Category Archives: Pediatrics

The Risks of Sports Specialization in Youth Sports

March 6, 2024 Teresa Stockton - Blog, Pediatrics, Sports and Fitness

Why There Are Downfalls to Sports Specialization

Sports specialization is common, but is it all it’s cracked up to be? Focusing on one sport might seem like the fast track to success, but there’s a flip side you should know about.

When your athlete specializes in one sport, they are more likely to experience overuse injuries, burnout, and negative impacts on their psychosocial well-being.

It’s vital to strike a balance and to give your athlete’s body breaks. Trying different sports and activities can boost an athlete’s skill set, lower injury risk, and help prevent burnout.

At PTandMe we’re all about supporting your athlete in their athletic pursuits. Our physical therapy partners can offer advice, help lower the risk of injury, and provide rehabilitative services for athletes already experiencing pain or recovering from injury.

The Risks of Sports Specialization in Youth Sports

Deciding to specialize in a sport isn’t something to take lightly. There are risks and downsides you need to know about. Here are some risks that athletes who specialize in one sport experience.

Overuse Injuries: One of the main downfalls of sports specialization is the increased risk of overuse injuries. Overuse injuries are subtle and occur over time, making them challenging to diagnose and treat. This can lead to injuries like stress fractures, jumper’s knee, shin splints, and more.

Stunted Athletic Growth: By only playing one sport, athletes miss the opportunity to develop versatile skill sets, and practice complementary movement patterns and training techniques.

Mental Strain/Burnout: Sports specialization can also mess with mental health. The pressure to constantly perform at a high level in one sport can lead to stress, burnout, and less enjoyment. It can even increase your athlete’s anxiety and performance pressure.

Balancing specialization with cross-training and rest can help your athlete avoid these issues and keep their athletic journey healthy and sustainable.

3 Common Overuse Injuries Due to Sports Specialization:

Jumper’s Knee (Patellar Tendonitis):

Jumper’s knee, also known as patellar tendonitis, can be caused by the inflammation of the patellar tendon. The patellar tendon is what connects the kneecap to the shin bone. This condition will weaken the tendon, and if left untreated, could tear it. This condition is typically caused by the overuse of the joints in your athlete’s knee. For example: repeatedly jumping and landing down on hard surfaces.

Overhead Injuries:

Another common overuse injury due to sports specialization is an overhead injury. Particularly seen among baseball players, these injuries are common among pitchers, as they can throw upward of 70 pitches a game. This amount of repetition is a prime example of how sports specialization can cause an injury.

Shin Splints:

Most seen amongst runners, shin splints are caused by an irritation of the tendons and muscles near the shin bones. Common causes of shin splints can be improper footwear, lack of flexibility in the calves, or repetitive motion, or stress at the shins.

Experiencing Burnout in Youth Sports

Overuse/overtraining injuries and burnout are major problems for adolescent athletes. Both can occur when students participate in sports year-round with no “off-season” or have insufficient recovery time between practices and games.

Watch for typical burnout signs:

Pain during or after activity, or while at rest
Lack of enthusiasm for practices or games
A dip in grades.

Prevent Overuse Injuries and Burnout with These Simple Tips:

Allow enough time for proper warm-up and cool-down routines.
Rest 1-2 days per week or engage in another activity.
Focus on strength, conditioning, or cross-training during the “off-season.”

While athletes may experience short-term gains, research shows that athletes who play multiple sports often have better overall athletic ability and are less likely to get overuse injuries. The NATA has also put together 6 tips to help reduce specialization-related injuries.

Our physical therapists are driven to help athletes young and old, prevent injury, and stay in their sport. call or schedule an appointment for more information about our sports injury prevention and recovery programs.

Backpack Safety 101

August 9, 2023 contentadmin - Back, Blog, Pediatrics

With summer coming to an end and the need for school supplies and backpacks returning, here are a few tips to keep in mind when shopping with your child. Continue below for back pack safety tips to make sure your kids don’t have any unnecessary back pain this year.

