Ysnseptember2014web

YOUTH SPORTS NEWS Volume1 Issue 192

PRICELESS SINCE 1997

September 2014

YSN’s Annual Guide to

YOUTH SPORTS MEDICINE Concussions Heat Illness Eye Injuries Overuse Injuries Broken Bones Lacerations Mouthguards Common Falls ADHD and Sports

ORTHOPEDIC URGENT CARE On-Site MRI Strains Sprains Fractures Dislocations Tendonitis

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MilPro Publications

Youth Sports

NEWS The Area’s Only Publication Devoted to Kids’ Sports

SEPTEMBER 2014 Youth Sports News is published monthly by:

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GUIDE TO YOUTH SPORTS MEDICINE When a line drive whacks little

Johnny in the head or when he twists his ankle driving to the basket, what, as parents, are you supposed to do?

Do you ice it, or should you apply heat? When he looks at you with that glazed look in his eyes, do you rush him to the hospital or simply give him an ice pack and send him for a slice of pizza?

We have solicited sports medicine professionals from around the Tampa Bay area to discuss the most common injuries in a particular sport, what state-of-the-art treatment is recommended for each one, what long term rehabilitation may be required, and most importantly, prevention of the injury in the first

As parents of kids who play sports, these dilemmas are all too common.

In addition, a kid who plays at the competitive level may be saying, “My shoulder has been bothering me,” and you figure it’s only a pulled muscle, when in fact, it might be something quite different and much more serious.

Competitive players push themselves to the extreme limits of range of motion.

Whether they’re pitchers trying to master a curve ball, swimmers trying to get that extra powerful stroke or golfers trying to attain the perfect swing, they all risk the same thing; over-use injuries and chronic conditions because they’re pushing their bodies to the extreme, without the benefit of proper training or conditioning.

method is: REST the injured area.

Avoid using and moving the body part needlessly. ICE application.

Apply an ice bag for 20 minutes at a time, as often as possible (20 minutes on/20 minutes off or 20 minutes every hour). COMPRESSION of the injured area. Apply an ace bandage wrap to the body part. Begin the ace bandage wrap farthest from the torso and wrap towards the torso. Overlap the bandage 1/2 the width with each circular wrap.

Compression should be snug, but not compromising the circulation. ELEVATE the body part, above the level of the heart. Moist heat, in the form of towels or pads, may be applied after 48 hours to a contusion ONLY IF swelling is no longer present. Upon return to play after a contusion, a protective foam pad may be applied to prevent future damage to the area.

CONCUSSIONS

place. We’ll also be addressing some general sports medicine topics like sports vision and ADHD and sports.

A common term you’ll hear throughout this issue is R.I.C.E. This will be in response to a variety of sprains and strains. The R.I.C.E

Concussions have been in the news with a breakthrough connecting ALS (Lou Gehrig’s Disease) with blunt force trauma (blows to the head). Some research has further concluded that kids may be more vulnerable than adults to lasting damage from these kinds of injuries because their brains are still developing. Once a child has had

Page 6

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Page 8 one concussion, he or she is four times more likely to get another according to the US Consumer product Safety Commission.

Concussions result from direct or indirect blows to the head, caused by mechanical forces. The brain is agitated and immediate, transient impairment of neural functions occurs.

Signs and symptoms of a concussion include disorientation or confusion, unsteadiness, disturbed vision, dizziness, headache, difficulty concentrating, irritability, amnesia, tinnitus (ringing in the ears) and altered consciousness. Concussions vary in severity dependent on the symptoms involved. Level of consciousness and severity of symptoms are significant. Athletes who lose consciousness or have symptoms that worsen, should be transported to a hospital for medical care.

Athletes who sustain a concussion may need to be observed closely throughout the night to check the level of consciousness and orientation (usually every 1-2 hours).

Treatment of concussions generally involves rest. This includes all activities requiring concentration (school work, video and other games, reading) and physical activity. The athletes should be monitored closely for deteriorating systems. Medication should be avoided, unless suggested by a physician.

Return to play following a concussion should only occur once all symptoms are completely gone.

A condition known as

MilPro Publications “second impact syndrome” occurs when athletes return too soon to sports participation. It involves secondary impact to the healing, still bleeding brain tissue and can have deadly consequences. Therefore, it is imperative that athletes are asymptomatic prior to return to activity.

Prevention of concussions involves proper selection and fit of equipment, as well as coaching proper technique

with proper hydration timing, proper hydration fluids, smart timing of games and practices and proper rest. A major factor leading to heat illness is humidity and an athlete is not without risk during the cooler months. High humidity prevents the proper evaporation of sweat, leading to the body’s inability to dissipate heat quickly. Children are more susceptible to heat than adults because they absorb more heat than adults and they cannot dissipate heat as quickly. Children also produce more heat during activities than adults. And children, like adults, don’t drink enough fluids during prolonged exercise.

Heat cramps are a form of muscle spasm and tightening that occur as a result of prolonged or intense exercise, usually in a hot environment, although they occur in cool temperatures as well. Treatment includes rest, cooling down if in a hot environment, gentle stretching and fluids, such as Gatorade.

to players. Helmets and mouth guards should be fit and maintained according to manufacturers’ instructions, and worn at all times during play to prevent concussions.

Coaches and players should use proper technique for contact. Players should NEVER lead to hit with the head down.

