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Cumulative Trauma

 

Doctor

Nowadays, children complete in numerous sports during a single year which can lead to Cumulative Trauma Disorders. These disorders can have a pronounced effect on the growth and development of these children as they enter adulthood and later, old age. Cumulative Trauma Disorders are disorders which are usually caused by excessive repetition and inadequate scheduling of exercise and rest periods. Cumulative Trauma Disorders are also known as RSI, or Repetitive Strain Injuries.

Cumulative Trauma cases often begin as simple muscle pain and fatigue to an overused area of the body. If recognized early, a short period of rest will usually lesson the pain. However, if ignored, it may result in nerve entrapment syndromes, myalgia, tendonitis, tenosynovitis, osteochondrosis, or common repetitive injuries such as "tennis elbow" or "little league arm.”

Two types of growth centers are responsible for the growth of bone, the "epiphysis" and the "apophysis.” The epiphyses are located at the ends of bones, and, in children, the shaft of the bone and the epiphysis is separated by an epiphyseal cartilage or plate. This plate provides the means for the bone to increase in length so only growing persons (children) have epiphyses. Being cartilaginous, these epiphyseal plates are vulnerable to the stresses and strains placed on them by repetitive, continual activities. Once adulthood is reached and growth is completed, the epiphyseal plates fuse and are replaced by bone. It is the period before this fusing that is of concern since it dictates the successful "normal" development of a child’s bones.

"Little league elbow" is an example of an injury to the epiphysis of children’s bones. It may be encountered by children who repeatedly throw a baseball during their childhood years. As a normal part of a child’s growth, stress is applied to the epiphysis by the strong pull of enlarging and growing muscles. Coupled with these normal stresses, the repetitive trauma of throwing a baseball can exert a great amount of force on, and can injure the epiphyses. Bone growth depends on its blood supply, and if the epiphysis is injured, blood supply will be interfered with and ultimately, growth could be hampered. Injuries to the epiphyses can result in angulation deformities, especially around the elbow, and this can give rise to either cosmetic deformities or modifications in the normal functioning of the limb. Therefore, any trauma to the child resulting in swelling, pain, or an inability to play his or her sport should be x-rayed.

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