The Sports Medicine and Performance Center at Children’s Hospital of Philadelphia is proud to celebrate 25 years of providing game-changing care for children and adolescents. Founded in 1999, the Center was the first in the region to offer dedicated sports injury programs for youth at all levels of activity – from casual recreational sports to elite athlete training. Since then, the Center has grown ten-fold, now offering surgical and non-surgical treatment, sports-specific wellness assessments, conditioning and nutrition – all focused on the unique needs of youth athletes and their families.
Three leaders from the Sports Medicine and Performance Center recently sat down to discuss how youth athletes, their injuries and treatments have evolved; the importance of physical therapy and mental health resources in recovery; and the many ways CHOP is helping kids, teens and young adults recover from injuries and return to the sports they love.
Participating were (pictured left to right):
- Theodore “Ted” J. Ganley, MD, founder and current Director of the Sports Medicine and Performance Center, who’s been at CHOP since 1997
- Naomi Brown, MD, FAAP, CAQSM, a Pediatric Sports Medicine Specialist and Director of Primary Care Sports Medicine, who’s been an attending physician at CHOP since 2013 and was a resident from 2006-2009
- Jeffrey Albaugh, PT, MS, ATC, Physical Therapy Supervisor with the Sports Medicine and Performance Center and Orthopedic Center, who’s been at CHOP since 2002
Why was CHOP’s Sports Medicine and Performance Center founded and how has its mission evolved in 25 years?
Dr. Ganley: The Center was founded with the notion that youth athletes are different than adult athletes and that we could address their unique needs. In the late 1990s, no program really existed that combined everything – sports medicine, sports surgery, physical therapy and athletic trainers – under one roof to support the youth athlete. CHOP leadership was instrumental in helping make our vision possible to create a formal sports medicine program dedicated exclusively to meeting the unique needs of children and adolescents who were still growing.
Albaugh: One of the first things CHOP did was develop protocols specific to pediatric rehabilitation and build our clinical excellence. We conducted research and developed procedures specifically geared to the pediatric and adolescent population. Dr. Ganley was one of the pioneers in developing physeal-sparing ACL reconstruction [to replace a torn ACL while minimizing damage to the physeal, also known as the growth plate].
Dr. Brown: The Center has grown tremendously – from two sports surgeons and one physical therapist when we started, to five sports medicine surgeons, eight sports medicine pediatricians and 25+ sports physical therapists. Today, we offer patients a complete range of surgical and nonsurgical treatments, as well as injury prevention support.
Compare today’s youth athlete to a typical youth athlete from 25 years ago.
Dr. Brown: Twenty-five years ago, I was that youth athlete. Back then, youth athletes played one sport a season and multiple sports a year. Today, the focus has shifted to performance athletes who are specializing at a younger age and performing at a higher level. There’s a focus on pushing the level of athleticism to maximize performance. About one in four youth athletes are now specializing in one sport year-round. The focus is less about fun and fitness, and more about training and performance.
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The Sports Medicine and Performance Center at Children’s Hospital of Philadelphia is proud to celebrate 25 years of providing game-changing care for children and adolescents. Founded in 1999, the Center was the first in the region to offer dedicated sports injury programs for youth at all levels of activity – from casual recreational sports to elite athlete training. Since then, the Center has grown ten-fold, now offering surgical and non-surgical treatment, sports-specific wellness assessments, conditioning and nutrition – all focused on the unique needs of youth athletes and their families.
Three leaders from the Sports Medicine and Performance Center recently sat down to discuss how youth athletes, their injuries and treatments have evolved; the importance of physical therapy and mental health resources in recovery; and the many ways CHOP is helping kids, teens and young adults recover from injuries and return to the sports they love.