HEAT ILLNESS

Heat illness comes in three stages: heat cramps, heat exhaustion and heat stroke. All three are preventable

Heat exhaustion is generated by prolonged periods of fluid loss during activity at high temperature. It is characterized by extreme weakness, exhaustion, profuse sweating, clammy skin, normal or slightly elevated temperature, thirst and decreased urine output. Sometimes, there is an altered mental state that ranges from giddiness to delirium.

Heat cramps may also be present.

Treatment includes rest, removal from the hot environment to a cool environment, rapid cooling (fans, ice packs) and fluids (water, Gatorade).

Intravenous fluids may be needed.

Heat stroke is a medical emergency!

It indicates the body’s inability to

MilPro Publications

Page 9 EYE INJURIES

According to a recent report, approximately 30% of eye injuries among children under 16 are sports related. And yet, 90% of those injuries are preventable. Children are particularly susceptible to eye injuries because of their underdeveloped depth perception, fearless style of play and athletic immaturity. The recommendation is that children wear eye protection for the following sports and recreational activities.: baseball, softball, racquetball, tennis, badminton, soccer, ice hockey, street hockey, basketball, lacrosse, archery, fencing, boxing and karate.

regulate heat. The athlete no longer sweats; is hot, red and frequently dry. The athlete will have mental impairment ranging from confusion, disorientation and agitation to hysterical behavior, delirium or coma. Body temperature will be elevated (approximately 105o F).

Treatment includes calling 911, rapid external cooling (ice, fans, wetting down, clothing removal), removal from the hot environment and fluids (water, Gatorade) only if conscious! Transport to a hospital will be required.

The “ABC’s” are an easy way for kids and parents to remember how to Defeat the Heat: Always drink before, during and after activity.

Bring the right fluids.

Sports drinks like Gatorade hydrate best.

Consider fluids as a part of essential safety equipment for sports.

Soccer: 50% of soccer eye injuries result in hyphema. Best Defense: Wearing polycarbonate goggles will help prevent swollen retina, inflamed iris and hyphema.

Basketball: More than 193,000 children ages 5-14 were treated in hospital emergency rooms for basketball related injuries in 2010.

Best Defense: Wearing polycarbonate goggles will help prevent fractured eye sockets, swollen retina, corneal abrasions and hyphema.

Here’s a look at the most popular sports and the recommended protective eyewear -

Football: The good news is that football related eye injuries have been reduced 90%. Best Defense: A facemask with a polycarbonate shield over the opening of the mask.

Will prevent corneal abrasions and hyphema.

Baseball/Softball: Baseball is the leading cause of sports related eye injuries in children. Best Defense: A polycarbonate face guard attached to the helmet. This will prevent corneal abrasions (scratches on the cornea), hyphema (bleeding in the eye), cataract and swollen retina.

Ice & Roller Hockey: Ice hockey is the second leading cause of winter sports injuries among children.

Best Defense: A facemask with a polycarbonate shield on the helmet will help prevent corneal abrasions, hyphema and swollen retina. There have been several blinding and

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Page 12 disfiguring traumas in hockey. The head and eyes must be completely protected.

Polycarbonate Lens Material and another material called Trivex ™ are the most impact resistant materials from which lens can be made. These materials are over 20 times stronger than regular lens material and can stop a .22 caliber bullet under some conditions. Obviously, contact lenses do not provide protection and regular eyeglasses are insufficient and can shatter when hit by a ball, puck, elbow, hand or the ground, and in some cases, produce an injury worse than if a person was not wearing glasses at all.

When shopping for sports eyewear protection, expect to pay between $35 and $100 for protective eyewear and at least $80 to $120 for eyewear with prescription lenses.

Purchase eyewear at a sports specialty store or optical store and don’t buy eyewear without lenses. Make sure the eyewear fits comfortably and securely and can fit on a helmet if necessary. Check the packaging to see if the eyewear is comprised of polycarbonate and has been approved by the American Society of Testing and Materials (ASTM).

If an injury to the eye does occur, take the child to an eye doctor or hospital emergency room. Some kids may see stars or spots, or notice a change in their vision, indicating an injury. But, damage from a blow isn’t always apparent even right after it happens. A “shiner” or black eye,

MilPro Publications is sometimes funny to look at but can indicate a serious injury that needs treatment and without treatment, can cause permanent loss of vision.

SHOULDER INJURIES

There are two common types of shoulder injuries: Shoulder Dislocation- Typically, this is reduced on the field by a trainer or doctor (or coach). If it is unable to be reduced, the player is usually sent to the hospital for reduction in the emergency room.

AC Separation a.k.a. Separated Shoulder- This is a tear in the ligaments between the clavicle and

acromion bone, which causes the clavicle (collar bone) to stick up.

Most of these are treated without surgery, although rehabilitation is often required before returning to play.

BACK INJURIES

Thankfully, these are mostly just sprains and often respond nicely to bracing and rehabilitation exercise.

More severe impacts can cause herniated discs or even fractures.

It is a well-known fact that football players, especially linemen who have had long careers, go on to get arthritis in their backs due to the stress placed on them during their

careers.

FINGER INJURIES

Injuries to the fingers are a common occurrence and are usually a result of a direct blow to the tip of the finger or the finger being forced beyond it’s usual range of motion. Most injuries can be managed in the field. Finger sprains or “jammed fingers” are the most common injuries and generally result from hyperextension of the proximal interphalangeal joint or second knuckle. The injured joint becomes swollen and tender, but the joint is not fractured or dislocated.

Treatment is based on comfort and splinting may be necessary to achieve this goal. An easy way to splint a finger is by “buddy-taping” the injured finger to the adjacent finger. R.I.C.E. therapy is helpful.