Size

Should Not Extend Above Shoulders
Should Rest In Contour Of Low Back (Not Sag Down Toward Buttocks)
Should Sit Evenly In Middle Of Back

Fit

Shoulder Straps Should Rest Comfortably On Shoulders And Underarms, With Arms Free To Move – Tighten Shoulder Straps To Achieve This Fit
Tighten Hip And Waist Straps To Hold Pack Near Body
Padded Straps Help Even Pressure Over The Shoulders

Weight Of Pack

Should Never Exceed 15% Of The Child’s Weight To Avoid Excess Loads On The Spine

Lifting Of Pack

Proper Lifting Is Done By Bending The Knees, Squatting To Pack Level, And Keeping Pack Close To Body To Lift First To Waist Level And Then Up To Shoulders

Carrying The Pack

Keep Both Shoulder Straps In Place And Pack Centered
Spinal Forces Increase With Distance From The Body’s Center

Posture

Uneven Stresses On The Spine Can Cause Muscle Imbalances. This Can Lead To Pain And Possibly Functional Scoliosis.

If your child does start to complain of constant back pain, talk to your pediatrician and make sure that it isn’t a more serious issue such as scoliosis.

Scoliosis is a medical condition in which the spine is curved either front to back or side to side and is often rotated to one side or the other. It can occur at birth (congenitally), develop over time having no obvious cause, but often seen related to posture and growth (idiopathically) or due to an injury or the other condition (secondarily), such as cerebral palsy or muscular dystrophy. The most common type is adolescent idiopathic scoliosis. It usually develops between the ages of 10 and 15, during periods of rapid growth. There are two kinds of curves, single or “C” curves and double or “S” curves. “C” curves are slightly more common than “S” curves. The curve can occur in the upper back (thoracic), lower back (lumbar), or a combination of both.

Strength for necessary upright postures of daily life is essential. Sometimes it cannot be maintained due to a “growth spurt,” fatigue from daily postural demands or poor postural habits common among adolescents. A physical therapist can analyze a patient’s history, habits and activities which may be contributing to their curvature and symptoms. Common findings include tightness and decreased motion and strength in the hips and pelvis, causing the lumbar spine to compensate with side bending and rotation. Treatment will include muscular re-educating techniques and manual techniques to restore motion, posture training, specific strengthening and home exercises.

Post Concussion Recovery: Why Baseline Testing is Important

August 10, 2022 Teresa Stockton - Blog, Head, Pediatrics, Sports and Fitness

Concussions are serious

Medical providers may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, the effects of a concussion can be serious.

Once an athlete has been suspected of having a concussion… when is it safe to go back to play? The answer is different for everyone, but there are few baseline tests that medical professionals can administer to make sure that a gradual return to play, work and activity is safe and won’t lead to further damage.

When an athlete has a concussion, it’s important to know how much their functional and cognitive abilities have been affected. With a baseline test you give medical professionals an accurate starting point to correctly evaluate the impact of the injury.

FAQs about Concussion Baseline Testing

Concussion baseline testing is a pre-season exam conducted by a trained health care professional. Baseline tests are used to assess an athlete’s balance and brain function (including learning and memory skills, ability to pay attention or concentrate, and how quickly he or she thinks and solve problems), as well as for the presence of any concussion symptoms. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a health care professional during the season if an athlete has a suspected concussion.

Baseline testing generally takes place during the pre-season—ideally prior to the first practice. It is important to note that some baseline and concussion assessment tools are only suggested for use among athletes ages 10 years and older.

How is baseline testing information used if an athlete has a suspected concussion?

Results from baseline testing can be used if an athlete has a suspected concussion. Comparing post-injury test results to baseline test results can assist health care professionals in identifying the effects of the injury and making more informed return to school and play decisions.

Education should always be provided to athletes and parents if an athlete has a suspected concussion. This should include information on safely returning to school and play, tips to aid in recovery (such as rest), danger signs and when to seek immediate care, and how to help reduce an athlete’s risk for a future concussion.

What should be included as part of baseline testing?

Baseline testing should include a check for concussion symptoms, as well as balance and cognitive (such as concentration and memory) assessments. Computerized or paper-pencil neuropsychological tests may be included as a piece of an overall baseline test to assess an athlete’s concentration, memory, and reaction time.

During the baseline pre-season test, health care professionals should also assess for a prior history of concussion (including symptoms experienced and length of recovery from the injury). It is also important to record other medical conditions that could impact recovery after concussion, such as a history of migraines, depression, mood disorders, or anxiety, as well as learning disabilities and Attention-Deficit/Hyperactivity Disorder.

