Microwave or Crockpot?
We want what we want and we want it now. A microwave meal is done fast but at the sacrifice of quality. Speed often leaves us with a pizza roll that is “destroy your mouth” hot on the outside and frozen solid on the inside. Positive adaptations take time. It takes patience and the right dosage to cultivate a favorable outcome.
From the time we were born, our bodies have been shaped. Muscles pulling on tendons, tendons pulling on bone, and bone shaping itself to best align with these forces. We are being constantly reshaped into more efficient versions of ourselves. Our tubercles, tuberosities, processes, and epicondyles are all products of the muscle and tendon repeatedly pulling on this area of bone. When we come across pain in one of these boney projections, or the associated tendon, in an otherwise healthy youth athlete we can assume that an adaptation is occurring too quickly. The immature skeleton cannot handle the volume or magnitude of forces it is being succumb too. This skeleton needs time to mature with a properly dosed amount of stress to guide the bodies architecture itself to handle more and more of this type of stress.
What do Osgood Schlatter’s disease, Sever’s disease, and Little League shoulder all have in common?
They are positive adaptations that are occurring way too quickly. The result of the microwave method of athletic development.
What is the difference in a little leaguers humerus from a mature 24 year old pitcher? The bone changes in length and bone density, and the vulnerable growth plate will close. On top of this, the bone will actually twist to create a shape more conducive to throwing. The anatomy shifts to make the task more efficient. If this twist happens too fast, we call it little league shoulder (or elbow).
Sabick, M. B. (2004). Humeral Torque in Professional Baseball Pitchers. American Journal of Sports Medicine, 32(4), 892–898. doi:10.1177/0363546503259354
What is the difference between an elite basketball players tibia and that of a 13 year old? Again, besides density changes, length changes, and closure of the growth plate, the pull of the patellar tendon over time on the tibial tubercle will create an increased anterior projection. This will increase leverage of the musculotendinous attachment, thus providing increased torque producing capabilities. If this positive change happens to quickly we call it Osgood Schlatter’s disease.
What is the difference between an elite sprinter’s calcaneus and that of a 13 year old? The posterior projection of the calcaneus will be greater creating greater leverage for the achilles tendon and the gastroc-soleus complex. If this positive adaptation occurs too quickly we call it Sever’s Disease.
When it comes to athletic development, forgo the microwave for the crockpot. Adaptation takes time. Be patient, don’t burn your mouth.
- Dr. Anthony Iannarino, Rehab 2 Perform - Bethesda
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