Contact us

Make an appointment

our specialists


  01 40 79 40 36






Sports Clinic

36 bd St Marcel

75005 PARIS

Sports clinic Paris

Metro: Saint Marcel

Parking 6 rue test


'Pages chirurgiedusport :


Ce site respecte les principes de la charte HONcode de HON Ce site respecte les principes de la charte HONcode.
Site certifié en partenariat avec la Haute Autorité de Santé (HAS).
Check here


Youtube video

Docteur GEROMETTA Antoine - Retour au sp ...

Monsieur Olivier HOMAGE - Chaussage et s ...

Docteur Nicolas LEFEVRE - LCA de l’enf ...

Docteur BOHU Yoann - 1ère luxation d’ ...

Surgical management 's knee osteoar ...

Ligamentoplastie du ligament croisé an ...

TKA MyKnee PTG Dr. Nicolas Lefevre

Cracked meniscus bucket handle dislocate ...

Arthroscopic knee surgery for fracture o ...

Total knee replacement (TKR), descriptio ...

DIDT TLS: surgery of the anterior crucia ...

Surgery sport, hamstring: surgery of the ...

Zapping meniscus

Combing the patellar tendon under arthro ...

Surgery sport, PIP Prevention of knee in ...

bucket handle meniscal 3D movie

Suture of the lateral meniscus injury ra ...

partial tear of the anterior cruciate li ...

Levy for the hamstring ACL reconstructio ...

partial ACL tear, technical anatomical r ...

Complete rupture hamstring tendon repair ...

Surgery sport, endoscopic treatment of c ...

compartment syndrome 's efforts

Rupture du tendon d'achille chirurgie du ...

greffe de me?nisque Dr Alain myer Dr Yoa ...

Docteur Nicolas LEFEVRE - LCA de l’enf ...

Monsieur Olivier HOMAGE - Chaussage et s ...

Docteur GEROMETTA Antoine - Retour au sp ...

Stops against abusive sports-indications!

Print Article

Some physical characteristics or child's health concerns are too often subject to abuses against-indications sports. Scoliosis, the ball joint pain, asthma, "heart murmur" or obesity are characteristic examples. Often, these problems do not affect the performance. More rarely, the sporting performance is not as good as the physical effort draws on a somewhat faulty function of the body. But in these circumstances, sport manages to cause the body to compensate, rehabilitates see corrects his disability. So detect these features proves essential. In most cases, we can reassure parents and the child and encourage all forms of physical activity. Often it is good to give some tips to help choose the discipline or to modulate its practice. More rarely, parallel to the sport, a dietary monitoring, medical or physiotherapy treatment should be initiated. So these children can enjoy all the benefits of exercise: they train their heart, they denser bones, they strengthen their back, they grind their joints and burn calories. They enjoy move and grow with their friends. Sometimes, during competitions, they say in the success. Better yet, these sports "special" treat themselves through physical activity or find that they are like any other.
Scoliosis and scoliotic deviation
In case of spinal scoliosis tilts, latch and turns like a spiral. On the contrary, scoliosis is a lateral deviation. The latter does not require any treatment. It allows all sports especially when compensating for a length discrepancy of lower limbs less than 1.5 centimeters. However, scoliosis deserves an annual or biannual monitoring especially in puberty. When it is below 13 °, sport is the therapeutic one. We must not confine children to swimming and "Expansion sports" like basketball or volleyball. Even in disciplines like tennis rotation proved beneficial. Only judo is to practice moderation because it causes falls and needed to wear his opponents asymmetrically. When scoliosis is between 13 and 25 °, the sport is associated with a targeted rehabilitation. Both physical activities help maintain good flexibility of the spine and chest, strengthen and improve the coordination of the muscles along the spine. The sports teacher takes care to integrate its meeting some specific exercises while avoiding the pain in the vicinity of the vertebrae. It Unfortunately, exercise is not intended to limit the development of scoliosis. In case of rapid deterioration or above 25 ° angulation, expert advice is essential as wearing a corset is possible. The latter may be removed during sports leisure practices that are beneficial.
The joints pain
In front of the knee, the patella slides in a corridor dug bone in the femur. When rubs or bumps during its journey, it becomes painful. During childhood, physical activity contributes to the formation of this joint; the contraction of the muscle of the thigh mold a deeper groove. So the ball is better fitted and its path is more harmonious. At puberty in young girls, ligaments gaining flexibility and hips widen. The patella is less well maintained and slides out of its bony corridor. The sport improves strength, endurance and muscle coordination guiding the ball. The educator strives to offer physical activity does not cause pain. It avoids the knee or squatting positions and proscribed walking duck. It does not propose imposing prolonged exercise posture maintaining flexion such as cracks and "chair". It directs the child to crawl rather than breaststroke. He advises cycling in reeling in small gears.
Asthma causes a restriction of the bronchial tubes that gene expiration. Sport sometimes favors the occurrence of crises by increasing the flow of air that irritates, cools and dries the airways. This phenomenon readily occurs at the end of intense and continuous effort, when the air is cold, dry, polluted or holders of allergenic substances. The teacher offers rather intermittent activities such as tennis or team sports. During endurance activities, check that the child remains below the threshold of breathlessness. If climate-risk conditions, it may occasionally exempt the child. Medical treatment is often proposed. The educator ensures the proper medical supervision and administration of the spray before the meeting. In these conditions sport is a true respiratory rehabilitation that help decrease her medication. Under the supervision of the teacher, the child tries to breathe through the nose maximum to warm the air entering the lungs. He learns to breathe slowly to avoid crushing the small bronchi. The warm up should be very gradual and discontinuous. Indeed, stopping the effort sometimes causes a small crisis followed by a period without crisis called "refractory period". We take this moment to make the workout. In practice, after 5 minutes of trotting, the educator program 2 to 3 sets of 30 second accelerations followed by 1 to 2 minutes of passive recovery. Swimming in a weakly chlorinated water proves ideal because the air is hot and humid and our young athlete learns to blow against resistance. However, diving is strictly against inappropriate. In a crisis occurring in depth, the lungs of air distendrait prisoner during ascent and cause extremely serious alveolar lesions.
The heart murmur
A harmless breath is seen during cardiac auscultation in 70% of children. Indeed, the ejection of blood by a strong heart through narrow vessels still causes some audible turbulence. A pathological breath is also understood in cases of rare heart defects. This may be either a blockage of the discharge orifice of the heart or of a leak by malformation of the valves separating the chambers of the heart. We must discuss these hypotheses when the breath is not changed when the child breathes or changes position and especially when it is associated with palpitations, discomfort or loss of consciousness. When in doubt, an ultrasound enables precise analysis of the morphology of the heart. If the breath is harmless, the heart muscle is completely healthy, there is no restriction sports! The educator takes care to reassure the child! If it sometimes perceives a "breath," the teacher reminds him that this is a natural phenomenon in an intense training unrelated to its "breath" in the heart.