However, caution must be used when using a compression wrap around fingers to avoid interrupting circulation or compressing nerves.

Once it is comfortable to do so, the splinting can be discontinued and range of motion exercises should be initiated to prevent stiffness and loss of motion.

HAMSTRING STRAINS

These are very frustrating stretches of the hamstring muscles. They are treated best with ice, compression and rest. It is very difficult to predict return to sports after this injury-some heal within days, some take several weeks.

QUADRICEPT CONTUSIONS

Usually the result of a direct impact to the front of the thigh (by a helmet).

MilPro Publications Ice and compression are importantearly motion helps to prevent stiffness.

KNEE INJURIES

The top three most common knee injuries include the medial collateral ligament (MCL), meniscus (knee cartilage), and the anterior cruciate ligament (ACL).

Unlike fractures, these injuries are likely to not involve any direct contact between athletes. Ligament ruptures occur when placing an excessive load on the knee during a rapid acceleration or deceleration.

These movements happen at such a high rate of speed that ligaments, tendons and muscles are unable to absorb the energy at that speed.

You can teach muscles to react quicker. This is accomplished with higher-level plyometric and agility exercise. Performing the appropriate exercises designed around sport specific activities will generally reduce your risk of sustaining a knee injury.

This has been shown quite convincingly in recent studies aimed at decreasing the ACL rupture rate in female athletes. There are several theories as to why female athletes suffer from these injuries more than males. Beside the differing anatomy, males and females jump and land in characteristically different ways.

By applying a plyometric training regimen to female athletes, the ACL rupture rates have been decreased.

ANKLE SPRAINS

Ankle sprains are caused by a sudden twisting motion, usually inward, of the ankle. The most common cause of an ankle sprain is when a

Page 13 player jumps up, and comes down on another player’s foot, forcibly turning the ankle in. This causes stretching or tearing of the ligaments on the outside of the ankle. Varying degrees of ankle sprains depend on how many ligaments are torn.

Signs and symptoms of an ankle sprain vary in intensity and are dependent on the degree of injury that is sustained. Pain, tenderness and swelling on the outside of the ankle are present. With a mild sprain, these will be situated just to the front of the ankle bone, whereas with a moderate to severe sprain, symptoms will be more diffuse around the ankle and foot. A ‘pop” or “snap” may also be heard or felt.

Treatment of ankle sprains consists of the “RICE” method. Moderate to severe ankle sprains should be seen by a physician for x-ray.

Weight bearing should be pain free once initiated. Pain free range of motion exercises are beneficial and may usually be performed immediately (gentle ankle pumps and ankle circles). Ankle braces are useful in helping to support ankle sprains and prevent future injury.

Strengthening, stretching, balance and range of motion exercises are used to rehabilitate ankle sprains.

Physical therapy may be ordered by a physician following moderate to severe ankle sprains to teach and supervise these exercises. Athletes should be given an agility test to determine pain free sport specific activities prior to returning to their sport without restrictions.

Several things may be done to help prevent ankle sprains. First, the muscles surrounding the ankle

should be stretched and strengthened properly. Calf tightness, in particular, has been shown to increase the likelihood of an ankle sprain.

Second, coaches and athletes should make sure that the playing surface and surrounding areas of the court are free and clear of objects. Next, proper footwear is an important factor in preventing ankle sprains.

Finally, wearing an ankle brace or applying athletic tape may help prevent future injury to a previously sprained ankle.

LACERATIONS

A laceration is a wound in which the flesh has been irregularly torn, and has a jagged edge appearance.

This injury occurs when a sharp or pointed object tears the skin tissue.

Treatment involves cleaning the wound to prevent infection. Using latex or vinyl gloves, first apply firm pressure to reduce bleeding, if necessary. Cleanse the laceration with antiseptic soap and water, removing dirt and debris in lengthwise movements. Be sure to dry the laceration throughout, as bacteria breeds in moist environments. Apply a sterile gauze dressing or bandage.

Wounds more than 1/2” long and 1/8” wide should be referred to a physician for suturing. Preventing re-opening of a laceration on return play involves covering the wound with a dressing, then securing with tape or wrap.

COMMON FALLS

As a parent, it can be difficult to decide when to seek medical attention for routine falls and injuries. Following are some of the most frequently asked questions by parents. The answers are based on

Page 14

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MilPro Publications

general recommendations and do not indicate an exclusive course of treatment. Variations due to individual circumstances may be appropriate.

Q “Does my child need stitches?”

A. Significant bleeding, which cannot be controlled, or lacerations that might be cosmetically significant, probably require sutures.

At the least, ground in dirt or gravel needs to be thoroughly cleaned out to prevent infection and/or permanent scarring. You have 4 to 6 hours to seek medical evaluation by a physician, and, the sooner the better.

Delayed closure of a contaminated wound considerably increases the incidence of infection.

Q “Does my child need an x-ray?”

A. Obvious deformities require an x-ray. In children, sometimes persistent bony point tenderness or swelling might indicate a growth plate injury, consequently requiring an x-ray and immobilization.

Q “My child hit his head. What do I need to look out for?

A. Signs that require medical evaluation after a head injury include persistent/inappropriate behavior, disproportionate pain, changes in vision and non-stop recurring vomiting.

BROKEN BONES

Just about any bone can be brokenfrom small bones such as fingers, to severe injuries such as the spine. All broken bones should be treated by an orthopedic surgeon. On the field, the athletic trainer will usually splint the injured extremity and then send the player for x-rays and appropriate medical follow-up.