Baseline testing also provides an important opportunity to educate athletes and others about concussion and return to school and play protocol.

Who should administer baseline tests?

Baseline tests should only be conducted by a trained health care professional such as a physician, physical therapist or trained ATC.

Who should interpret baseline tests?

Only a trained health care professional with experience in concussion management should interpret the results of a baseline exam. When possible, ideally a neuropsychologist should interpret the computerized or paper-pencil neuropsychological test components of a baseline exam. Results of neuropsychological tests should not be used as a stand-alone diagnostic tool, but should serve as one component used by health care professionals to make a return to school and play decisions.

How often should an athlete undergo concussion baseline testing?

If baseline testing is used, research suggests that most components of baseline testing be repeated annually to establish a valid test result for comparison. Baseline computerized or paper-pencil neuropsychological tests may be repeated every 2 years. However, more frequent neuropsychological testing may be needed if an athlete has sustained a concussion or if the athlete has a medical condition that could affect the results of the test.

Many physical therapy clinics have therapists that have been trained in baseline testing software and techniques. Physical therapists can also specialize in return to sports programs for athletes that have experienced concussions. The decision of when you go back to your sport can be a critical one… especially if you go back to soon. Prevent this by having an accurate baseline available for your healthcare professionals.

Need Physical Therapy? Find a PT Near You!

more information can be found at http://www.cdc.gov/headsup/

Additional articles from PTandMe about concussions can be found here:

High School Sports Injuries

August 11, 2021 contentadmin - Blog, Pediatrics, Sports and Fitness

Every year, millions of teenagers participate in high school sports. An injury to a high school athlete and the pressure to play can lead to decisions that may lead to additional injury with long-term effects. High school sports injuries can cause problems that require surgery as an adult, and may lead to arthritis later in life.

When a sports injury occurs, it is important to quickly seek proper treatment. To ensure the best possible recovery, athletes, coaches, and parents must follow safe guidelines for returning to the game.

Teenage athletes are injured at about the same rate as professional athletes, but because high school athletes are often still growing they are more susceptible to muscle, tendon, and growth plate injuries.

Types of High School Sports Injuries

Injuries among young athletes fall into two basic categories: overuse injuries and acute injuries. Both types include injuries to the soft tissues (muscles and ligaments) and bones.

Acute Injuries
Acute injuries are caused by a sudden trauma. Examples of trauma include collisions with obstacles on the field or between players. Common acute injuries among young athletes include contusions (bruises), sprains (a partial or complete tear of a ligament), strains (a partial or complete tear of a muscle or tendon), and fractures.

Overuse Injuries
Not all injuries are caused by a single, sudden twist, fall, or collision. Overuse injuries occur gradually over time, when an athletic activity is repeated so often, parts of the body do not have enough time to heal between playing.

Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates. For example, overhand pitching in baseball can be associated with injuries to the elbow. Swimming is often associated with injuries to the shoulder. Gymnastics and cheerleading are two common activities associated with injuries to the wrist and elbow.

Stress fractures are another common overuse injury in young athletes. Bone is in a constant state of turnover—a process called remodeling. New bone develops and replaces older bone. If an athlete’s activity is too great, the breakdown of older bone occurs rapidly, and the body cannot make new bone fast enough to replace it. As a result, the bone is weakened and stress fractures can occur—most often in the shinbone and bones of the feet.

Concussion
Concussions are mild traumatic brain injuries. They are caused by a blow to the head or body that results in the brain moving rapidly back and forth inside the skull.

Although some sports have higher instances of concussion—such as football, ice hockey, and soccer—concussions can happen in any sport or recreational activity.

Growth Plate Injuries
Growth plates are areas of developing cartilage tissue near the ends of long bones. When a child becomes full-grown, the growth plates harden into solid bone.

Because growth plates are the last portion of bones to harden (ossify), they are vulnerable to fracture. Growth plates regulate and help determine the length and shape of adult bone, therefore, injuries to the growth plate can result in disturbances to bone growth and bone deformity.

Growth plate injuries occur most often in contact sports like football or basketball and in high impact sports like gymnastics.

Treatment

Treatment will depend upon the severity of the injury, and may include a combination of physical therapy, strengthening exercises, and bracing. More serious injuries may require surgery.