Doctor Stéphane CASCUA. - 4 mars 2011.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.


Read also ...

The most read articles

The Iroman lack of iron, the other sports too!

Doctor Stéphane CASCUA.

Iron is essential to your health and performance. It is a central component of hemoglobin. The latter is contained in red blood cells and gives it color. It is the iron that captures oxygen when blood passes through the lungs. It carries the precious gas to muscles. When they arrived, it drops its cargo which then allows the burning of energy substances and muscle contraction.

When you run or when you jump, your heels hit the ground and the fat pad of the foot of the plant is crushed. It is through many blood vessels. These red blood cells burst and release their hemoglobin. Iron is released into the blood and pass into urine.

Muscle contains a twin sister of hemoglobin, myoglobin. The latter also contains a lot of iron which sets some oxygen. This small local reserve allows starting the contraction before the blood vessels do not provide the necessary complement. When you experience aches, your muscle membranes are victims of micro-fissures. Myoglobin and iron leaves the muscle and gaining the blood. The precious metal is eliminated in the urine.

When you make an effort, the majority of blood flow is directed towards your muscles. There remains very little to the digestive tract and the bladder wall. These organs suffer from lack of oxygen and are shaken with every stride. Small areas are damaged and start to bleed. Red blood cells and iron are lost in the feces and in urine.

You enter the assiduous why athletes often lack iron, especially if they do not take care to concoct "menus and recipes" adapted. Sports are even more concerned since all these iron losses are added the massive elimination of blood during menstruation!

That is why it is good to occasionally perform a blood test to assess the stock in body iron. This levy is necessary when it comes to review a state of fatigue. It unnecessary to dose iron in the blood because the body is able to keep within the limits of normal while the reserves are at their lowest! It is necessary to measure levels of "serum ferritin" because this structure is the storage form of iron.

The bone is strengthened or crack in contact sports

Doctor Stéphane CASCUA.

Each sports movement constitutes a solicitation for the bone structure. At each reception process, the tibia runner undergoes vibratory impacts. Unrolling not, the hiker twists slightly small bone in his foot. Even the body-builders, powerfully contracting its muscles, pulls on his bone.

