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Chiropractic Care for the Child Athlete

Écrit par Joel Miller, D.C., F.I.C.P.A.   
07 Octobre 2008
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Chiropractic Care for the Child Athlete
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There are some negative opinions in chiropractic regarding contact sports like boxing and football. Some of our colleagues feel these sports should be avoided. Whatever your particular opinion, these sports (pee-wee football, boxing and the like) have been around for decades and are here to stay.

The sports chiropractor should not attempt to replace the medical staff already in place at any level of competition. However, it has been my experience that as chiropractors if we care for the athletes chiropractically and not attempt to interfere with or replace the trainers, medics or EMTs, our acceptance both on and off the field is much greater. Having been a team chiropractor for numerous athletic teams from professional baseball, wrestling, and boxing to the little league football and soccer levels, I'd like to share some information, as well as my experience, as such.

Almost all organized levels of children's sports have age and weight limitations. In some sports, such as martial arts, events not only have an age and weight requirement but they also have the children categorized (or matched) according to their skill level. Team chiropractors' should be aware of the proper use of safety equipment and proper fit of protective gear like football helmets, pads and sparring gear used in contact sports.

Injuries to children's spines are not unique to contact sports like football or martial arts. They are also seen in non-contact sports like gymnastics and competitive cheerleading. Injuries to the pediatric spine vary according to the specific mechanism of injury. Therefore, the pediatric sports chiropractors knowledge of particular sports is helpful in assessing the care he or she will render.

Specific to the child athletes' spine one should have knowledge of the ossification centers. The primary centers at the vertebrae, or centrum, and the neural arch unite forming the vertebral arch. Fusion of the body with the posterior elements occurs as early as 3-6 years and as late as 16 years. The secondary centers of ossification, consisting of the two vertebral body end plates, the two transverse processes and the spinous process fuse between 14 and 25 years of age. Also the joints of Luschka are not fully formed until age 7. Additionally, some bones, such as the sacrum, do not fuse until well into the second decade of life, and thus may function as individual vertebrae depending on age.

Subluxations, fractures or failure of fusion of secondary ossification centers can result from head impacts as experienced in football or martial arts, or from falling on the child's feet or buttocks as in gymnastics or cheerleading. Development of the normal spinal curves will assist in dissipating compressive forces or loads. However, athletics may induce concussive forces the body cannot adapt to thus resulting in vertebral subluxation complexes.

The common area of injury from a head impact is the mid to lower cervical (C4-C6). The common area of injury from a forces from below, as in falling on the feet or buttocks, is T-9 - L2. Flexion injuries of the spine commonly affect the C4-C6, T5-6 and L1-L2. And one should always check the upper cervical spine.