By Andrew Getzin, MD
Over the past few decades, there has been an increase in the amount of sports training in which young children participate. They are playing quantities that approach those of older athletes. In addition, many children are specializing in one sport on year-round traveling teams. As a result, children are developing more injuries and at an earlier age.
Whether your child is active in different sports or is concentrating on one sport, it’s not uncommon to feel sore and achy after a game or a serious workout. Fortunately, kids are resilient and typically recover quickly. If your child is hurting a few days after an activity or is limping, a physician should see him or her. Your doctor can help to distinguish between a minor problem and one that needs ongoing medical attention.
It is helpful for parents to be aware of a few common problems of young athletes to know when to seek medical attention.
A stress fracture is an injury to a bone that occurs from repetitive actions that stress, but do not actually break, the bone. Humans continually absorb old bone and lay down new bone in a relatively even balance. When children are consistently working very hard, as they do during sports activity, their bodies may have a difficult time meeting the demand to lay down new bone. This imbalance can lead to small microscopic fractures that collectively constitute a stress fracture. With continued activity, a stress fracture can develop into a break in the bone.
In children, almost all stress fractures occur in the lower limbs or the back. The main symptom is pain. Children may also experience swelling, weakness, and a change in the way they walk or run. Treatment for a stress fracture depends on the location of the injury, but will typically include rest, physical therapy, appropriate modification of activity, and potentially splinting or casting. Some stress fractures may even require surgery, especially if they have not been identified and treated promptly.
Osgood-Schlatter disease is another type of injury primarily related to overuse. It is the most common form of a group of injuries collectively called apophysitis, in which growing children develop inflammation at the growth plate of their bones.
Osgood-Schlatter disease develops most often in children involved in jumping sports such as basketball and volleyball, particularly if they have just undergone a growth spurt. Children experience pain in the front of the knee where the patella tendon inserts into the shinbone or tibia initially with activity, but the pain can increase to be felt even at rest. Once properly diagnosed, Osgood-Schlatter disease can be treated with anti-inflammatories, icing, physical therapy, and activity modification. Left untreated, the young athlete will experience increasing pain.
Concussions are common injuries caused by trauma to the head and are most often experienced in contact sports. They may be ignored by children who want to resume play and are unaware of the potential long-term problems that can develop. Symptoms of concussions include headache, nausea or vomiting, dizziness, inability to concentrate, poor sleep, loss of appetite, and feeling disoriented. Treatment for a concussion is to cease participation in sports until the doctor clears your child for activity. Premature return to participation increases the risk of another concussion because the child’s balance is still impaired, as well as an uncommon but potentially fatal problem called second impact syndrome.
The risk for long-term problems after receiving one concussion is low. However, the damage of multiple concussions is cumulative. People can develop a problem called post-concussive syndrome, where they experience long-term symptoms similar to an acute concussion, resulting in difficulties with concentration and memory. In addition, recent studies have linked multiple concussions to an increased risk for depression.
Stress fractures, Osgood-Schlatter disease, and concussions are three of the most common sports injuries. If you have concerns about your child’s injuries, have your child examined by a doctor with knowledge about injuries and sports. You can also look for information on some of the more common sports-related injuries at the Web site of the American Academy of Pediatrics at www.aap.org or at www.physsportsmed.com.
Dr. Getzin is board certified in family medicine and has a board certificate of added qualifications in sports medicine. He is in practice at Cayuga Sports Medicine, where he can be reached at (607) 252-3580. Dr. Getzin also serves as medical director of Island Health and Fitness.