Return to Play

A player’s injury must be completely healed before he or she returns to sports activity.

In case of a joint problem, the player must have no pain, no swelling, full range of motion, and normal strength.
In case of concussion, the player must have no symptoms at rest or with exercise, and should be cleared by the appropriate medical provider.

Prevention
Many high school sports injuries can be prevented through proper conditioning, training, and equipment.

High school athletes require sport specific training to prevent injury. Many injuries can be prevented with regular conditioning that begins prior to the formal sports season. Injuries often occur when athletes suddenly increase the duration, intensity, or frequency of their activity. Young athletes who are out of shape at the start of the season should gradually increase activity levels and slowly build back up to a higher fitness level.

Using proper technique for the position being played is also key to preventing injury. Proper equipment—from the right shoes to safety gear—is essential. In addition, injuries can be prevented when athletes understand and follow the rules of the game, and display good sportsmanship.

Information provided by American Academy of Orthopaedic Surgeons

How to Make an Ergonomic School Space at Home

August 19, 2020 Teresa Stockton - Blog, Pediatrics

Make an Ergonomically Friendly School Space

With many districts beginning the school year at home, we wanted to continue our back to school theme, and talk about how to set up an ergonomically friendly school space for your child.

The good news is that kids have the same needs as adults, just in smaller sizes. To make an ergonomic school space for your child, you will want to make sure their:

Feet are flat on the floor or resting a footrest
Wrists and hands don’t rest on sharp or hard edges
Chair offers back support
Computer screen is at or slightly below eye level
Mouse and keyboard are positioned at a 90-degree angle to the elbows and the shoulders are relaxed.

If your child is using a laptop for online learning it can be difficult to position both the screen and keyboard at the prime levels for your child. We recommend that parents use a stand-alone keyboard and mouse. Now you can lift the laptop onto a stand or books until the screen is eye level. Looking down for an extended period can lead to neck and back pain.

Breaks Between Classes:

Breaks between classes are a great time to get your kids moving! Kids need about an hour of physical activity each day. To help with this, we have put together a list of physical activity recommendations. We have ideas for students from elementary through high school, so make sure to check it out and have fun with it!

Start the school year off right by taking advantage of our tips on how to make an ergonomic school space for your child. If you or your child begin to experience pain while working from home or participating in online learning, we have a talented group of physical therapists throughout the country that can help you get rid of pain and make sure your home setup is working for your family.

How to Handle a Concussion in Youth Hockey

December 18, 2019 Teresa Stockton - Blog, Head, Pediatrics

Youth hockey is very much a contact sport so it’s no surprise that concussion is a particular problem that arises quite regularly. It’s a real concern though because while concussion can be quite a mild injury, it can also be serious but it’s difficult to detect the severity of it without medical intervention. The problem arises, especially in youth hockey circles when players don’t report their concussion injury specifically for fear they will lose out on the remainder of a game or any future games. Of course, that is incredibly naïve, but you’re dealing with young people who aren’t mature enough to understand the complexities and possible dangers of the injury.

In youth hockey, the players are exuberant and excited about every moment they get on the ice. If they receive a blow to the head, generally their aim is to bounce back as quickly as possible. However, a concussion in youth hockey can be debilitating and crucially, it requires firstly medical attention and then it requires a huge degree of rest in order to help the recovery. The victim also should be monitored at the early stages by a parent. Education is required also by coaches to make players understand how to avoid or prevent concussion through their skills in the game.

The guys at Tucker Hockey have created this comprehensive infographic below that covers everything you need to know about concussion specific to youth hockey, although the elements are transferable to youth players in any sport. It explains some interesting concussion-related statistics; it outlines the symptoms of a concussion; it details how players, coaches, and parents should react to an instance of concussion and it also looks at recovery from the injury plus lots more. Check out the full graphic below!

If a child experiences a concussion and struggles with recovery, physical therapy can help. Physical therapists that have return-to-play programs are able to guide patients through a stepwise protocol. This helps athletes remain symptom-free and to prevent serious conditions associated with a second head injury due to early return to sport.

PT News November 2019

November 27, 2019 Teresa Stockton - Aging, Blog, Pediatrics, PT News, Sports and Fitness

This time in PT News we recap what our clinics have been posting throughout November 2019. We are excited to begin a new year of new posts featuring published articles from PTandMe partnering clinics!

