Conjoint Sports Medicine: Preparticipation Screening, Concussion, and Overuse Injury
Core concepts
Pediatric sports medicine emphasizes preparticipation cardiovascular screening (personal and family history of syncope, chest pain, sudden death, Marfan features, murmurs) to flag conditions such as hypertrophic cardiomyopathy. Understand concussion management: remove from play, no same-day return, physical and cognitive rest followed by graded return-to-learn before return-to-play, and recognition that symptoms evolve. Know overuse injuries - Osgood-Schlatter, Sever disease, Little League shoulder/elbow, spondylolysis - driven by training volume and growth plates, and the value of relative rest rather than immobilization.
Know heat illness prevention (acclimatization, hydration, avoiding highest-heat sessions) and the emergency of exertional heat stroke (cool first, transport second). Recognize RED-S (relative energy deficiency in sport) as a cause of amenorrhea, stress fractures, and impaired performance. Understand female athlete triad components and screening.
Traps
- Allowing same-day return to play after suspected concussion.
- Treating growth-plate pain as "growing pains" when training load is the cause.
- Missing cardiac red flags in a young athlete with exertional syncope.
- Assuming a stress fracture requires surgery when load modification is usually first-line.
Rule of thumb
For concussion, use the "when in doubt, sit them out" rule and never return an athlete to contact the same day. For overuse, a useful anchor is to reduce training volume and address technique before advanced imaging.