Participating were (pictured left to right):
- Theodore “Ted” J. Ganley, MD, founder and current Director of the Sports Medicine and Performance Center, who’s been at CHOP since 1997
- Naomi Brown, MD, FAAP, CAQSM, a Pediatric Sports Medicine Specialist and Director of Primary Care Sports Medicine, who’s been an attending physician at CHOP since 2013 and was a resident from 2006-2009
- Jeffrey Albaugh, PT, MS, ATC, Physical Therapy Supervisor with the Sports Medicine and Performance Center and Orthopedic Center, who’s been at CHOP since 2002
Why was CHOP’s Sports Medicine and Performance Center founded and how has its mission evolved in 25 years?
Dr. Ganley: The Center was founded with the notion that youth athletes are different than adult athletes and that we could address their unique needs. In the late 1990s, no program really existed that combined everything – sports medicine, sports surgery, physical therapy and athletic trainers – under one roof to support the youth athlete. CHOP leadership was instrumental in helping make our vision possible to create a formal sports medicine program dedicated exclusively to meeting the unique needs of children and adolescents who were still growing.
Albaugh: One of the first things CHOP did was develop protocols specific to pediatric rehabilitation and build our clinical excellence. We conducted research and developed procedures specifically geared to the pediatric and adolescent population. Dr. Ganley was one of the pioneers in developing physeal-sparing ACL reconstruction [to replace a torn ACL while minimizing damage to the physeal, also known as the growth plate].
Dr. Brown: The Center has grown tremendously – from two sports surgeons and one physical therapist when we started, to five sports medicine surgeons, eight sports medicine pediatricians and 25+ sports physical therapists. Today, we offer patients a complete range of surgical and nonsurgical treatments, as well as injury prevention support.
Compare today’s youth athlete to a typical youth athlete from 25 years ago.
Dr. Brown: Twenty-five years ago, I was that youth athlete. Back then, youth athletes played one sport a season and multiple sports a year. Today, the focus has shifted to performance athletes who are specializing at a younger age and performing at a higher level. There’s a focus on pushing the level of athleticism to maximize performance. About one in four youth athletes are now specializing in one sport year-round. The focus is less about fun and fitness, and more about training and performance.
Every generation gets a little bigger, a little faster and a little stronger. Nutrition has improved for many families and kids are getting more protein in their diets. The number of hours participating in sports has increased and so has early specialization.
What are the most common sports injuries among youth athletes today and how has that changed?
Dr. Ganley: As imaging and diagnostics have improved, so has our ability to better understand a child’s injury and plan better treatments. Every few years we learn more from studies that help us better understand pediatric injuries, refine treatments and improve prevention efforts. I credit Jeff [Albaugh] with a phenomenal job with the Ready. Set. Prevent. lower extremity injury prevention initiative that better prepares athletes for play; and Naomi [Brown] for her work with our Dance Medicine Program. As our Center grows, we continue to customize services to offer more dedicated clinics to youth athletes and their families.
Dr. Brown: There has been an increase in youth playing sports over the last 25 years, especially females. More than 60 million U.S. children aged 6-18 participate in organized sports each year – affecting nearly three out of every four families. Nearly 50% of all injuries sustained by middle and high school students during sports are due to overuse injuries like strains, sprains, fractures and torn ligaments. The rate of sports injuries is greatest among youth participating in football, girls’ soccer and boys’ wrestling.
How has diagnosis and treatment of sports injuries changed for youth athletes?
Albaugh: Assessments and interventions have evolved over the years. The use of technology and video with assessments have allowed us to better identify impairments and address them more quickly. While manual techniques and physical exercise are still the primary ways that we address these injuries, we’re incorporating a lot more technology into our rehab plans of care now. We’ve created specialized programming for running medicine, dance medicine and gymnastics to address the needs for these specific types of athletes – not just to treat their injuries, but to teach them how to prevent future injuries.
Dr. Brown: We have many more resources available today. We are now using bedside ultrasound, as well as ultrasound-guided injections, biologics, novel bracing and orthotics. We have better physical therapy services and non-operative techniques we can employ before considering surgery.
