Injuries of the School Age Athlete

  • Over 1/3 of school age children sustain an injury severe enough to be treated by a doctor or nurse. Children's vulnerability to injury can be attributed to their larger surface area to mass ratio, disproportionately large heads, ill-fitting protective equipment, the vulnerability of growing cartilage, and poorer motor skills prior to puberty.

    • Contusions (bruises), sprains (a stretch injury to a ligament) and strains (pushing a muscle beyond its limit)are the more common injuries.
    • In pre-adolescents, strains occur commonly at the apophysis (where the tendon attaches to the bone). Repetitive motion and overuse can cause apophysitis.
    • Osgood-Schlatter disease is one of these (causing tenderness over the tibia tubercle). For Osgood-Schlatter, rest is prescribed, along with ice, anti-inflammatory medications, and quadriceps-stretches. Some doctors prescribe knee straps.
    • Sever's Disease is less common and occurs in very active children (with tenderness over the posterior aspect of the heels). Sever's is treated with rest, heel lifts (to relieve tension on heel), & daily heel stretches.
    • Little league Elbow occurs over the medial and lateral epicondyles.  For little league elbow, limit the number of innings pitched per game (3-4 max) and nuumber of pitches per wk (200 max).
    • Non-traumatic knee pain (Patellar Femoral Pain syndrome) gives children dull, aching knees. Knees hurt for may hrs. and when climbing stairs. These children need to be assessed by a specialist because there are multiple causes for this syndrome. Quadriceps strengthening is one useful way to prevent this syndrome.
    • Any ankle swelling over lateral mallelus (the bony prominence on outer side of ankle) requires immediate assessment because of possible growth plate fractures.
    • Children may feel a 'pop' and then have swelling within 6 hrs. when they have an Anterior Cruciate Ligament (ACL) injury. They result from quick deceleration or quick changes in direction and are on a dramatic rise, with girls most vulnerable. This always requires a full assessment. (from Sports Med 2003)