MOUTHGUARDS

Mouthguards are worn to prevent the breaking of a jaw if an athlete is hit in the face a certain way. The weakest part of the lower jaw is in the same area where the lower wisdom teeth are located. When hit in the face or lower jaw, a mouthguard acts as a shock absorber to absorb the force from the hit. Without the mouthguard, the force goes into the bone of the lower jaw and breaks the jaw.

The other purpose of the mouthguard is to keep the lips and teeth from getting damaged. Especially in those wearing braces, the danger athletes face who choose not to wear a mouthguard, is having their lips peeled off the braces by an oral surgeon after being hit in the mouth by another player, ball or piece of equipment.

When wearing braces, mouthguards bought at the sports store (that you have to boil to shape them to your teeth) cannot be used. A special mouthguard must be worn that is only used for braces, that you do not boil. The boiled type of mouthguard

fits so tightly on the teeth, that it prevents the teeth from being moved by the braces.

These days mouthguards come in many colors to match your favorite color or teams’s color. Some high schools and colleges actually make you wear mouthguards with colors so that referees can enforce the mandatory wearing of a mouthguard during games.

ADHD AND SPORTS

What is ADHD? And what is all the hype about this disorder? ADHD is an abbreviation for Attention Deficit Hyperactivity Disorder. There are two main types of ADHD, the impulsive type and the inattentive type.

Inattentive children are the ones who are careless, have poor attention, do not seem to listen well, do not follow through on instructions, have poor organizational skills, lose things, are easily distracted and forgetful, and wear out care givers. These children are also described as loving, affectionate, sweet and giving.

MilPro Publications Impulsive children are the ones who cannot sit still, cannot easily stay seated when expected, run or climb excessively, have difficulty being quiet, talk excessively, are always “on the go,” have difficulty waiting their turn, interrupt others and blurt out answers. These children are often characterized as sweet and loving, but are also sometimes aggressive and defiant.

What will help these children who often lag behind socially? Parents want to do whatever is best for their children, and parents of a child with ADHD have typically tried everything. Sports participation is an often asked question and sports is a great recommendation for a child diagnosed with ADHD, as long as the child is appropriately matched with the sport.

For example, to take a boy with ADHD, who has trouble paying attention and concentrating, who cannot easily wait his turn and is not greatly coordinated, and put him in little league, is aversive for the child, the coach and the parent. This is the

Page 17 child in the outfield who is playing with the grass, looking at the birds flying overhead, and when the ball finally comes his way, he is not aware of the ball’s existence.

So, what to do? Take him to see children his age play a sport in which he’s interested. Let him see what’s involved. Have him talk to a coach about the sport before signing up, so he knows what to expect.

Or, if you have a son or daughter who is very active, loves to run and never seems to wind down; look for a sport where these qualities would be an asset, such as basketball or soccer. If you have a child who is very aggressive, look into football. If you’re looking to boost self-esteem and confidence, try a sport that’s not a team sport, like karate. Swim team can also be a good choice because the child doesn’t have to complete unless or until he/she wants to.

Allow your child to try different sports as you find the right fit. Don’t be discouraged, there is something out there for everyone.

Talk with the coach and let him/her know your child’s special needs. Find a patient coach willing to work with your child; one who is willing to give your child positive encouragement and one who is willing to play your child. This does get more difficult as the child gets older. But, as your child gets older, he/she is in a better position to participate in the sports plan.

So go ahead and play ball!

SPORT SPECIFIC INJURIES BASEBALL INJURIES: Little League’s Elbow (inside elbow pain) is probably the most common overuse injury in baseball. This is an irritation of the growth plate and the muscles that attach to it.

Overuse injuries occur over time from repeated motion. Immature bones, insufficient rest after an injury and poor training or conditioning contribute to overuse injuries to children. Little leaguer’s elbow occurs from excessive pitching and/ or poor throwing mechanics.

Pitchers 6-17 years old are at the greatest risk for little leaguer’s elbow. This age group is skeletally immature. Risk factors include throwing the “breaking ball” at to early an age, throwing too many pitches per game or innings per week, poor mechanics as a result of faulty coaching or instruction, inadequate practice or conditioning habits because of substandard coaching practices or genetic makeup not optimal for baseball. The athlete may also develop elbow pain as a result

Page 18

MilPro Publications

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(727) 526-PEDS (7337) www.northeastkids.com

MilPro Publications

Page 19

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Page 20

MilPro Publications

of a tight shoulder secondary to poor flexibility.

Symptoms of little leaguer’s elbow include elbow pain and tenderness, specifically inside (medial) on throwing, swelling at the inside of the elbow (sometimes), loss of full extension and loss of control and speed of throw. If these symptoms are not treated appropriately, serious damage can result such as permanent loss of elbow range of motion, permanent loss of pitch control and stress reaction/fracture. Treatment includes rest, ice (20 minutes on/30 minutes off, 3-4 times per day), gentle range of motion activities with a gradual return to throwing when pain free.

The Professional Baseball Athletic Trainers Society provides the

following recommendations for pitchers: No curveballs before the age of 14, no sliders until age 18, change-ups can begin at about age 11. Maximum pitch count per week as per Little League’s governing body is as follows: Ages 9-10, max 75 pitches; ages 11-12, max 85 pitches; ages 13-16 max, 95 pitches and over 17, max 105 pitches.

