Sports Injuries in Children

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There has been a very interesting reversal over several years of orthopaedic problems in children. About eighty percent of young athletes who are treated for orthopaedic problems are suffering from overuse injuries. Only twenty percent are seen for acute injuries such as fractures. Ten or twenty years ago it was just the opposite.

One of the problems could be the emphasis on organized team sports rather than neighborhood or sandlot sports activities. When children are playing with friends in the neighborhood they discontinue the activity when they get tired. When they are on a team they are afraid to quit when they are tired or hurt because they will disappoint their coaches, parents and teammates. An old saying in sports medicine is that horses never ran themselves to death until there was a rider on its back. It is well known that parents can push their children too hard for personal reasons such as fulfilling their own dreams or excessive pride in their children's accomplishments athletically.

Overuse injuries are not caused by a single even or injury, but a gradual accumulation of minor injuries or as it is sometimes called, micro trauma.

Children seem more vulnerable to overuse injuries than adults because of their immature skeleton containing multiple growth centers and the relative tightness of their ligaments and tendons as they are growing.

The most common overuse injuries in children are the following:

  1. Shin splints - This is a condition of the lower leg between the knee and the ankle seemingly caused by repetitive pounding or running which causes inflammation in tissues surrounding and between the bones of the lower leg.

  2. Runners Knee - Pain in the front of the knee caused by the patella tracking improperly out of the groove in which it normally slides.

  3. Little League Elbow - Injury to the growth center or epiphysis on the medial or inner side of the elbow caused by throwing activities.

  4. Shoulder Problems in Swimmers - Inflammation in the tendons on the front part of the shoulder caused by impingement or friction or pinching of the tissue under the bony aspect of the shoulder termed the acromion.

  5. Gymnastic Activities Causing Back Pain - Stress fractures can occur in the vertebra by the frequent forward and backward bending of the back also termed flexion and extension of the spine.
An additional reason for more overuse injuries at this time is an increase in the intensity and duration of training.

Overuse injuries can occur in any sport that involves intensive training, but some feel that the rate is probably higher in individual sports such as figure skating, gymnastics, dance, and swimming.

Certainly organized sports should not be discouraged nor should individual sports for that matter. There are many benefits to the young athlete from organized sports and a few risks.

We are trying to encourage physical activities in young people to prevent obesity in children and adolescents which appears to be spiraling out of control. The whole emphasis is to get sedentary children up and doing active things.

Athletic trainers and physical therapists believe strongly that any sport can be done safely with proper guidelines that are followed by coaches and athletes. Coaches and parents need to be educated regarding training related injuries.

A simple way to avoid overuse injuries seems to be to never increase the intensity, duration, frequency or distance by more than 10 percent per week.

We are often asked about what age and what type of weight training children can participate in. This will be the topic of a related article in the Online Orthopaedics Library.