Sports Injuries For The Child And Adolescent
Children and adolescents tend to experience different injuries to adults. Some of these injuries are less serious than the alternative adult injury, such as in the case of greenstick fractures of the long bones in children (instead of complete fractures in adults). However in many cases if these injuries that are particular to the young athlete are not identified early and managed properly, they can result in medium to long impairments
Apophyseal avulsions - Rather than tear a ligament or muscle, the younger athlete may suffer an avulsion (separation) of the tendon from the bone. This is because the attachment point of the tendon to the bone (apophysis) is a cartilage-like tissue, which is weaker than the tendon itself.
Apophysitis - The apophyseal site may also become inflamed (apophysitis) through over-use or inefficient movement patterns. This is common in the knee or heel in children who do a lot of running and jumping, and in the elbow in children who perform a lot of throwing. This condition can be sometimes dismissed as “growing pains”.
Growth Plate Fractures
The area within growing bones between the growth plate (epiphysis) and the adjacent part of the long bone (metaphysis) is vulnerable to injury. Instead of a sprain to the ligaments around a joint, a child may suffer a shearing type of fracture through this region in the bone.
One of the assets of being a child when it comes to bone injuries is that the wider parts of the long bones (metaphysis) are tougher and more elastic than this region in adult bones. This means instead of suffering a complete fracture through the bone, a child’s bone may just buckle a little (greenstick fracture), which requires a shorter length of time in a cast than a complete fracture.
Perthes’ diseasePerthes’ disease refers to an Osteochondrosis (degenerative changes in the bone and cartilage) of the femoral head (top end of the thigh bone), which typically affects children (boys more than girls) between the ages of 4 and 10 years. The child will complain of an ache in the thigh, groin or knee and this will often cause them to limp. If one of our physiotherapists suspects this may be the cause of your child’s pain we will refer you to your family doctor for radiographic investigations (xray). When caught early enough this condition can be managed well with modification of activity levels and, when the time is right, some gluteal strengthening exercises.
Plain x-ray showing the flattened femoral head due to osteochondrosis
Slipped femoral epiphysisThis describes a condition wherein the head of the femur (top end of the thigh bone) slips at the growth plate between it and the neck of the femur. This typically occurs in 12-15 year olds. The child will often complain of pain in the groin, thigh or knee. This pain will usually cause the child to limp. If one of our physiotherapists suspects this may be the cause of your child’s pain we will refer you to your family doctor for radiographic investigations (x-ray). When caught early enough this condition can be managed well with modification of activity levels and, when the time is right, some gluteal strengthening exercises.
Plain x-ray (beneath) showing slipped femoral capital epiphysis