DANCE INJURIES: Dancer’s Hip is a painful snap occurring in the groin area when the leg is coming down from a position of full abduction and external rotation (as in vertical forward split with the knee pointed out). This has recently been found to be caused by a tendon rubbing on the hip bone, causing a painful tendonitis. The problem can be treated by correcting errors in technique and alignment and by proper stretching and strengthening of hip muscles.

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Foot injuries are very common in dancers.

These include stress factures of various bones of the foot, impingement in the ankle and tendonitis.

Dancing en pointe may be associated with increased risk of injuries to children, and the age at which this technique should be introduced is uncertain.

Flexibility of the foot and ankle as well as strength

of the foot and ankle are important considerations.

A very serious problem that may concern dancers and gymnasts, particularly females, is improper diet and eating disorders - anorexia nervosa and bulimia. The emphasis on a slender physique and low body weight may lead some dancers or gymnasts to lower their food intake so much that they deprive their bodies of essential nutrients. This can lead to major medical problems such as osteoporosis (low bone density) with greater risk of stress fractures and altered menstrual cycles.

Children with these problems should be under the care of a doctor.

FOOTBALL INJURIES: Did you know that nearly one out of every three kids that plays football each year will be treated for a football related injury?

Stingers: These occur when the nerves in the area of the neck are stretched, causing a temporary numbness, sharp stinging pain and sometimes weakness in the arm.

Luckily, these usually go away on their own. A stinger should always be reported to the coach, athletic trainer and doctor.

Hip Pointers are contusions to the area of the hip known as the “iliac crest.” Treat with ice and padding.

GOLF INJURIES: Most golf injuries are a result of micro trauma secondary to repetitive abnormal stresses applied to the body that can lead to a more painful and significant disability.

Golfers Elbow (medial epicondylitis)

MilPro Publications is most frequently associated with excessive grip tension during the golf swing, but also occurs in golfers who have not developed a smooth and balanced swing. Excessive grip tension can also lead to wrist and hand disorders. Hitting a “fat shot” can cause tendonitis in the arm, and infrequently, can result in a fracture in one of the small bones in the wrist.

Some of these problems can be overcome by golf-specific strength and flexibility programs. By correcting swing flaws, many of these “over-use” injuries can be prevented TENNIS INJURIES: Research has shown that up to 50% of teen tennis players will, at one time or another, become afflicted with tennis elbow. Tennis Elbow, or medically speaking, lateral epicondylitis, is tendonitis of the muscle called the extensor carpi radialis brevis, which is attached to the lateral epicondyle of the humerus. Symptoms include burning elbow pain, radiating pain down the arm and general elbow stiffness. It is caused by repetitive stress to a specific region. This injury

Page 21 is painful and can linger. It can not only limit your tennis playing but can also effect many every day activities such as brushing your teeth, opening doors and carrying groceries.

Treatment for tennis elbow starts with a conservative protocol such as R.I.C.E. Cortisone shots are usually the next phase and finally, surgery if symptoms persist. Surgery focuses on excision of diseased tissue or reattaching the tendon. Even though the symptoms can be treated, when injury occurs, we should not just treat, we should find out why the injury occurred and how to prevent it. Factors include lack of external rotation in the shoulder, lack of back mobility, technique, racket size and muscular imbalances.

Prevention exercises should include stretching of the elbow extensors; and strengthening of the elbow and wrist extensors and flexors. The racket itself is also very important.

In fact, inappropriate racquets are the primary reason kids end up with tennis elbow. Weight, head size and grip need to be considered when selecting a racquet.

BASKETBALL/VOLLEYBALL INJURIES: Patella tendonitis or “jumper’s knee,” is inflammation of the patella tendon in the knee.

It is caused by sudden or repetitive forceful extension of the knee, usually from jumping. Extreme tension is placed on the patella tendon from repetitive jumping and inflammation often occurs as a result.

Signs and symptoms of jumper’s knee include pain and tenderness just below the knee cap. Different stages of pain occur with this injury: Stage 1: Pain after sports activity.

Stage 2: Pain during and after sports activity (not effecting performance).

Stage 3: Pain during activity and prolonged after activity (affecting performance). Following Stage 3, pain could progress to constant pain and/or complete tendon rupture. It is essential to be aware of and sensitive to the signs and symptoms of jumper’s knee and begin treatment early.

GYMNASTICS INJURIES: A common injury, especially upon returning to gymnastics after time off, is skin tears. These may occur due to friction between the skin and the equipment or grips, especially new grips. Fresh chalk should be used regularly and the equipment should be kept clean of built-up chalk to prevent skin tears. Regular cleansing and lubricating of skin tears encourages healing, and callouses should be gradually builtup to prevent tears, as well.

SWIMMING INJURIES: Swimming is often referred to as the ideal form of exercise because it is so free of injury. Although there is much lower incidence of traumatic

Page 22

MilPro Publications

“The Charter Scho “The Charter School Advantage”

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MilPro Publications

Page 23

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MilPro Publications Thursday Nights Starting December 5th – On Going Countryside Rec. 7pm-8:30pm

injury compared to some other sports, in competitive or frequent swimming, there are a large number of over-use or repetitive microtrauma injuries. These injuries most commonly affect the shoulder joint and surrounding muscles.

This is an Advanced Training Class designed to help take your serious player to the next level!

This training is a full 90 Min. of Ball handling, One on One Offensive Moves, Shooting, Driving & Attacking the Basket, Proper Defense, Boxing Out for Rebounds, Speed and Agility Training, Footwork, Post Moves and Overall Training for the Next Step of Basketball!!

