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 Sports And Injuries

september 2012

Orthopaedic Issues In Athletic Children

Dr S Krishna Reddy
Overuse injuries in athletic children are very disturbing because of the gradual harm they cause. Often kids drop out of sports but don’t admit to being in pain. Thus, several injuries go undetected leaving the affected tissues in a growing child permanently injured. Parents and coaches must be watchful.

Sports related injuries in youngsters have become a common concern these days, as more and more children participate in organized sports. The rigorous training to which athletic kids are subjected can lead to overuse and burnout and set the path for injuries.
Young athletes are at risk for several sports related injuries due to bad techniques, ill-fitting protective gear, imbalance, training mistakes and even malnutrition.

Injuries resulting from sports are of two types: Macrotrauma and Microtrauma.

Macrotrauma: They are acute injuries such as concussions, spinal cord injuries, fractures or dislocations.

These are repeated injuries, which start off as microscopic in magnitude and areusually dismissed initially. The initial neglect makes the injured area susceptible to repeated stress and in turn, it leads to severe pain and at times even major disability. Stress fractures and small muscle tears are examples of microtrauma.

While macrotrauma is easily identified, parents, coaches and the young athletes themselves need to be aware of microtrauma. Overuse injuries are the most disturbing because of the gradual harm they cause. Often kids drop out of sports but don’t admit to being in pain. Thus, several injuries go undetected leaving the affected tissues in a growing child permanently injured.

Preventing Injuries
A lot of sports related injuries in children can be prevented by following a few simple measures.
  • Identify and treat flat foot. Flat footedness is painful, causes imbalance and decreases the athletic efficiency of a youngster.
  • Coaches must teach their young wards the reflex techniques through which they can avoid or minimise injury from a fall. Children should be taught how to fall! Spinal damage and leg injuries from sports can be prevented so.
  • Any bone deformities, abnormal growths or shortening/lengthening of bones should be subjected to an orthopaedic check up. Since several problems manifest as a child grows, a yearly check-up is recommended.
  • A good and well balanced diet is a must for strong bones or bone health.
  • Athletic training should not exceed the individual child’s capabilities. Young athletes need to figure out their limits for themselves and stick to it. Pushing them beyond their physical limits is harmful.
  • Children having hyperlaxity/ hypermobility of joints (joints that stretch farther than normal) should be particularly careful, as they are more prone to injuries than other children.
Dos And Don’ts
  • Warm up prior to any sort of physical activity makes the muscles limber and prevents injuries.
  • Be aware of painless limps and get them checked by a doctor.
  • Keep an eye out for deformation of spine from an early age. Early detection and treatment enables better treatment of the condition.
  • Any pain or swelling in the bones should be referred to an orthopaedic surgeon to rule out complications.
  • Joint fractures cause growth disabilities and also stiffen the joint. Follow your surgeon’s advice to treat the condition.
  • In case of minor injury without an open wound, apply an ice pack as a first aid measure.
  • Do not use a tight bandage for limb injuries. It obstructs blood flow and can lead to serious complications.
Any sort of athletic activity in children and teens leads them to experience some discomfort. Since they are growing, some aches and pains are expected along with an increase in the level of their physical activity. However, it is always advisable to pay attention to their complaints and make sure untreated injuries do not hinder a child’s normal growth.

Coaching Pitfalls
Parents should also be aware and take a pro-active role in the child’s athletic life. Overzealous coaches often cause more harm than good. Common mistakes to look out for include:
  • Demanding too much time or commitment from young athletes, so that they are over trained, burned out, or continually injured.
  • Not giving enough time to rest. Days of intense and heavy practice should always be followed by rest days.
  • Setting standards beyond the child’s capacities. Every athlete’s capacity is different. The achievement standards set should be within the athlete’s capabilities.
  • Focusing on winning rather than playing. A coach who focuses more on winning than on playing the game teaches his/ her players to win at any cost, which often include injuries too.
Dr S Krishna Reddy is Senior Consultant Orthopaedic Surgeon, Apollo Health City, Hyderabad.