Pediatric Orthopedic Surgery in Focus – Overuse Injuries in Children

Read on as our team from The Orthopedic Center of Palm Beach County discusses pediatric overuse issues: what they are, how to prevent them, and how to treat them.

Modern data show that one key to promoting the holistic well-being of children includes participating in sports and cultivating routine exercise habits. However, too much physical activity can lead to serious injuries that may cause long-term musculoskeletal and bone issues as children grow.

Background & Anatomy

Anatomically, children grow continuously and unevenly. Growth in children occurs along growth plates, which are areas where bodily connective tissue resides. Growth plates help to determine the future length and shape of a child’s bones as they mature.

Because bones grow first, they pull tight any surrounding muscles, ligaments, and tendons, which increases a growing child’s susceptibility to injury. Although severe overuse injuries along growth plates can be acute and sudden, it’s more common for them to occur over stretches of time, hence the term “overuse.”

Causes of Overuse Injuries

Often, an athletic activity—such as running, biking, throwing, swimming, or a combination of motions related to some sport—will put stress upon the body. Often, this stress may not immediately register as pain, and so as the child repeats the activity over and over, it will cause more stress. This cycle effectively prevents the child’s body from having the adequate time it needs to fully heal and grow.

Today, it’s quite common for children to take part in sports year-round, and even more common for them to focus on a single sport in order to improve their skills and cultivate dedication. Unfortunately, this combination can be costly, since it requires children to apply repeated stress to the same specific muscle groups.

All too often, the child engages in the above cycle, which creates muscle growth imbalances. These imbalances lead to serious musculoskeletal problems that, if we do not not address them quickly enough, can require orthopedic surgery.

Symptoms & Injuries

To both prevent and diagnose overuse injuries, coaches and parents should be aware of signs and symptoms. These include:

● Chronic pain that increases in intensity

● Redness and swelling

● Lack of interest in the physical activity

● Changes in movement, form, or technique

Sever’s Disease: Sever’s is an inflammatory condition that affects the heel bone in children. It typically results from repeated foot strikes to the ground during running or jumping. The problem occurs mainly during growth spurts. Using proper footwear and ensuring proper rest of the foot between exercises can alleviate it. Once the child’s bones have hardened, Sever’s disease will not recur.

Jumper’s Knee: Jumper’s knee occurs when repetitive contractions of the thigh muscles cause strain on the patellar tendon, which attaches to the growth plate on the kneecap. The condition gets its name due to its frequency in children who play sports that require jumping, such as volleyball and basketball.

Osgood-Schlatter Disease: The characteristic symptom of Osgood-Schlatter disease is a pain at the front end of the knee resulting from inflammation of the growth plate along the upper part of the tibia. The inflammation is due to a repeated tightening of the tibia’s growth plate (tibial tubercle) via the patellar tendon.

Stress Fractures & Reactions: A stress fracture is the result of an overworked muscle deferring its stress load onto the bone. If too much stress lands on a bone without sufficient rest, the bone’s structural integrity will fail, and small cracks will occur. Similarly, a stress reaction is the result of growth plates widening irregularly due to stress exposure

Strains & Sprains: Strains and sprains are what happens when the body’s soft tissue (ligaments tendons, muscles) receive damage. Such damage can result from a single, improper motion or from repetitive stress and overuse.

Treatment & Prevention

If you think your child or children may be suffering from an overuse injury, the first step towards healing is to seek advice from a licensed pediatric orthopedic surgeon such as Dr. Ezra Berkowitz at The Orthopedic Center of Palm Beach County, who diagnoses, treats, and manages bone joint problems in children.

Depending upon the severity of the injury, a surgeon may suggest any combination of the following:

• Inclusion of adequate periods of rest between physical activity

• Cessation of focus on a single sport or exercise

• Administration of nonsteroidal anti-inflammatory medicine

• Application of casting, bracing, or therapeutic techniques to trouble areas

• In severe cases, use of modern surgical techniques

Dr. Ezra Berkowitz at The Orthopedic Center of Palm Beach CountyMay Be Able to Help Your Child

Your child can heal and recover with the medical care of Dr. Ezra Berkowitz, a pediatric orthopedic surgeon at the Orthopedic Center of Palm Beach County, FL. Please call 561-967-6500 to schedule a consultation.