May 2018

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Editor Message


Parents: Friends or foes?

When it comes to taking care of young patients, parental buy- in to the practitioner’s advice and therapeutic plan can make the difference between a good outcome and a poor one. It takes good communication skills and time to educate parents so they understand the logic and, ideally, the scientific evidence, behind treatment decisions and clinical recommendations.

Yet, practitioners still struggle to make a connection with parents that will lead to good device adherence or enough time and effort spent on rehabilitation after an injury, for example.

Parent’s critical role in clubfoot outcomes is well understood, yet, as writer Katie Bell reports on page 6 in “Abbreviated brace-wear times in clubfoot patients bar best outcomes,” many still don’t stick with the bracing protocol over the long- term. Relapse and surgery are often the result.

Athletic trainers and coaches who work with young athletes know that sport specialization and high-volume training are important risk factors for overuse injuries and burnout. Conveying their concerns to parents, however, remains challenging.

The survey-based study Keith Loria reports on in this issue (See “Most youth coaches unaware of general sport-volume recs,” page 5) found that nearly three in four coaches had a high level of concern regarding parent behavior in youth sports and that roughly one-third reported feeling significant pressure from parents regarding their coaching decisions.

Communication, persuasion, and building alliances with parents probably come more easily to some practitioners than others, and LER: Pediatrics will cover pitfalls and tips for navigating the parent-provider relationship in an upcoming article.

Have you got a story to tell? Wisdom to share?

If you’ve developed strategies for getting past parental compliance barriers or tricky communication issues—or have learned from a difficult experience—I’d like to hear from you. Email me at

By Emily Delzell, Senior Editor


  • Most youth coaches unaware of general sport-volume recs

    Sports specialization guidelines need higher profile – Youth sport coaches are concerned about the increased risk of overuse injuries seen among young athletes who play a single sport year-round or otherwise train at high volume. Most are unaware, however, of sport-volume recommendations created to reduce these injuries…

    By Keith Loria

  • Brace-wear times for clubfoot patients still fall short

    Device wear critical to relapse prevention – The Ponseti method for managing idiopathic clubfoot deformity provides satisfactory results at intermediate follow-up, but the need for anterior tibial tendon transfer remains an important adjunctive treatment, according to research from the University of California, Los Angeles (UCLA).

    By Katie Bell

  • PE classes increase physical activity, reduce sedentary behavior

    Funding for these school programs in jeopardy – Attending physical education (PE) classes is associated with a higher level of physical activity (PA) and a lower level of sedentary behavior (SB) in and out of school in children from countries at various levels of development, according to a…

    By Katie Bell


  • Management of Joint Hypermobility

    Joint hypermobility, often discovered when clinicians evaluate kids for another lower extremity issue, can cause pain, fatigue, and other symptoms that lead children to avoid exercise and drop out of sports. Hypermobile joints can also increase risk for traumatic injuries and for adult musculoskeletal conditions such as osteoarthritis.

    By Keith Loria

  • Concussion and lower extremity injury

    As in adults, youth athletes who sustain a concussion increase their chances of experiencing a lower extremity injury, and the rise in risk can last for at least a year. Researchers are investigating the reasons underlying the connection, as well as trying to answer the crucial question: when is it safe for athletes to return to play?

    By Jill R. Dorson