Our Aim is to Train, Motivate, Encourage, and Give Your Player the Confidence that is Needed to Become a Great Player On and Off the Court!!!!

Recommended ages 8 and up (first 20-Kids Max) Cost is $130 for the full 8 weeks or $20 per week.

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Shoulder injuries: There is perhaps no joint in the human body more complex, fascinating or baffling as the shoulder. It can assume over 1,600 positions in 3 dimensional space and the price to be paid for such an extreme range of movement is the lack of overall stability. To achieve peak performance during overhead activity, there must be optimal balance between mobility and stability.

Swimmers who over-stretch their shoulders in an attempt to increase the range of their stroke, without improving their functional muscle and joint stability, are at increased risk for rotator cuff injury. That’s why, in every case, prevention is so much better than cure.

When it comes to sports injuries with kids, remember to err on the side or caution. Use common sense, they’re not pro athletes yet! Their bodies are still developing and today’s game is not a “make or break” situation for their future.

Contributing writers to this issue: Kelly Bashant Certified Athletic Trainer and Certified Strength and Conditioning Specialist Mease Sports Medicine Center Safety Harbor 727-725-6151

MilPro Publications Drs. Choi, Mirabello, Shim and Torke Florida Sports, Orthopedic and Spine Medicine Palm Harbor 727-787-5577 Dr. Edward J. Huggett, Jr. Huggett Vision Institute Holiday 727-780-0199 Dr. Michael Jordan East Lake Pediatrics Stonebridge Park Boot Ranch 727-772-1452

Page 25 Flora Zaken-Greenberg, Ph.D. The Florida Center for Cognitive Therapy Clearwater 727-791-0886 Drs. William C. Cottrell and David Thompson Board Certified Orthopedic Surgeons Orthopedic Associates of West Florida Clearwater 727-461-6026 Dr. Brian Maiocco Orthopedic Surgeon

Orthopedic Specialists Palm Harbor 727-938-1935 Dr. Andrew Maser Orthopedic Surgeon Orthopedic Specialists Palm Harbor 727-938-1935 Erik Lehane STARS, LLC Sports Orthopedic Physical Therapist 727-365-6110

Largo’s Florida Top Dog All-Stars Small Senior Level 4 team were presented with their Summit Championship rings this past August. The girls won the prestigious National Championship at Disney’s Wide World of Sports. First row: Madison Pate, Morgan White, Kendall Ciaravino, Aubrey King, Avery Matranga and Kealoha Abasial.

Second row: Taylor Trusley, Hannah Gars, Tatiyana Aldina, Eva Smith, Mariesha Swinton, Alexis Smith, Coaches Ashley Roscoe and Kim Roscoe. Back row: Coach Linda Roscoe, Kaylen Stine, Bailey Beiswenger, Tori Trusley, Mia Fetner, Meghan Nixon, Delaney Iomicka, Mindy Do and Brenna Martgan.

Page 26

MilPro Publications

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MilPro Publications

Page 27

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Page 28

MilPro Publications

WHAT’S UP IN SEPTEMBER? THE CITY OF Safety Harbor 727-724-1530 Homeschool Fridays

Visit the website for more information and registration, www. safetyharborrecreation.com

Youth Basketball Clinic

The City of Safety Harbor offers classes specially designed for the Homeschool origin. All of our Homeschool classes are a big hit with our already established Homeschool group and are offered on Fridays. We have a variety of classes such as woodcarving, drawing, highland dance, archery, novelists, physical education, and gymnastics. If you would like more information or to register, visit our website, www. safetyharborrecreation.com

Tuesdays, 9/09-10/28; Beginners (Ages: 8 – 11): 6:15 – 7:15pm, Advanced (Ages 11 – 15): 7:15 – 8:15pm Come meet Coach Trevor Bing on the court to get professional assistance on the game of Basketball. Coach Trevor will teach the fundamentals and skills that are needed to play a skillful game on basketball. Coach will focus on running drills to obtain the skills being provided. You may register at www.safetyharborrecreation.com

Volleyball, Values, and Gameplay

Court Surgeons Elite Basketball

Wednesdays, Beginners: 6 – 7pm; Intermediate, 7 – 8pm Join Coach Carrie on Wednesdays to learn the basics of Volleyball: bump, set, spike, serve, and dig.

While learning the core skills of the game, Coach Carrie will emphasize and teach the importance of sportsmanship, teamwork, responsibility, and confidence.

Once the child has conquered the beginning skills, they may move up to the next level, Intermediate.

During any phase of the game and practicing, your child may join us on Saturdays (11:30am – 12:30pm) to focus on the gameplay aspect of Volleyball and put their newly acquired skills to the test!

Program for Teens Thursdays, 9/06 – 10/30; 6:15-7:30pm Court Surgeons Elite Training is a one of a kind basketball skill training program. This elite program will include skills in training fundamentals and technique as well as advanced one on one moves (position specific).

This program will include hands on training along with classroom style teachings. This program will require dedication, determination and drive. Each participant will receive an evaluation and Court Surgeons t-shirt. For more information, please contact the Safety Harbor Community Center, (727)724-1530.

Happy Feet Soccer Programs

at Safety Harbor Safety Harbor is now offering Happy Feet Soccer Programs for youth of ALL ages. Practices will be held every Tuesday at Safety Harbor City Park. Times vary according to your child’s age. Monthly sessions will begin September 9, and will go through January 2015. Sign up now! Limited space available for each monthly session. If you have any questions about the program, please contact the Safety Harbor Community Center at (727)724-1530.

