SPORTS INJURIES IN CHILDREN



12.05.22



By Free Motion Physiotherapy





Children are being introduced to and specializing in a variety of sports at a younger and younger age, and as a result sporting injuries in children are becoming more common. The fact that young athletes are still growing, puts them at greater risk of developing sports related injuries compared to adults.


It is important to prevent, diagnose and treat these injuries as soon as possible to limit the disruption of growth, development of bad habits, and avoid future health problems.



Growth can Complicate Injuries



During adolescence, children experience growth spurts, a sudden increase in height and weight. These growth spurts can make children more susceptible to sports injuries for several reasons.


Firstly, maturation and puberty in children occurs over a span of 3-5 years and while some experience these changes between the ages of 10 and 12, others only experience their growth spurts later between age 13 to 16.


This means that peers in the same year group may vary substantially resulting in younger, weaker athletes competing with bigger, stronger athletes who have matured earlier. In an attempt to dominate or compete with their larger opponents, smaller athletes can over-exert themselves.


Children lose co-ordination as they adapt to their new bodies. Growth does not always occur proportionally, whereby the arms and legs may grow faster than the torso. This means that children must adapt to a new centre of gravity and can often lose coordination and control over their body movements. Studies have found that children who experienced severe growth spurts showed a more irregular and less smooth gait pattern when compared to those children who grew more steadily. This lack of control over motor skills can increase the risk of injury in sport.


Children may experience muscle/tendon imbalances during adolescence. Their bones lengthen more quickly than the muscles and tendons do meaning that muscles are then especially tight and as a result, children lose flexibility. Therefore, unless enough time is allowed to build up strength, any load or strain can then lead to injury.


Lastly, as a child grows, their condyles (bone ends) are predominantly Cartlidge which is later gradually replaced by bone during adolescence. This puts them at risk during growth spurts and is why fractures are relatively common in child sports injuries.


Although children are more susceptible to injury during adolescence for the reasons discussed, this doesn’t mean sports should be avoided. An involvement in sports can help teenagers to develop proper posture, learn to control their bodies and form healthy habits which will ideally continue through their lives. It is therefore important to understand the most common sports injuries that children experience in order to recognise injury early on and also practice prevention as much as possible.



Types of Child Sports Injuries



There are two types of common child sports injuries – acute injuries and overuse injuries.


Acute injuries are those which occur suddenly like breaking a bone, tearing a muscle, or bruising. They occur because of sudden trauma like falling or crashing into another player during sports. Certain bones, or parts of bones, are more vulnerable during puberty and as a result, certain acute injuries are more common in children than others.


Overuse injuries occur because of repetitive motion over an extended period. Exercise can be thought of as a process of both breaking down and building up tissue. When the breakdown occurs faster than the build-up, overuse injuries occur.


Common Causes of Child Sports Injuries

  • Sudden increase in intensity, duration, or frequency of activity
  • Improper technique
  • Imbalance between strength and flexibility
  • Improper equipment for the activity
  • Improper surface for sport or activity


Most Common Acute injuries



1. Growth Plate Fractures:



Young children are most vulnerable to fractures in the growth-plate areas. The most common growth plate fractures occur in the following bones:

  • high bone (femur)
  • Lower bones of the leg (tibia and fibula)
  • Outer bone of the forearm (radius), at the wrist
  • Ankle, foot or hip bone
  • Long bones of the fingers (phalanges)

They occur twice as often in boys as in girls. Boys are most likely to experience growth plate fractures between 14 and 16 years old whereas girls are most likely to suffer these injuries between 11 and 13 years old.



2. Dislocations (shoulder and kneecap)



Shoulder dislocations are most common in contact sports like rugby, and overhead sports like, volleyball, basketball, softball and weightlifting. Previous reports have shown high school athletes are 4 times more likely to suffer from shoulder dislocation injuries than adults.


Kneecap dislocations can be caused by contact or by over-twisting or overextending. Kneecap dislocations are common in contact sports such as rugby, but also jumping and twisting sports like basketball, volleyball, soccer, gymnastics, and dance. It’s less common in sports that require more knee protection like hockey.



3. ACL Ligament injuries



The ACL is one of the most commonly injured knee ligaments. The injury used to be considered an adult injury, but as children have become more involved in competitive sports, more young athletes are suffering from ACL injuries.


According to the National Institutes of Health, girls are 8 times more likely to suffer an ACL injury. Children are at risk during activities that involve deceleration or quick changes of direction such as netball, hockey or soccer.


Fortunately, ACL injury can be prevented by strengthening the knees.



Most Common Overuse Injuries



1. Jumpers knee (patella tendonitis)



The Patella (kneecap) is held on place by the Patella Tendon. Tension from the Quadriceps muscle places strain on the patella as it moves back and forth. Repeated friction and pulling on the tendon can lead to inflammation and pain below the knee and upper shin. Most common in jumping, sprinting and twisting sports.



2. Shin Splints



Shin splints results from muscles, tendons and bone tissue becoming overworked. Excessive running, running on hard surfaces or wearing the wrong footwear can lead to tension and loading on the shin bone where the lower leg muscles attach. This causes pain and tenderness over the shin area.



3. Severs disease (heel pain)



Sever’s disease is a painful condition of the heel occurring in growing children. Repetitive running and jumping activities cause the Achilles tendon which attached to the back of the heel to pull on the growth plate of the heel leading to pain and inflammation.



How to Prevent Overuse Injuries



Evidence has shown that children who specialize in a sport at an early age are more prone to overuse injuries as they reach adolescence. When a child uses the same muscle groups and applies the same strain to the same body part over and over, overuse injuries occur. Young athletes should be encouraged to play a variety of sports to build different muscle groups rather than focussing on a single sport.


Aches and pains should be addressed early on and parents should encourage rest periods from organised sports allowing the body time to recover.



Injury prevention:



  • Practice multiple sports (not just one all year round)
  • Pay attention to aches and pains (rest and recover)
  • Take long-term breaks from your sport (use school holidays for recreational sport)
  • During your breaks, take part in low-impact cross-training (yoga, swimming, biking)
  • Consult a Physiotherapist if you have any questions or concerns.


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