1. Low Back Pain – A Powerful Guide

Written by Wright Physical Therapy with multiple locations throughout the heart of the Magic Valley, Boise and Eastern Idaho.

Daily, we see patients who are concerned about the course they should take to heal their back pain. Our aim with these individuals is to utilize a skilled classification system and evidence-based treatments to aid in identification and treatment of Low Back Pain (LBP). Read more

2. Prevent Low Back Pain While Shoveling Snow

Written by Rehab Associates of Central Virginia, an outpatient physical therapy practice with multiple locations throughout Central VA.

As I was shoveling the snow off my driveway this week, I quickly realized that I needed to adjust my technique or I was going to pay for it later. Injury can result from repetitive movements with a general lack of awareness and variability in movement and may be prevented with some easy steps. Read more

3. Relieving Your Pain the Natural Way – Physical Therapy as the Safer Relief Alternative

Written by Cornerstone Physical Therapy an outpatient physical therapy practice with locations throughout Greater Columbus, OH.

It is no secret that the United States is a country with very high levels of medication. It is also a common practice for physicians to prescribe heavier pain relievers, such as the opioids that have resulted in a country-wide epidemic. While the effects of these drugs can be frightening, there is a safer solution available: physical therapy. Read more

Find these locations and others to start feeling better today!

PT News October 2019

October 30, 2019 Teresa Stockton - Aging, Blog, Pediatrics, Sports and Fitness

This time in PT News we recap what our clinics have been posting throughout October 2019. We are excited to begin a new year of new posts featuring published articles from PTandMe partnering clinics!

1. Sports Specialization Vs. Sports Diversification in Youth Athletes

Written by The Center for Physical Rehabilitation with multiple locations throughout greater Grand Rapids.

Early specialization in one sport has become a trend in youth athletes across the country. This shift is one that has young athletes training year round to develop a specialized skill be able to play at the highest level of competition. Read more

2. Food is Your Fuel

Written by Rebound Physical Therapy, an outpatient physical therapy practice with locations throughout greater Bend, OR.

Truth: we are not nutritionists. That said, after a bit of trial and error and working with patients and various health professionals, we have picked up on these and common do’s and dont’s. Lindsey Hagen, PT, and healthy running nut discusses the importance of balance in your diet and making sure you do what is best for your body, as they say, “You do you…” Read more

3. Climbing Stairs – One Step at a Time

Written by The Jackson Clinics an outpatient physical therapy practice with locations across Kansas, Missouri, and Iowa

Although going up the stairs may feel challenging, some people experience more pain going down. This is because your muscles have to work hard to control your weight as you descend. If you have suffered from knee problems in the past or continue to have problems, it is probably time to look at increasing strength to make navigating stairs less difficult. Read more

Find these locations and others to start feeling better today!

PT News September 2018

September 26, 2018 Teresa Stockton - Blog, Pediatrics, PT News, Shoulder

This September in PT News. Featuring published articles from PTandMe partnering clinics!

1. Childhood Arthritis and How Physical Therapy Can Help
Written by Cornerstone Physical Therapy with 5 physical therapy locations in Ohio.

Juvenile arthritis (JA) isn’t a specific disease, but an inflammatory and autoimmune condition in youngsters under age 16. JA affects approximately 300,000 children just in the U.S. and it’s classified within seven different types, depending upon a range of symptoms and coconditions. Read more

2. Hands-on physical therapy effective for common shoulder conditions
Written by the Therapy Team at Rehab Associates with physical therapy locations throughout Central, VA.

Shoulder problems are one of the more common issues that affect the musculoskeletal system, as its prevalence in the general population has been reported as high as 4.8%. The most common shoulder condition that causes pain is shoulder impingement syndrome (SIS), which often results from too much overhead activity. Read more

3. Tummy Time Positions
Written by the Therapy Team at The Center for Physical Rehabilitation (CPR) in Grand Rapids, MI and the surrounding communities.

