Most parents know that an active child is a healthy child – but what about the inevitable injuries if they play sports? Sally Harris, M.D., MPH, a specialist in pediatric and adolescent sports medicine at the Palo Alto Medical Foundation, says the most common serious sports-related injury for young children (prior to puberty) is a broken bone, also called a fracture. Before reaching puberty, children’s flexible bones are their most vulnerable points as cartilage is still filling in and the ends of the bones are weaker and softer to allow for growth.
Signs of a Fracture
It can be hard to tell if your child has a broken bone. “Often, there may not be any obvious outward signs such as swelling or bruising, and your child may still be able to move an affected hand, foot or leg,” Dr. Harris says.
The most reliable indicator that something is wrong is if the pain from the injury continues much longer than one would expect for a normal playground or sport accident. “If your child is hurt playing a sport and is still in pain several hours after the injury occurred, don’t delay, go to the doctor,” Dr. Harris advises.
Once the X-ray has confirmed the diagnosis of a broken bone, a cast is the best treatment choice for young, active children, as it will allow healing and prevent the possibility of further injury. If the X-ray does not show a broken bone, close monitoring may still be necessary as not all fractures are visible on X-rays of young children. If they pain continues despite the X-ray being "normal," your doctor will want to know as this is a sign further evaluation of the injury is necessary.
“Typically, a child will need to wear the cast for approximately four weeks,” Dr. Harris says. “Once the cast is removed, your child may experience some stiffness around the affected area for about a day, but young children rarely need physical therapy after a common fracture.”
A wrist or ankle brace can help prevent another injury when your child goes back to a favorite sport after a fracture. This is particularly important for ankle injuries.
“Parents need to know that some ankle injuries leave the ankle weaker and ligaments looser for many months,” Dr. Harris says. “During this time, a brace can provide support until that area has regained strength and stability.”
Braces are better than tape because they do not loosen with activity as tape does, Dr. Harris adds. In addition, parents should not believe the myth that long-term wearing of ankle braces weakens joints. The opposite is actually true with protected ankles becoming stronger, not weaker.
For sports such as skateboarding, snowboarding, ice skating or rollerblading, wrist braces are a must to prevent fractures from the most common injuries with those sports – a fall onto the palm of the hand. “Wrist braces really work,” Dr. Harris says. “For your young snowboarders, you can get mittens with integrated wrist braces, which can be easier for your child to put on and take off.”
Pain from Physical Stress
Other causes of pain your young child might experience can be growth-related and, depending on your child’s age, may appear in certain areas of the body such as the back of the heel, knee cap or top of the shin. This type of growth-related pain is caused by the stress of the sports activity on areas of active growth in your child’s body. It is different than what is often described as “growing pains” that occur during the evening or nighttime and move up and down the lower legs.
“If your child is experiencing pain in a specific area that consistently appears during or after playing a particular sport and lingers for two weeks or more, then you should check in with your child’s doctor for an evaluation,” Dr. Harris says.
Young children, before puberty, are at low risk of overuse injuries as they lack the body weight and speed needed to generate the forces necessary to cause this type of injury. In fact, before puberty is often the best time physically for your child to maximize her participation in a sport she loves. This all changes at puberty.
“As your child enters the teen years, keep in mind that teenagers’ bodies are particularly vulnerable to overuse injuries as their bones, muscles, tendons, ligaments and joints are going through their most rapid period of growth,” Dr. Harris says.
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