Little Toes Soccer: Ages: 2-3; 3:30pm Big Toes Soccer: Ages:45; 3:45-4:30pm Future Legends Soccer: Ages: 6-10; 4:45-5:45pm .

West Florida Flames soccer club needs players (East Lake/Palm Harbor Area)

The following teams need players: U16 Boys NPL 2 Defenders U9 Girls CDL U10 Girls CDL U13 Girls CDL U13 Girls USA Goalkeeper U16 Girls NPL For More Info Call John Orr @ (727) 459-7287

PINELLAS PARK UNITED YOUTH

MilPro Publications

SOCCER RECREATION REGISTRATION Recreational Registration: Ages 4-18 Boys and Girls “Scholarship available” September 6th, 10:00am - 12:00pm at the complex, under the pavilion September 13th, 10:00am - 12:00pm at the complex, under the pavilion September 20th, 10:00am - 12:00pm at the complex, under the pavilion.

For More Info Call 727-742-6883, email geraldmorindoc@aol.com

Largo United Soccer Club Fall Recreational Soccer Registration Largo Soccer Complex 1779 Belcher Rd. S, Osceola High School 9751 98th St. N. Thursdays: September 4th, 11th - 6:30pm to 8:30pm Saturdays: September 6th, 13th – 9:00am to 11:30am Cost: $99 for U6 $135 for U8 $150 for U10 & Older A city of Largo recreation card is required for all participants Recreational Season runs October thru February Practices: U6 – U8 will practice one night per week. U10 and Up will practice twice per week.

Games will start the first Saturday in November and end the 2nd week of February.

Page 29 If you are interested in coaching U6 please contact Al Sousa, Director of Coaching and Player Development, at luscdoc@yahoo.com.

LARGO REC Fall Youth Athletic Programs Instructional Basketball Program/League

This program is designed to teach the skills of basketball through instruction and games.

Program will include 45 minutes of instruction followed by 30 minutes of game time.

(Ages 9-11) Sept 13-Nov 15 Saturday 10-11:15am $45 (Ages 12-14) Sept 13-Nov 15 Saturday 11:30am-12:45pm $45

Instructional Soccer Program/ League

This program is designed to teach the skills of basketball through instruction and games.

Program will include 45 minutes of instruction followed by 30 minutes of game time.

(Ages 6-8) Sept 6-Nov 1 Saturday 9-10:15am $45 (Ages 9-11) Sept 6-Nov 1 Saturday 10:30-11:45am $45

Instructional Volleyball Program/League

This program is designed to teach the skills of basketball through instruction and games.

Program will include 45 minutes of instruction followed by 30

minutes of game time.

(Ages 9-15)Nov 1-Dec 13 Saturday 2-3:15pm $55

Sports Crazy Not enough P.E. at school?

Enjoy games such as wiffle ball, dodgeball, kickball, four square, capture the flag and more! Each week we will play a different game.

(Ages 9-13) Sept 9-30 Tuesday 6-6:45pm$24/$30 Oct 7-28 Tuesday 6-6:45pm $24/$30 Nov 4-25 Tuesday 6-6:45pm $24/$30 Dec 2-16 Tuesday 6-6:45pm $18/$22.50

Volley Tots

This program introduces the little ones to the game of volleyball through fun activities and skill games.

(Ages 5-8) Nov 1-Dec 13 Saturday 1-1:45pm $42/$52.50

Youth Cross Country Increase your child’s endurance as we run around the surrounding areas of the Highland Recreation Complex. (Ages 7-15) Sept 10-Nov 12 Wednesday 6-7pm $40/$50

For more information call Brian Harter Athletics Specialist (727) 587-6740 x5046 bharter@largo.com

Page 30

MilPro Publications

Tri-County Services of Pasco, Inc.

Since 1995 Legal Assistance without the high cost of an an attorney. Sometimes you need a lawyer, but when you don’t, we can help!

• Divorce • Paternity • Child Support • Custody • Visitation Bay Performing Arts Academy •Tampa Bankruptcy where the focus is on performance • Other Family Law Matters Come be part of our musicals Willie Wonka Kids Or Disney’s Mulan Jr.

SAVE ON ATTORNEY’S FEES! The help you need when you need it most!

We will guide you through the legal system!

7649 SR 54, New Port Richey

727.807-6987

Join us today!

Open House January 5 & 6 5pm—8 pm Saturday January 7 10 am—2pm

St PeterSburg Store 3487 4th St N 33704

Palm Harbor Store 31071 US Hwy 19N 34684

727.894.0906

727.330.7785

Hours: M-F 10-5:30 Sat 10-5, Sun 11-4

developing your talent and confidence, so no matter what you choose, you will have the opportunity to put your talents to work. We work hard to find places to showcase your talent.

Hours: M-F 9:30-6:00 Sat 10-5, Sun 11-4

Tampa Bay Performing Arts Academy

Studio — 35157 US Hwy 19 N in the Palm Harbor Plaza

(se corner of US 19 & Alderman Rd, next to Play it Again Sports)

Where the focus is ALWAYS on Performance!

Studio 727-784-6598 email: into@tbpaa.com Www.tbpaa.com

Grades K-4

2+

NoW oPeN IN trINItY!

Assessment & Evaluation join our• Preparation of Court Documents • Attorney Referral if necessary Encore Performance Team * We are not attorneys and do not give legal advise.

