Newcastle Sports Injury Clinic specialises in diagnosing, treating and preventing children’s injuries.
Children and adolescents often present with particularly distinct injuries and overuse syndromes. Their musculoskeletal system is very different to an adult’s, due to the changes that occur during the growth process. Growing bone, muscles, tendons and ligaments have inherent areas of weakness. Combined with the vast increase in the number of children and adolescents participating in sports, and competitive elements becoming more and more popular, paediatric and adolescent injuries, repetitive strain and postural issues are more prevalent than ever. In addition, several congenital issues may also become apparent during the growth process, and symptoms are often misleadingly provoked by similar activities.
After the age of 10, up to the age of 18 to 20, growth tends to occur in ‘spurts’. This makes adolescents particularly vulnerable to injury due to sudden, transient imbalances between bone mass and muscle strength, loss of coordination and increased energy expenditure. Other factors that may predispose children and adolescents to injury include muscle tightness or imbalance, joint stiffness or hypermobility, low core stability and poor posture. As well as these, external influences such as flaws in sporting technique, sudden increases in training load, early specialisation and returning to train too soon after injury also place excessive stress on a growing musculoskeletal system.
Persistent musculoskeletal symptoms among children and teenagers should not be overlooked as ‘growing pains’, as these can often be explained by underlying conditions, injuries or postural imbalances.
An adolescent is not just a mini adult and should therefore not be treated as such. An adolescent should be assessed and treated with growing physiology in mind and often treatment of ‘common adult injuries’ need to be managed differently in the adolescent. Normal adult treatment methods can make a growing child’s injury worse.
Below are a few of the most commonly seen paediatric and adolescent injuries:
Stress fractures, also known as hairline fractures, occur as a result of overuse. When muscles become fatigued, any added load and impact transfers to the bones, occasionally leading to small fissures. Stress fractures often are due a rapid increase in the amount or intensity of training. Over 50% of stress fractures occur in the lower leg and foot. Pain with activity is the most common complaint with a stress fracture.
Shin splints, or medial tibial stress syndrome (MTSS), is defined as pain along the edge of the shinbone. This is commonly caused by repetitive trauma to the connective muscle tissue surrounding the shinbone. Shin splints are triggered by physical activity, mostly involving running and jumping. Shin splints are the most prevalent lower leg injury, affecting approximately 13% of all high school age runners.
Osgood Schlatter’s disease
Osgood Schlatter’s disease describes an overuse injury whereby inflammation of the patellar ligament occurs at the tibial tuberosity. It most commonly affects young adolescents. Osgood Schlatter’s Disease is characterised by a painful bump just below the knee, where the attachment of soft tissues pulls on the top layer of bone. It can be triggered by repetitive running, jumping and quick changes of direction as well as growth spurts. The presenting symptom is usually intense knee pain, aggravated by exercise and especially ascending or descending stairs.
Patellofemoral dysfunction is characterised by knee pain, mostly but not limited to the front of the knee, especially during knee flexion, repetitive or high impact exercise and ascending or descending stairs. It is commonly caused by abnormal or prolonged repetitive forces affecting the joint between the kneecap and the femur, and can involve swelling, cartilage wearing (chondromalacia patellae) and bony changes. It is usually associated with tight muscles or malalignment of the kneecap, and may be predisposed by growth spurts.
Sever’s disease, or calcaneal apophysitis, is an inflammation of the growth plate at the back of heel, typically seen in growing children and adolescents. It is characterised by pain in the heel, sometimes so severe that it may cause limping, although external appearance is almost always normal. The condition occurs as a result of overuse of the bone and tendons in the heel, caused by sports, increased weightbearing, poor foot posture and predisposed by growth spurts.
Perthe’s disease is a childhood hip disorder that involves the disruption of blood flow to the head of the femur. This causes the bone to die and stop growing, and over time, leads to a collapse, deformity and inherent weakness of the femoral head. This can alter the shape and mechanics of the hip joint and cause tightness, weakness and atrophy of the surrouding muscles and ligaments. It is most commonly diagnosed during childhood, and increases the risk of developing hip osteoarthritis later on in life. The first signs usually involve pain in the hip, groin or knee, which may lead to limping or guarding.
Scheuermann’s disease is a spinal disorder that becomes apparent during childhood or adolescence, characterised by an uneven growth of the vertebrae whereby the posterior part grows further than the anterior part causing vertebral wedging. This leads to a signature curvature of the spine that causes the top of the back to appear more rounded than normal. It commonly causes lower and mid-back and neck pain, which can be severe and disabling. The surrounding muscles and ligaments also become overstretched and weak, which also contributes to the symptoms.
Scoliosis is a medical condition that is characterised by a lateral spinal curvature. The curve is usually ‘S’ or ‘C’ shaped, which may become worse over time. It often becomes apparent during childhood or adolescence. Mild scoliosis is a common occurrence, and typically does not cause symptoms. When scoliosis is more severe, the pronounced curvature can cause abnormal spinal loading, irritation of muscles and other soft tissues and breathing problems, as well as other symptoms associated with the compression of internal organs. Scoliosis can be classified as structural, whereby the curvature is fixed, and functional, in which the underlying spine appears normal and the curvature is caused by leg length discrepancy, muscle imbalance or postural issues.
Our multidisciplinary team at Newcastle Sports Injury Clinic combines health professionals from various backgrounds to provide the best service when assessing, diagnosing and treating your child.
Our services appropriate for children and/or adolescents include:
- Bespoke Physiotherapy Service
- Fast Track Imaging
- After School Appointments
- Dedicated parent and baby sessions at our Jesmond clinic