DESCRIPTION
Participation in sports helps to promote and maintain a child’s physical and emotional well-being. However, while these activities have many benefits, unsafe participation or overexertion can lead to injuries. Children who are still growing are at increased risk for incurring such injuries and having them lead to long-term health issues.
CAUSES
Overuse injuries typically occur as a result of participation in activities or sports that use the same muscle groups, causing stress to these specific areas that can lead to muscle weakness and injury. Sports injuries are often a result of poor training or practice, lack of adequate protective gear (ex: mouth guards, head gear, etc.), or insufficient stretching and warm-up exercises before play.
SYMPTOMS
The most common symptoms of overuse and sports injuries are:
- Pain which increases with activity
- Swelling of the area of injury
- Changes in technique of playing the sport
- Decreased interest in practice
COMMON TYPES OF INJURIES
Hamstring Strain
Hamstring strain is a common injury often seen in athletes who participate in sports and activities that require running, jumping, or kicking. The hamstrings are tendons that are located at the rear of the thigh and they can become strained when stretched excessively. Symptoms include a sudden sharp pain or popping sensation in the rear of the thigh at the time of injury followed by swelling, bruising, or muscle weakness. In severe cases of hamstring strains, a tendon can be torn away from its bony attachment resulting in an avulsion injury. Most hamstring strains will resolve themselves with rest. Surgery is only recommended when a hamstring has completely ruptured.
Iliotibial Band (ITB) Syndrome
The iliotibial band is a tough group of fibers that begins at the pelvis’ iliac crest, runs along the outside of the thigh, and ends at the outer side of the shin bone just below the knee joint. It works in conjunction with the thigh muscles and stabilizes the knee joint. Iliotibial band syndrome describes a condition where the iliotibial band rubs against the lower outer portion of the femur at the knee joint. This injury can occur as a result of quickly increasing distances with running or biking type activities. Individuals with lower limb issues are at greater risk of developing ITB.
Jumper’s Knee
Sports such as basketball and volleyball can cause stress and tissue damage in the knee resulting in kneecap pain. This can be treated by resting and applying ice packs to the knees every few hours.
Knee Sprain
Knee sprains occur when knee ligaments are twisted or turned beyond their normal range. Knee sprains can be caused by a fall and landing on the knees, forceful twisting of the knee, a sudden stop while running, or a direct blow to the knee. Pain occurs soon after injury and may increase upon moving the knee in addition there may also be swelling, bruising, and restricted movement of the knee. If the pain persists over a long period of time, knee arthroscopy may be needed to repair the torn ligament.
Little League Elbow
Little leaguer’s elbow (medial apophysitis) is an overuse condition that occurs when repetitive throwing creates stress on the muscles and ligaments of the elbow. The growth plates at the bone ends can become inflamed or in severe cases may break from the upper arm. The condition is typically caused by a poor or inadequate training regimen. The most common symptoms include elbow pain, tenderness, restricted motion, locking of the elbow joint, and swelling on the inner side of the elbow. Surgical treatment to remove loose bone fragments and reattach the ligament may be required in severe cases where there is a break from the bone. Little leaguer’s elbow can be prevented by warming up and reducing the number of pitches a child throws.
Meniscal Tears
The menisci are “c” shaped pieces of cartilage in the knees which act as shock absorbers for the area between the thigh (femur) and shin (tibia) bones. Meniscal tears are usually caused by twisting or over-flexing the knee joint and often occur in athletes who play sports such as football, tennis, and basketball. The meniscus has no direct blood supply so when there is an injury to the meniscus, healing does not take place.
Symptoms of a meniscal tear include knee pain when walking, tenderness and swelling of the knee, limited knee motion, joint locking, and a “popping” or “clicking” feeling at the time of injury. Meniscal tears are diagnosed with physical examinations that include a McMurray test of the knee where it is bent, straightened, and rotated in and out to see if there is any pain or clicking. Your doctor may also order imaging tests such as knee joint x-rays and an MRI to help confirm the diagnosis. Mild meniscal tears can often be treated with rest while more severe injuries may require physical therapy and/or knee arthroscopy.
Sever’s Disease
Running and jumping puts repetitive stress on the heel’s growth plate as the foot strikes the ground. This can lead to inflammation in the heel which causes swelling. Sever’s disease can be treated with resting, using heel pads, and stretching exercises; anti-inflammatory medications can be used in cases of severe pain.
Shin Splints
Shin splints (medial tibial stress syndrome) describe pain and inflammation of the tendons, muscles and bone tissue around the tibia. The most common cause of shin splints is overuse of the muscles and bone tissue of the tibia during repetitive sports activities or a sudden change in the level of physical activity. Runners, dancers, and individuals with flat feet or rigid arches are at a higher risk of developing shin splints. Symptoms of shin splints include pain, swelling, weakness, or numbness in the front of the lower leg. Most cases of shin splints can be resolved with rest. Cases of shin splints that cause severe pain due to compartment syndrome may require a fasciotomy surgical procedure to split the tough and fibrous tissue to relieve the pressure built up within the muscle compartments.
Strains and Sprains
Soft tissues such as muscles, ligaments, and tendons are often injured due to overuse. Rest can help to reduce the pain caused by strains and sprains. Physical therapy exercises can also be used to strengthen these tissues and restore mobility.
Stress Fractures
When muscles become fatigued, they can transfer stress to bones which creates small cracks or fractures in the bone. Stress fractures typically require six to eight weeks to heal during which time activities that involve the affected muscles and bones should be limited to prevent the development of a severe acute fracture.
Tennis / Golfer’s Elbow
Overuse of the arms or a traumatic blow to the hand can cause inflammation of the muscles on the outside of the elbow (tennis elbow) or inflammation of the tendons on the inside of the elbow (golfer’s elbow). These injuries may cause severe pain and tenderness that radiates down into the forearm, particularly with use of the hand and wrist. Adequate rest and immobility are key to allowing the affected muscles and tendons to heal. A tennis elbow strap may also help to relieve pressure from the muscle attachment.
TREATMENT
Many injuries can be resolved with the R.I.C.E. method
Rest
Take a break from the activity that caused the injury until the body has had a chance to recover. Crutches may be recommended for leg injuries to prevent the legs from bearing weight.
Ice
Ice packs applied to the injured area will help to control swelling and reduce pain. Ice should never be placed directly on the skin. Instead, ice should be wrapped in a towel and applied to the affected area for 15-20 minutes four times per day.
Compression
Applying an elastic wrap or compression stocking to the injured area can help to minimize swelling.
Elevation
Elevating the knee above the level of the heart can help to reduce swelling.
Non-steroidal anti-inflammatory drugs may be prescribed to reduce pain and inflammation. Once the pain has subsided your doctor may recommend physical therapy to regain strength and speed up recovery.
PREVENTION
Overuse and sports injuries can be avoided by not overdoing any single sport, stretching and warming up before activities, using protective gear, and resting between practices and games.
Sources
- Overuse Injuries in Children. (2012, December) AAOS.org. Retrieved on July 30, 2014, from http://orthoinfo.aaos.org/topic.cfm?topic=A00613
