Do not ignore sports-related injuries in kids

As many children take to sports, inspired by famous sportspersons, sometimes the intense training and continuous hard work during their growing years can create problems in the form of injuries.

Thirteen-year-old Reeta, a budding tennis player, came to see me with a chronic knee pain that prevented her from lunging and jumping. She had already taken medicines and physiotherapy sessions without any medical guidance for eight weeks, but the pain had only worsened. Her anguish about not being able to play was compounded by her parents’ anxiety about her missing the trials for the national games. After examination, I found she had Osgood Schlatter’s disease, a relatively benign, self-limiting disorder that usually affects kids going through growth spurts who use their knees a lot to run, jump or play sports, causing strain at the growing end of leg bones. The treatment is simple — medicines, rest and avoidance of strain for a few weeks. The condition usually heals when children stop growing.

Another similar medical issue, called Sever’s disease, can cause heel pain in budding sportspersons. Sometimes, even at a young age of about 11 to 12 years, these high-performance children may have overworked their bodies during the growing years, causing pain, limitation in activities and apprehensions about their sporting future. At times, because of demanding parents and coaches, the problem can be caused by overtraining and exertion. These problems can occur in other children also and not just sporty kids. Sometimes, parents seek or opt for shortcuts to healing, not understanding the seriousness of the situation, and accepting that the body has to heal first to perform to its best later.

Due to growth spurts, children are more vulnerable to certain types of sports injuries, open-growth plates (areas of developing tissue near the ends of long bones), and their natural tendency to push their physical limits without understanding the consequences.

In adolescents, the situation is often different, as they are stronger and bigger, play more rugged contact sports and often underplay their injuries. Mohit, a 17-year-old footballer in a hill school’s team, came to me with a swollen knee, pain and a wish to play in an inter-school tournament within a month! On examination, I found he had a torn knee ligament (ACL) with a damaged meniscus ((rubbery disks that help cushion the knee joint).

On eliciting detailed history, he admitted to having been injured two months earlier too, but had still played a match without telling anyone about the ligament injury. This caused his knee to “give way” during the game. The twist further caused a secondary injury to his cartilage.

This kind of injury usually needs surgical intervention, followed by an aggressive rehab protocol (which again, children ignore to their peril), if the child wants to play competitive sports again. Even the ankles of young jumpers and shoulders of adolescent throwing athletes (javelin, discus throwers and boxers) suffer such ligament damage, with many of them ignoring the first incident, and only seeking medical advice and treatment after multiple episodes of so-called “repeat injury”, which, in fact, is instability of the joint due to lax or torn ligaments.

These cases, too, require surgical interventions if they want to continue playing. Such cases should only be handled by experts who have the experience of treating similar problems. An improper intervention and a “short cut” in a growing athlete can often be a disaster.

Many kids may give up or may need to give up competitive sports altogether after an injury. However, they still need to go through a proper rehab programme that may continue for a few years, as it is crucial to keep their joints stable, even if they only have torn ligaments and not some major injury.

With an emphasis on high-end sports rising, pain and injury are common in growing children. Diagnosing and treating sports injuries in growing children is a delicate process, given the unique challenges posed by their developing bodies. Early intervention, appropriate treatment, and a gradual return to physical activity or sport are crucial to ensure a full recovery.

Not all children may need surgical interventions, most just need patience, rehab and some rest and time off from the sport. Children and their guardians must understand that often, what is more important is the health of the child, and not the next tournament that s/he could potentially win.

The writer is Director, Orthopaedics and Sports Medicine, Fortis Hospital, Mohali