Table Of ContentContemporary Pediatric and Adolescent Sports Medicine
Series Editor: Lyle J. Micheli
Lyle J. Micheli
Laura Purcell Editors
The Adolescent
Athlete
A Practical Approach
Second Edition
Contemporary Pediatric and
Adolescent Sports Medicine
Series Editor
Lyle J. Micheli
Division of Sports Medicine
Boston Children’s Hospital
Boston, MA
USA
More information about this series at http://www.springer.com/series/11729
Lyle J. Micheli • Laura Purcell
Editors
The Adolescent Athlete
A Practical Approach
Second Edition
Editors
Lyle J. Micheli Laura Purcell
Division of Sports Medicine Department of Pediatrics
Boston Children's Hospital McMaster University
Boston, MA Hamilton, ON
USA Canada
Additional material to this book can be downloaded from http://extras.springer.com.
ISSN 2198-266X ISSN 2198-2678 (electronic)
Contemporary Pediatric and Adolescent Sports Medicine
ISBN 978-3-319-56187-5 ISBN 978-3-319-56188-2 (eBook)
https://doi.org/10.1007/978-3-319-56188-2
Library of Congress Control Number: 2018939545
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The Micheli Center for Sports Injury
Prevention
The mission of the Micheli Center for Sports Injury Prevention is at the heart
of the Contemporary Pediatric and Adolescent Sports Medicine series.
The Micheli Center uses the most up-to-date medical and scientific infor-
mation to develop practical strategies that help young athletes reduce their
risk of injury as they prepare for a healthier future. The clinicians, scientists,
activists, and technologists at the Micheli Center advance the field of sports
medicine by revealing current injury patterns and risk factors while develop-
ing new methods, techniques, and technologies for preventing injuries.
The Micheli Center, named after Lyle J. Micheli, one of the world’s pio-
neers in pediatric and adolescent sports medicine, had its official opening in
April 2013. Thus far, the Micheli Center has served more than 2800 athletes
and has published more than 100 studies. Dr. Micheli is the series editor of
Contemporary Pediatric and Adolescent Sports Medicine.
Consistent with Dr. Micheli’s professional focus over the past 40 years,
the Micheli Center conducts world-class medical and scientific research
focused on the prevention of sports injuries and the effects of exercise on
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vi The Micheli Center for Sports Injury Prevention
health and wellness. In addition, the Micheli Center develops innovative
methods of promoting exercise in children.
The Micheli Center opens its doors to anyone seeking a healthier lifestyle,
including those with medical conditions or illnesses that may have previously
limited their abilities. Fellow clinicians, researchers, and educators are invited
to collaborate and discover new ways to prevent, assess, and treat sports
injuries.
Series Editor Biography
Dr. Lyle J. Micheli is the series editor of Contemporary Pediatric and
Adolescent Sports Medicine. Dr. Micheli is regarded as one of the pioneers of
pediatric and adolescent sports medicine, a field he has been working in since
the early 1970s when he co-founded the USA’s first sports medicine clinic for
young athletes at Boston Children’s Hospital.
Dr. Micheli is now director of the Division of Sports Medicine at Boston
Children’s Hospital, and Clinical Professor of Orthopedic Surgery at Harvard
Medical School. He is a past president of the American College of Sports
Medicine and is currently the Secretary General for the International
Federation of Sports Medicine. Dr. Micheli co-chaired the International
Olympic Committee consensus on the health and fitness of young people
through physical activity and sport.
In addition to many other honors, Dr. Micheli has served as Chairperson
of the Massachusetts Governor’s Committee on Physical Fitness and Sports,
on the Board of Directors of the United States Rugby Football Foundation, as
Chairman of the USA Rugby Medical and Risk Management Committee, and
on the advisory board of the Bay State Games. He served as Attending
Physician for the Boston Ballet from 1977 to 2016 and is Medical Consultant
to the Boston Ballet School.
Dr. Micheli received his undergraduate degree from Harvard College in
1962 and his medical degree from Harvard Medical School in 1966. As an
The Micheli Center for Sports Injury Prevention vii
undergraduate student, Dr. Micheli was an avid athlete, competing in rugby,
gridiron football, and boxing. Since graduating, Dr. Micheli has played prop
for various Rugby clubs including the Boston Rugby Football Club, the
Cleveland Blues Rugby Football Club, Washington Rugby Club, and Mystic
Valley Rugby Club, where he also served as team coach.
