label use. In a survey of the American Association for Pediatrics, 92% of the doctors treated concussions in their practice. The physicians did not prescribe anti-inflammatories during the acute phase.
Studies show improved behavioral changes in children and Parkinson's disease. Dr. Halstead explains why he is critical of the University of Pittsburgh's findings.
There is no conclusive research for or against the use of Melatonin in brain injury, but recent studies suggest it could improve function. A colleague at Washington University studied the benefits of giving hypertonic saline after a concussion in an ER for pain management.
Medication Overuse (02:08)
A study demonstrated that headaches improve in patients who stop taking over the counter analgesics. Dr. Halstead summarizes his talk on medication use in pediatric concussions.
ADHD and the Athlete (03:26)
Dr. Kelsey Logan will discuss the prevalence, challenges, pathophysiology, and effective treatments for Attention Deficit Hyperactivity Disorder in children. Simply changing the definition of ADHD increases the number of children diagnosed. The disease is more prevalent in the Midwest and east coast than the west coast.
Challenges of ADHD (02:11)
Children afflicted with the disorder carry an increased risk of spontaneous sexual encounters, impulsive behavior, more prone to injury, substance abuse, legal problems, and slower processing and self-esteem. Athletes will tend to experience difficulties responding to rules.
Slower to Mature (02:51)
Children afflicted tend to have underdeveloped or slower growing prefrontal cortexes, caudates, and cerebellums. Huge amounts of dopamine and norepinephrine are released in the brain, which leads to distractive behaviors.
Effect on Movement and Development (03:25)
More than 50% of children with ADHD demonstrate issues with fine motor skills. Dr. Logan suggests that physicians look for difficulties in coordination in children in late elementary school to determine if testing is necessary. Treatment studies have determined that drugs create more improvements than behavior therapy.
Treatment Effect on Sports (04:32)
Successful treatment improves motor skills and dynamic balance. Dr. Logan reviews recent studies that demonstrated the positive effect of physical activity and medication combined. John Ratey described exercise as taking a little amount of Prozac and Ritalin.
Osteochondritis Dessicans OCD and Return to Play (03:02)
Dr. Andrew Gregory hopes to define, common sites, treatment options, and returning to play of an osteochondroses diagnosis. Apophysitis is an irritation of the growth plate affecting both the cartilage and bone. James Paget first diagnosed the disorder.
Osteochondritis Dissecans (02:29)
OCD is a joint disorder that creates a legion in the subchondral bone that affects the articular cartilage. It appears most predominantly on the medial femoral condyle. Juveniles tend to possess open physes, which begin to close around adolescence.
Studies indicate that OCD causes focal avascular necrosis in the subchondral epiphyseal bone. Juveniles diagnosed heal more frequently and completely than adolescents or adults. Additional prognostic factors include duration, size, site, fragment stability, and articular surface.
Diagnosing OCD (02:07)
Look at x-rays of children diagnosed with OCD. Dr. Gregory discusses the symptoms. Physicians classify OCD into four stages depending on severity.
Clinical Utility of MRI (05:05)
Dr. Gregory elaborates on a study that determined MRI's were inefficient in diagnosing stages of OCD but helped determine knee stability. Nonoperative treatment includes activity restriction, physical therapy, ice, NSAIDs, braces, and x-rays. Arthroscopic surgery is recommended when it is a grade IV lesion or the patient demonstrates mechanical symptoms.
Q/A: How Long to Use Conservative Treatments? (02:23)
Dr. Gregory explains that with patients diagnosed with a stage one or stage two lesion, it depends on the family, but he tends to wait to determine the change in the lesion after time passes.
Q/A: Getting Information to Colleagues about the Benefit of Exercise and ADHD (01:01)
Dr. Logan agrees that physicians need to counsel their patients about the benefits of physical activity.
Q/A: Sending Elbows Before Knees (00:49)
Dr. Gregory explains that fewer studies have been conducted on patients with OCD in the elbow and ankle. The physician normally sends his patients to a surgeon faster if they are diagnosed with a lesion in the elbow.
Q/A: ADD, ADHD, Anxiety, Depression (00:57)
Dave Weldy suggests that physicians should examine patients for anxiety and depression first. Dr. Logan explains that the overlap in brain pathways is very significant and clinicians can examine children concurrently for all the disorders.
Q/A: Identifying Athletes With Body Image Issues (02:05)
Dr. Kelly explains that athletic trainers are the first line of defense against eating disorders and should watch what the athlete imbibes.
Credits: Sports Medicine Pediatrics (00:20)
Credits: Sports Medicine Pediatrics
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