Story by: Sara Thompson on October 28, 2021
There are many benefits to kids participating in sports, from confidence-building and physical health to boosting social skills and problem-solving ability. However, there are risks of sport-dependent injury in growing children.
There are patterns to the kinds of injury that vary from sport to sport. Soccer players may have knee and ankle problems. Football players run the risk of concussion, as well as arm and knee injury. Baseball players have higher rates of shoulder and elbow injury. Most injuries fall into one of the following categories:.
“We’re seeing overuse injuries more and more,” said Joshua W. Meier, M.D, pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. “More children are joining sports teams starting at an earlier age and are specializing in one sport, which they play year-round via school, travel and specialty teams,” Dr. Meier said.
Overuse injury comes from stress on the growing skeleton and affects the growth plates.
“Growth plates are a line of cartilage and growing bone,” said Dr. Meier. These areas of the bone occur as the bones increase in length and circumference and are easier to injure because they are flexible.
Overuse injuries can be called by a more specific term based on the cause, such as gymnast’s wrist, Little League shoulder/elbow, jumper’s knee or Sever’s disease, to name a few. Typically, overuse injuries are painful with activity, but there is little or no pain when at rest. There may be mild swelling, but no serious injury is present.
Treatments for overuse injury
“I tell patients rest is the most important treatment for overuse injury,” Dr. Meier said. “Depending on the injury, we advise a forced period of rest, anywhere from four to six weeks.”
The most common growth plate breaks occur in the wrist and ankle. These fractures are scored from 1 to 5 using the Salter-Harris classification. For instance, a Salter 1 usually is not a significant injury and does not cause long-term growth problems, unless the bones are seriously displaced. Depending on severity and location, fractures can be treated with specialized medical equipment such as a boot or mobile cast, or a wrist support.
A less common break is called an avulsion fracture, where a small piece of the bone attached to a tendon or ligament gets pulled from the main part of the bone. The hip, elbow and ankle are typically where this kind of fracture occurs.
Treatment for avulsion fractures is crutches and weight bearing movement as tolerated for about two to four weeks while the bone fragment reattaches to the main bone. Physical therapy that addresses range of motion and strengthening for about four to eight weeks also is commonly recommended.
Connect with Norton Children’s Orthopedics of Louisville.
Sprains and strains are typically found in older children. A sprain is damage to the ligament, and a strain is a muscle or tendon injury. Treatment for these injuries includes:
These are most common in sports where quick movements such as pivoting or changing direction are heavily used: basketball, gymnastics, cheerleading and football. Injuries to the knee include patella dislocation and anterior cruciate ligament (ACL) tears.
Older children are more likely to benefit from physical therapy. It is very helpful to getting them to return to play, and works on balance, strength and mindset.
“I will typically let the physical therapist decide when a kid is ready to get back to playing,” Dr. Meier said.
Gender assigned at birth can account for slight differences in how often or to what degree the above injuries affect an athlete. Inherent differences in the makeup of bone, tissue and fat differs between the two groups.
“Females tend to reach skeletal maturity closer to 14 years old, and males are closer to 16,” Dr. Meier said.
In some cases, there are rules in place to help kids avoid injury. For example, there are limits on how many pitches a kid can throw in a Little League or softball game. Additionally, braces, straps, pads or brief immobilization can help slow or prevent injury. Encouraging cross-training in multiple sports is also beneficial in preventing injury. Exposing kids to a variety of activities is also helpful, including non-sports such as theater, music or art.
“I tell people, even kids need an off season,” Dr. Meier said.