Dr. Ganley: Because of better knowledge and better diagnostics, there are some conditions where we’re performing fewer surgeries today. In part, that’s because kids have an ability to heal in ways that adults can’t. With excellent rehabilitation support at CHOP, we have been able to minimize surgical intervention in many instances. Sports medicine is rehabilitative medicine: Our team is not just working to get kids stronger physically, but mentally and emotionally as well.
How has the evolution from multi-sport athlete to year-round, single-sport athlete changed the type, scope and severity of injuries sustained?
Dr. Brown: We’re seeing a higher amount of bone stress injuries and overuse injuries due to the sports-specialized athlete. Overuse injuries include things like Little League shoulder, Little League elbow, stress fractures and gymnast’s wrist. We’re also seeing an increase in ACL injuries and diagnosing more concussions in our practice today. This is due to a variety of factors including better diagnostic skills and more recognition of these types of injuries. Parents and athletes are seeking medical help sooner after injuries.
What is CHOP doing to improve outcomes for youth athletes?
Dr. Ganley: Patient-reported outcomes were something that didn’t really exist 25 years ago, but it’s something we pioneered at CHOP. Today, we survey patients before and after treatment to ask them how they are feeling, how successful their treatments were, and what additional resources we can offer to help. We collaborate with mental health colleagues to build patients’ grit, so they become stronger physically and emotionally after their injury.
Dr. Brown: We’ve improved access to care, with sports physicians seeing patients at 8 locations throughout the region, allowing us to evaluate and treat patients sooner. We provide guidance on proper treatment – which may include a range of non-surgical options such as advanced imaging, physical therapy or surgical referral – and follow-up care. Physical therapy has had a tremendously positive impact on patient outcomes.
Albaugh: On the physical therapy side, we focus a lot on prevention: Learning how the injury occurred and why. Teaching youth athletes active conditioning exercises to stretch and strengthen can decrease their chance of reinjury. And teaching them ways to improve their overall athleticism.
What role does mental health have in sports medicine care and treatment?
Dr. Brown: We have a lot more candid conversations about mental health today and how an injury may affect not just an athlete’s physical body, but also their mental health. With the addition of Mary Daley, MD, FAAP, CAQSM, who’s board-certified in psychiatry, adolescent psychiatry, pediatrics and sports medicine, we are able to improve our research on mental health and youth athletes.
Albaugh: A lot of kids are identified by the sports they play; that’s where many get their friend groups. And when they are injured and can’t play, that can have a significant impact on their mental health. We’ve seen that across the board, and it’s become a much larger component coming out of the COVID-19 pandemic.
Dr. Ganley: We have more conversations with patients and family. We continue to assess patients, review the latest research and practice guidelines, then we present options for treatment. Patients (and their families) have a much larger voice today and share in all decisions about their care.
How do you believe sports medicine care and treatment will change over the next 25 years?
Albaugh: We’ve seen so much change in the past 25 years – especially when it comes to girls’ and women’s sports. Today, girls are doing the exact same training as boys, have the exact same exposures and by adding new sports like flag football, we’re seeing their risk of injury equaling and sometimes surpassing their male counterparts.
Dr. Brown: Technology is evolving quickly and we’re learning how best to use it. Gait and motion analysis helps us pinpoint injury etiology, allowing us to improve prevention efforts and decrease overuse injuries.
Dr. Ganley: The principles of sports medicine may remain fundamentally the same, but CHOP will continue to grow and expand to meet our patients’ needs. We will continue to analyze and pioneer treatments for youth athletes. And while machine learning and AI [artificial intelligence] will improve, we’re still going to need the very best sports medicine physicians and surgeons to make the best decisions for each individual patient. CHOP will continue to be leaders in both quality care and patient safety.
Why choose CHOP for sports medicine care
CHOP’s Sports Medicine and Performance Center is the region’s premier healthcare resource for youth athletes. We are nationally recognized for our surgical expertise and innovative treatments.
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