Dr. Micheli has authored over 300 scientific articles and reviews related to
sports injuries, particularly those sustained by children. His present research
activities focus on the prevention of sports injuries in children. Dr. Micheli
has edited and authored several major books and textbooks.
Preface
It is with great pleasure that we introduce the second edition of The Adolescent
Athlete: A Practical Approach.
This updated edition is inspired by the popularity of the first volume—and
the amount of new information in the field that warrants a place in these
pages.
All the chapters have been updated. Some of the more important additions
are updated references, color figures, and inclusion of cutting-edge discus-
sion of management of such high publicity sport injuries as concussions,
ACL tears, and femoroacetabular impingement.
This new information makes this second edition an important contribution
to the literature. Yet the fundamental reasons for this book remain the same.
We still believe strongly that good health should be a goal of all children and
adolescents, as well as the parents and guardians who care for them. Regular
physical activity is part of achieving this goal. Sports can provide manifold
benefits, including fitness, motor skill development, teamwork, and of course,
fun. As with any pursuit that provides such benefits, however, there are risks
involved, particularly for growing athletes. Physicians and other health pro-
fessionals caring for active children should be able to provide appropriate
care and advice for sport and fitness-related medical issues.
We received very positive feedback on the first edition’s emphasis on
being a practical guide for those who provide sports care for young athletes.
The focus in this updated edition remains musculoskeletal injuries that occur
in this unique population, as well as conditions that may present as a muscu-
loskeletal injury, but may have more serious consequences. The first section
of the book focuses on rehabilitation and diagnostic imaging of musculoskel-
etal conditions in adolescents. The second section—organized according to
anatomical region—addresses specific injuries that adolescents may sustain
as a result of sport/activity participation. Each of these body part–specific
chapters begins with a review of the relevant anatomy, followed by details of
clinical evaluation. Specific injuries, such as acute and chronic injuries, are
described in detail, including the management/treatment of each condition.
Prevention of injuries and return to play guidelines are given full attention, as
befits a book published under the Micheli Center for Injury Prevention. Each
chapter concludes with “clinical pearls” that provide an insight into the way
each of our expert authors practice their craft.
We thank all those who donated their time and expertise to making this
second edition possible. Revising and updating chapters is a time-consuming
ix
x Preface
and painstaking process, and we are very grateful to the chapter authors for
their commitment. We also appreciate the effort and attention to detail of our
editors at Springer. Without these contributions, this new and updated version
of a very valuable resource would not have come to fruition.
Boston, MA, USA Lyle J. Micheli
Hamilton, ON, Canada Laura Purcell
Contents
1 Current Pediatric and Adolescent Sports Medicine:
An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Laura Purcell and Lyle J. Micheli
Part I Rehabilitation and Diagnosis
2 Principles of Rehabilitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Michelina C. Cassella and Kathleen Richards
3 Diagnostic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Diego Jaramillo and Vernon M. Chapman
Part II Anatomic Regions
4 Traumatic Head Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Laura Purcell
5 Cervical and Thoracic Spine Injuries . . . . . . . . . . . . . . . . . . . . . 65
Pierre d’Hemecourt and Jessica Flynn Deede
6 Lumbar Spine Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Merrilee Zetaruk
7 Thoracoabdominal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Hamish Kerr, Brady Bowen, and Deborah Light
8 Adolescent Shoulder Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Nathaniel Cohen and Treg Brown
9 Elbow and Forearm Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Anthony Luke, Margaret Lo, and Marc R. Safran
10 Injuries to the Wrist, Hand, and Fingers . . . . . . . . . . . . . . . . . . 179
Praveen G. Murthy and Donald S. Bae
11 Pelvic, Hip, and Thigh Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Jason H. Nielson and Tyler J. Kent
12 Knee Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
Michelle McTimoney
xi
Description:Now in a revised and updated second edition, this practical text on the adolescent athlete provides penetrating insights into musculoskeletal care for growing athletes. Chapters are logically organized by anatomical region and are written by experts in the field, focusing on improved clinical decisi
