Managing and preventing injury in children requires a different approach to adults. Children are not just small adults and management has to reflect this. Children’s bones are still growing and the presence of the growth plate or apophysis creates a group of conditions unique to children. The following information talks about some of the more common children’s sporting injuries we see.
Heels - Severs syndrome, sometimes known as severs disease is the most common form of heel pain in children. The typical age of onset is around 10 – 11 years of age and it occurs commonly in running sports. Severs is one of the disorders known as traction apophysites. Basically this describes traction on a growth plate. This problem self resolves, usually within a year and is not serious. However it can limit sporting performance and participation and can benefit from professional advice.
Ankles - Sprained Ankles are common in children’s sport. There are several forms that can be categorised as high ankle sprains (or syndesmotic injuries), or low ankle sprains, the most common being the lateral ligament of the ankle. The lateral ligaments of the ankle are the most commonly injured in particular the anterior talofibular ligament. These injuries are caused when the foot and ankle turns in. Accompanying the lateral ligament sprain can be a sprain to the bifurcate ligament.
The medial ligament of the ankle is rarely injured. High ankle sprains or syndesmosis injuries are less common but are potentially serious and must be identified. A syndesmosis is a slightly moveable joint and in the ankle it describes the joint between the tibia and the fibula.
Thighs - Growth plate injuries to the attachment of rectus femoris and Sartorius create pain at the upper part of the thigh. These occur often when high force e.g. kicking a ball causes these tendons to simultaneously stretch and contract, causing the growth plate to pull away. Simple muscle strains to the quadriceps, hamstrings and groin are also common.
Knees - Anterior Cruciate Ligament (ACL) injuries are becoming more frequent. Ligaments join bone to bone and the anterior cruciate or ACL is the primarily stabilizer for rotatory stability in the knee. It is commonly injured, with females more commonly injured than males. It frequently requires reconstruction, even in children. Unfortunately recurrence of this injury appears to be more common in children than adults, and with recovery times around 12 months it is crucial that preventative programs are implemented.
Osgood Schlatter’s Syndrome – this is a common cause of knee pain in adolescents. It presents as pain at the front of the knee below the kneecap or patella. It generally presents between 12 and 15 years of age. However it can limit sporting performance and participation and can benefit from professional advice.
Guidelines for Preventing Sports Injuries
The American Academy of Orthopaedic Surgeons, Pediatric Orthopaedic Society of North America, Canadian Orthopaedic Association, and American Orthopaedic Society for Sports Medicine designed Play It Safe! to help parents, coaches, and children prevent sports injuries.
“Play It Safe! “ encourages children to:
- Be in proper physical condition to play a sport
- Know and abide by the rules of the sport
- Wear appropriate protective gear (for example, shin guards for soccer, a hard-shell helmet when facing a baseball pitcher, a helmet and body padding for ice hockey)
- Know how to use athletic equipment (for example, correctly adjusting the bindings on snow skis)
- Always warm up before playing
- Avoid playing when very tired or in pain
- Qualified Coaching
Beyond the play it safe principles it logical that if you can identify individual risk factors that exist in a child, then these can be dealt with and prevent the injury from occurring. Examples of these may be:
- An inadequately treated prior injury
- Muscle strength or control insufficiency
- Motor control problems
- Joint hypermobility or instability
Risk factors can be identified in a Musculoskeletal Screening. Screening can take many forms. FMS or functional movement screenings are one example. We find that a screening approach customised to the particular sport yields the most information and leads to the best outcomes. It is not logical that the screening for swimming will be the same as the screening for football.
Physiotherapists are the key professional who should conduct these screenings. A Physio who knows your sport, its risks and demands, and who understands children’s sport is the ideal person for this job. At Advanced Physiotherapy we offer screenings to individuals and to teams.
Contact one of our Sports Physiotherapists on 49545330 if you want further information.