The American Academy of Pediatrics recommends that babies are placed on their backs for sleeping and on their tummies for supervised play time as part of their daily routine. So many of our carriers, including car seats, car seat stroller combos, bouncers and swings put our kids into a supine (aka, on their backs) position and make it more challenging to incorporate tummy time into your day. Read more

Treating Childhood Obesity With Activity

October 5, 2017 Teresa Stockton - Blog, Pediatrics

When talk focuses on childhood obesity in the United States, words like “critical” and “epidemic” are often used. The tried-and-true prescription of more exercise and better nutrition still holds true, but overweight children face unique challenges when it comes to weight loss.

Why Has Childhood Obesity Increased and What Are the Effects?
The statistics are disturbing. Not only are the overall obesity rates increasing, the heaviest kids are heavier than they were 30 years ago. Why is this happening? Experts who have studied childhood obesity attribute it to a change in lifestyle. The active lifestyle of the past—walking to school, playing outside, and engaging in after-school activities—has been replaced by a sedentary lifestyle of watching TV, playing video games, and using electronic devices like phones, computers, and tablets. Eating habits have changed noticeably, with convenience foods that are higher in fat and calories replacing fruits and vegetables.

The consequences of obesity are significant. A child who is obese may develop high blood pressure, high cholesterol, and type 2 diabetes. These conditions can increase the risk of cardiovascular disease such as a heart attack and stroke. In addition, older teens who are obese may have an increased risk of death during adulthood.

Obesity can also affect emotional health. A child who is obese may have emotional problems in school, and struggle with low self-esteem and depression.

What Is One of the Best Solutions?
Exercise is one of the main tools to fight childhood obesity. The US Department of Health and Human Services encourages children of all ages to be physically active. If your child is overweight, obese, or even of normal weight, recommendations to improve your child’s health include:

Encouraging your young child (aged 1-4 years old) to actively play daily in a safe environment
Encouraging your older child (aged 5 years and up) to participate in moderate to vigorous activity every day—Your child should aim for at least one hour per day of moderate to vigorous activity. At least 3 days out of the week should be vigorous activity.

Since children often engage in shorter bursts of activity throughout the day, it is okay to count these times as exercise.

Examples of different types of physical activity include:

Moderate-intensity: Brisk walking, hiking, skateboarding, baseball, rollerblading, and bike riding
Vigorous-intensity: Jumping rope, running, and playing sports like basketball, hockey or tennis

The main difference between moderate- and vigorous-intensity exercises is the demand on the body. Vigorous activities force the body to work harder. The heart beats faster and breathing becomes more rapid, but energy is used up faster.

Rollerblading
Learning karate
Playing organized sports (field hockey, soccer, football)
Swimming
Gymnastics
Strength training with weights
Rock climbing
Cross-country skiing

Before your child jumps into a new fitness routine, it is important that you work with your child’s doctor. Being obese can put a strain on muscles and bones, possibly causing back pain and foot or ankle problems. The doctor can assess your child’s overall health and recommend safe exercises.

What Else Can Be Done to Encourage Activity?
Another important piece to the puzzle is to focus on screen time. Screen time refers to how many hours per day your child spends in front of a screen—whether it be watching TV, playing video games, or using electronic devices. These are sedentary activities that contribute to obesity. The NHLBI recommends that screen time should be limited to less than 2 hours per day, which leaves more time for exercise. You can further encourage your child to be active by planning family outings, like going on a hike, riding bikes, or playing flag football. That way, the whole family can become healthier together.

by Patricia Kellicker, BSN and Rebecca J. Stahl, MA

RESOURCES:
American Council on Exercise
http://www.acefitness.org

Shape Up America
http://www.shapeupus.org

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Healthy Alberta
http://www.healthyalberta.com

REFERENCES:
Aerobic, muscle, and bone-strengthening: What counts? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/what_counts.htm. Updated June 5, 2015. Accessed March 2, 2016.

Chapter 3: Active children and adolescents. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/chapter3.aspx. Accessed March 2, 2016.

How much physical activity do children need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/basics/children/index.htm. Updated June 4, 2015. Accessed March 2, 2016.

Krul M, van der Wouden JC, Schellevis FG, van Suijlekom-Smit LW, Koes BW. Musculoskeletal problems in overweight and obese children. Ann Fam Med. 2009;7(4):352-356.

NCHBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 12, 2013. Accessed March 2, 2016.

Obesity in children and adolescents. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 10, 2016. Accessed March 2, 2016.

Last reviewed March 2016 by Michael Woods, MD Last Updated: 3/2/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.