Ask many pediatric providers to serve as part of a sports medicine team, and quite likely you will get a lack of perceived comfort with lamentations over insufficient specific training1 and experience.
However, ask those same providers to profess aptitude with injury prevention, discussing growth and development, and using risk-benefit analysis, and you will encounter a far more confident response.
The discipline of pediatric sports medicine deals not just with musculoskeletal care, but rather encompasses a host of medical and orthopedic concerns to optimize safe and lifelong participation in sports and activities. Pediatric health care providers' well-known general medical and anticipatory guidance skills absolutely make them a natural and trusted part of the sports medicine team.
The goal of this special two-part sports medicine issue of Pediatric Annals is to use illustrative sports medicine presentations to make the pediatric provider realize just how much they already know about important growth, development, and injury prevention components in sports medicine. The articles presented will also bridge particular gaps in musculoskeletal or activity-specific issues with evidence-based clinical recommendations that can readily be shared with young patients and their families.
The significance of injury prevention is highlighted in the outstanding article on shoulder injuries in young throwers authored by Dr. John A. Schlechter. He provides a thorough review of the pertinent anatomy and physical examination techniques used in the diagnosis of this type of overuse injury. However, the discussion on reducing risk, including rest periods and limitations on excessive amount and intensity of pitching, is of particular value to the office-based clinician. The ability to have regular encounters with young patients and their families allows enhanced opportunities for “teachable moments” to impart this information and to reduce likelihood of a future injury-related visit.
In their eloquent overview of the advanced skill of en pointe ballet dancing, Drs. Jeffrey C. Lai and David W. Kruse underscore the notion that an individualized review of physical and emotional development is the form of readiness assessment for beginning to dance en pointe. Readers will not only enjoy learning about the unique history and terms used in ballet that will enable them to better relate to their young dancers, but will also have greater confidence in looking at the “big picture” in providing expert recommendations about higher level dance participation.
Young athletes commonly present to the pediatric provider to obtain a medical and musculoskeletal preparticipation evaluation (PPE) which, in part, attempts to identify those who are possibly at higher risk for serious health consequences during exercise. Drs. Kelly Chain and Andrew Gregory provide a thoughtful review of evidence both in favor of and against routine incorporation of an electrocardiogram (EKG) as part of the PPE to reduce the risk of sudden cardiac death. They provide the pediatric provider with ample discussion points on currently known capabilities and limitations of the EKG to share with families in an effort to make informed decisions, while also making solid suggestions for future study and inquiry.
This issue is an extension of the textbook Pediatric Sports Medicine: Essentials for Office Evaluation,2 also published by SLACK Incorporated (the publisher of Pediatric Annals).
We are thankful for the work of our authors who all bring real-world experience to their articles by describing specialist-level evaluation and management concepts in a way that can be readily translated to all pediatric clinic and visit settings. We trust that these articles will increase the reader's comfort in advocating for active young patients and their families.
- Demorest RE, Bernhardt DT, Best TE, Landry GL. Pediatric residency education: is sports medicine getting its fair share?Pediatrics. 2005;115:28–35.
- Koutures CG, Wong VYM (editors). Pediatric Sports Medicine: Essentials for Office Evaluation. Thorofare, NJ: SLACK Incorporated; 2013.