Each strain injures a little bone of sports. Fortunately, during the rest period, the bone trying to rebuild. If time allows, if they bring him the necessary food, it is repaired! It reconstructs even louder than before as if to prepare for new mechanical attacks. This phenomenon is called by coaches cycle decompensation / overcompensation. This process has been described in many body organs and functions: muscle, stock energy, hormones, etc. It is a key driver of growth.

Thus, it was shown that the well-trained marathoner had stronger bones than sedentary. Indeed, its more dense bone structure, higher in fiber and calcium. In addition, the microscopic architecture of the bone is perfectly oriented along the axis of mechanical stresses.

Indeed, the chemical structure of the bone is comparable to reinforced concrete. The protein network is the steel rods. Calcium is comparable to concrete mired these metal axes. At the hip and pelvis direction of the bone structure is very characteristic. On a radiograph, it is found that the fibers leave the femur, the thigh bone, tilt in, come from hip to withstand the weight of the body resting on the hips. The lines of force from the right leg and left leg meet in the middle of the basin and support each other in the manner of the nave of a church.

Physical activity associated with a sufficiently high protein diet, vitamin D and calcium is a great engine of bone construction. This cocktail is particularly useful to hinge periods of life. During growth, it is necessary to eat 4-5 dairy products every day to build strong bones. It should also move: it is essential to practice a sport requiring the running and jumping at least 3 times a week for 30 minutes. In the absence of impact, bones harden less. It has been shown that a young competitive swimmer had lower bone density than sedentary because he was deprived of gravity during those long hours of pool training. In addition, bone densification stops 25 years. At this age you have made up your bone capital for life!

In adulthood, sport reinforces very hard bone and the amount of calcium necessary for the maintenance of bone is still debated. In case of fracture, the rest of the broken area needed a few weeks to allow to "ensnare" the broken area. In addition, gradually increasing mechanical stress are indispensable to "mechanize" the callus. Again, they help to guide the fabric of the bone in the center of the constraints to prepare him for his mission. An increase in calcium intake in consolidation period is proposed by some doctors without that interest has been really shown.

After menopause, the bone structure is gradually degraded to make the brittle bones is osteoporosis. Ladies, remember, your resistance to hip fracture depends on your diet and your sport for 25 years! If physical activity after menopause can no longer denser bones, reduces the loss of bone tissue. So it is advisable to go see jumping around or jog. It is also good to make the soft gym to maintain bone strength to strength. To make the most of this stimulation, it is again necessary to take 4-5 dairy products daily. It should also go out every day to enjoy the sun and make the vitamin D essential for the absorption and calcium binding. Fresh coordinating sports such as Thai Chi or "balance workshops" have proven effective in reducing the risk of falls and fractures.

If the sporting activity is excessive, the micro-cracks caused by impacts on the bones fail to consolidate over the rest. Rather, these lesions worsen in the next workout. Finally the splits right through bone, it breaks without any violent trauma. It is the stress fracture. In a postmenopausal woman, it was demonstrated that 6 hours of sport load per week may be sufficient to break insidiously bones. Among younger adults, this type of injury is favored by dietary deficiencies and hormonal disorders. Lack of calcium, vitamin D and protein alters the rebuild bone victim of microcracks in the exercise. Insufficiency sex hormones reduces the stimulation microscopic chemical plants be responsible for the synthesis of bone tissue. Functional changes occur when the deep depletion of the body. That kind of burnout is most often diagnosed in women because it causes menstrual irregularities and a cessation of menses. The victim is found in a state of "early menopause". In humans this hormone suffering is more insidious but it exists and its effects on bone density are comparable. The sports overwork cocktail, dietary deficiencies and disappearance of rules typically found in young women anorexic. Faced with a stress fracture, the sports physician must remain vigilant. It should not simply treat a "bone". It has an obligation to support a whole person, he is responsible for seeking overtraining or behavioral disorders.

Technical cruciate ligament

By Dr. Nicolas Lefevre

More videos

Last publications

Feature: knee prosthesis

total knee replacement

Feature: knee ligaments

Dossier: Ambulatory Surgery ACL

Dossier: meniscus


Feature: Shoulder sportsman

Folder: hip prosthesis

Dossier: break hamstring

Dr. Lefevre proximal anatomie_ischio_jambier_rupture chirurgiedusport

Dossier: prosthetic and sports

hip replacement and knee and sports

Dossier: PRP

Chirurgiedusport - Who are we - Contact us - Legal Notice - Web design Digitaline - EMC2 Studio development - Clinique du Sport