Children's (paediatric) sports injuries

Kids are NOT small adults!!!! As such, common injuries that occur differ vastly. The main reason for this is that a child's musculoskeletal system (bones, muscles, tendons, ligaments etc) is growing and developing, which means the processes that are active in order to facilitate this development present their own challenges when it comes to sport.

Perhaps the most common overuse sporting injury in the developing child is 'traction apophysitis' this commonly occurs in the knee (Osgood-Schlatter, Schinding-Larsen Johansson) and the heel (Sever's) but can also present anywhere where a tendon attaches to bone.

Traction apophysitis commonly happens in active individuals who have recently grown. Individuals tend to be 7-15 years old with the majority being 10-14. It develops when the stresses placed on the tendon insertion are too great due to over loading and an imbalance between bone length, which will most likely have increased recently, and muscle-tendon length, which has increased at a slower rate. This causes inflammation and irritation to the tendon insertion on to the bone.

In the past, this has been referred to as 'growing pains' and historical management has included rest until the pain goes away. However, it has also been suggested that this condition is 'self limiting' in most cases, meaning that it will resolve over time without specific management no matter what sport you do, even if you continue to have pain.

Given these polar approaches, it seems sensible to take a balanced approach. Stretching to help increase soft tissue length and maintaining activity / sporting levels without pushing too far in to pain is the most commonly accepted method of management. It is also essential to carry out a full biomechanical assessment of the affected limb to see if there are any features that need to be corrected, such as flat feet, in order to off load the irritated tendon insertion.

All episodes of traction apophysitis should be assessed in order to understand the reasons behind your child's pain! That way, you increase the chances that they will be able to continue playing sport comfortably!

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