Or learn to sing & perform in 5510 River Road,or Suite 210Voice • New Port Richey 34652 Private Group Lessons 727.847.6637 • PBallew@tri-countyservices.net Our dedicated staff knows that being out and performing is vital to www.tri-countyservices.net

Grades Grades K-4 K-4 Grades K-4 Grades K-4 Grades K-4

Ages 12+ Ages Ages 12+ 12+ Ages 12+

Ages 12+

Grades Grades 4-8 4-8 Grades 4-8 Grades 4-8 Grades 4-8

HS—Adult HS—Adult HS—Adult HS—Adult HS-Adult

Grades 4-8

HS—Adult

Ages 6-16 Ages Ages 6-16 6-16 Ages 6-16

Ages 6-16

Limited spots available for each show.

REGISTER TODAY! Ages 6-16 35157 19 N, Palm Harbor 35157 USUS 19 N, Palm Harbor 35157 35157 US US 19 19 N, N, Palm Palm Harbor Harbor

www.tbpaa.com • 35157 US 19 N, Palm Harbor • 727.784.6598

MilPro Publications

Page 31

Shoes, Dresses, Skirts, Tops, Tights, Shorts & Skate and Gymnastics Wear for all Ages. We also do Custom Orders and Carry Required Colors for Area Schools

tennis profile

HALEY MISENHELDER

Sixteen year old tennis player, Haley Misenhelder, who trains with Erick Chall at the Seminole Lake Family Tennis Center, has sung the National Anthem at several baseball games.

2113 Central Avenue, St. Pete, FL 33713

Mon-Fri 12pm-7:30pm • Sat 11am-6pm • Sun 2pm-5pm

Mention this Ad for 10% Discount. Expires 10/31/14.

Born in St. Petersburg, the 5’5,” 125 pounder is a sophomore at Florida Online Virtual School, where she lists her favorite subject as math.

HURRY!

RegistRation ends septembeR 30th accepting students of all ages and levels of study.

3705 Tampa Rd, OldsmaR, Fl • 813.814.0587 •

TampabayballeT.cOm

FALL REGISTRATION JuST DANcE AcADEmy Ballet • Pointe • Tap • Jazz • Hip Hop • Modern Contemporary • Turns & Leaps • Tumbling Competition Company Rhythmic Adult Exercise Mommy & Me Classes Yogalates Dance Classes Birthday Parties Group & Private Lessons For Ages 2 to Adult

Fall Classes beginning NOW!

835 S PINELLAS AvE, TARPON SPRINGS (in

the Winn

Dixie Shopping Center)

727.643.3563 www.GOTDANcER.cOm

Haley’s favorite movie is Divergent and Jennifer Lawrence is her top rated actor. Friends tops her list of favorite TV shows and Bart Simpson is her number one TV character.

When not playing tennis, Haley enjoys shopping, traveling, water sports and the beach. Her favorite sports team is the Tampa Bay Bucs and Kobe Bryant is her top rated player.

When asked the question, “What is the biggest problem in society today?” Haley’s response was, “Texting and driving.”

Haley’s future plans include going to college on a tennis scholarship, becoming a tennis pro and studying orthodontics.

R •

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MilPro Publications

“We Burilsd Leade at t 1 Studene.” a Tim

We Teach Respect Every Day!

Award Winning Programs from Ages 3-Adult

We Can Cre Impressive ate an in Your Chil Change d’s Behavio r!

Come Check Us Out! We’re building

Center!

NEWAll Abilities Equestrian Equine Assisted Therapy Barn Times for Children Homeschool Classes Farm Interactions Horse Camps • Field Trips L.E.A.P.

Pro Karate Center Since 1975 843 County Road 1, Palm Harbor

(Life Skills, Education, Agriculture and Purpose)

727-734-9659

www.saddleupridingclub.org

Our Certified Instructors Teach Stranger Awareness!

9301 62nd Street, Pinellas Park ksipos@saddleupridingclub.org

727.520.3132

www.prokaratecenter.com

Introductory offer

99

BACK TO SCHOOL SPECIAL $

6 weeks of karate Lessons - incLudes uniform Pro Karate Center

843 County Road 1, Palm HaRboR • 727.734.9659

witH tHis CouPon . not valid witH otHeR offeRs . new students only . offeR exPiRes 10/31/14

Saddle Up participates in the Special Olympics

Open to the public monthly for horse rides and fun petting zoos.

“Hands and hooves building a better community.”

WEST FLORIDA LIGHTNING AQUATICS We Teach Kids to Swim for Health, Safety, Fitness and Fun! High Quality Professional Coaching and Technique Instruction for All Ages and Abilities for Ages 3 and Up

YEAR ROUND SWIM TEAM FALL SCHEDULE

Practices for Silver Group (Beginners) and Gold Group Starting NOW! Mondays through Thursdays 5:00 pm to 6:30 pm Those interested should email zookeeper5721@gmail.com or just come to Southwest Rec at 4:45 pm any evening, Monday through Thursday and look for Cathy.

FALL SWIM AMERICA SWIM LESSONS September 2nd to 25th Tuesday and Thursday Evenings 5:00 pm and 5:40 pm • $90 (A valid City of Largo Rec Card is required.)

Email Director Cashel Mack at zookeeper5721@gmail.com

www.wflaswimming.com

All lessons are at the Southwest Pool, 13120 Vonn Road in Largo.

All lessons are taught by certified Swim America instructors and supervised by our professional swim team coaching staff.

WFLA is the ONLY Swim America Lesson Program in Pinellas County!