Young Athletes Sports Injuries

Every year, millions of kids participate in sports. Child athletes are injured at about the same rate as professional athletes, but injuries in kids can impair growth and may lead to long-term health problems.

INJURIES OCCUR IN TWO WAYS:

Overuse Injuries and Acute Injuries

OVERUSE INJURIES

Overuse injuries are not caused by a single twist, fall or collision.  They occur gradually over time with repetitive activity where the body does not have enough time to heal been playing.  Overuse injuries can affect muscles, ligaments, tendons, bones, and growth plates.  The most common signs of overuse is pain that increases with activity, swelling, changes in form or technique and decreased intensity or interest in practice.  

COMMON OVERUSE INJURIES

HEEL PAIN

Sever’s disease is one of the most common causes of heel pain in children.    It is an inflammatory condition of the growth plate in the heel bone.  Running, jumping, and being active lead to repetitive stress on the growth plate as the foot strikes the ground.  Initial treatment may be rest, heel pads, stretching exercises and/or anti-inflammatory medication.

SHIN PAIN

Osgood-Schlatter disease causes pain at the front of the knee.  It is an inflammatory condition of the growth plate at the upper end of the shinbone (tibia) where the patellar tendon attaches to the bone.  During activity (running, jumping)  the quadriceps muscles pull on the tendon which pulls on the growth plate causing inflammation, swelling, and tenderness.  Initial treatment may be rest, immobilization, stretching exercises, and anti-inflammatory medications.  Fractures can result if activities are continued without adequate rest.

KNEECAP PAIN

Also referred to as “Jumper’s knee”, this condition occurs in the lower portion of the patella (kneecap), where the patellar tendon attaches to the growth plate of the kneecap.  Repetitive stress on the tendon, most often caused by jumping, can injure and irritate the growth plate causing mild to severe pain.  Initial treatment is rest from sports until resolved, ice several times a day, and anti-inflammatory medications.  Fractures can result if activities are continued without adequate rest.

ELBOW PAIN

Overhand throwing injuries most commonly occur in pitchers, however they can be seen in any child who participates in repetitive overhand throwing.  Overhand throwing stresses growth areas leading to excessive inflammation of ligaments, cartilage and growth plates.   As with all overuse injuries, resting from the activity until the pain resolves is very important.  Elbow injuries can become very complicated very quickly if left untreated.  Seek medical treatment if pain continues after a few days of rest.

Medial apophysitis, (the most common elbow injury) also referred to as “Little Leaguer’s elbow” causes pain on the inside bump of the elbow (medial epicondyle).  The muscles that control wrist motion attaches here and with excessive overhand throwing can irritate and inflame the growth plate.

Osteochondritis dissecans, another common source of pain in the elbow occurring on the outside of the elbow.  Excessive overhand throwing can compress the young bones of the elbow joint, causing small pieces of cartilage and bone to loosen and float inside the joint.

Stress Fractures

These occur when muscles become fatigued and too much stress is being placed on the bones.  As bone is a living tissue, it is constantly building up and breaking down, however overdoing an activity can cause the bone’s re-growth to fail and a small crack develops.  Most stress fractures occur in the weight bearing bones of the lower leg and feet.  Do not participate in activities if you have a stress fracture.  Stress fractures typically heal in 6-8 weeks.  Resuming activities before a stress fracture has completely healed, can cause the fracture to redevelop larger, become harder to heal, and can lead to chronic problems where the stress fracture might never heal properly.

PARS STRESS FRACTURE

Low back pain may seem like a common issue for teen athletes, but up to one-third of these cases might be caused by pars stress fracture, or spondylolysis. This condition is harmful to fast-growing bones. It occurs when the back is repeatedly twisted or hyperextended. It results in fracturing of the pars interarticularis, the bony arch that connects the spine’s facet joints. Left untreated, stress fractures may interfere with bone growth, cause early osteoporosis, or cause spondylolisthesis, in which one vertebra slides over another. Pars stress fracture is seen in activities like gymnastics, cheerleading, ballet, volleyball, diving, pole-vaulting, high jumping, weightlifting, and offensive and defensive line positions in football. Nutritionally deficient diets can aggravate symptoms. Our spine specialist can diagnose and treat this condition, but the best defense is working with your child’s coach to encourage proper form, adequate rest periods, and a nutritious diet. Longer periods of rest, proper stretching techniques (especially the hamstrings) and bracing can help the pars interarticularis heal.  

Growth Plate Injury

Repetitive stress on a growth plate can be painful and if ignored, can impair growth.  Over stressing a growth plate, leads to irregularity or widening of the growth plate.  A growth plate can be permanently damaged and actually stop the bone from growing, leading to deformity.  Seek medical attention if pain continues after a few days of rest.  

Sprains / Strains

Every sport activity can injure muscles, ligaments, and tendons from overuse.  Resting and anti-inflammatory medication will almost always relieve pain caused by sprains or strains.

Concussions

Concussions are a mild traumatic brain injury caused by sudden impact to the head or a sudden jolt to the body that causes your brain to move forward and backward in the skull suddenly.  Concussions should NOT be taken lightly, especially if a child has or has potentially incurred them in the past.  Concussions can lead to permanent lifelong neurological damage.

Some signs of Concussions are:

• Headache
• Dizziness
• Nausea
• Drowsiness
• Numbness/Tingling
• Difficulty concentrating
• Loss of Balance
• Blurry Vision

Athletes suspected of a concussion should be cleared to return to sportsonly by a doctor specially trained in managing and assessing concussions.

ACUTE INJURIES

An acute injury is a sudden, spontaneous and often overwhelming injury that results from a sudden movement or impact during an exercise or sports activity. Following the injury, there is often times sudden and severe pain, swelling, tenderness, difficulty with movement of the affected area and trouble weight bearing if the injury is to the lower extremity.  

Examples of some Acute Sports Injuries

• Broken bones
• Concussion
• Dislocated shoulder
• Fractures
• Knee injuries, such as ACL and meniscus tears
• Muscle sprains and strains
• Rotator cuff tears. 

Some Injury Signs

• Avoiding weight
• Avoiding use
• Inability to sleep
• Pain
• Stiffness in joint
• Stiffness in muscle
• Swelling
• Bruising
• Change in form
• Headaches
• Irritability
• Unusual weakness
• Tingling in fingers or toes

Orthopedic Specialists has sports medicine fellowship trained physicians here to help so DON’T WAIT TO SEEK MEDICAL ATTENTION, THE SOONER AN INJURY IS DIAGNOSED, THE MORE EFFECTIVE IT CAN BE TREATED, AND THE SOONER AN ATHLETE CAN RETURN TO PLAYING.  

Preventing Sports Injuries

• Have your child receive a pre-participation physical.  Having an annual pre-participation physical by a highly qualified healthcare professional allows for the screening, prevention, and treatment of many conditions.
• Warm up properly; this includes stretching the muscles to release tension (stretch until resistance, then hold for 10 seconds and repeat so muscles loosen), jog in place to warm muscles and slowly increase heart rate.
• Strength training combined with conditioning exercises during practice to strengthen muscles used in play your activity.
• Increase flexibility. Stretching exercises after games or practice can increase flexibility. 
• Take time off.  Plan to have at least 1 day off per week and at least one month off per year from training for a particular sport to allow the body to recover.
• Wear the right gear.  Players should wear appropriate and properly fit protective equipment for their sport.
• Use the proper technique. This should be reinforced during the playing season.
• Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness. 
• Play safe. 
• Do not play through pain.
• Avoid heat illness by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing.