4 Common Categories of Sports Injuries in Children

Do you know that sports injuries are the second leading reason for children and adolescents to attend hospital emergency departments? The high number of injuries in children is due to the vast amount of time they spend on sporting activities. As a child’s body is still growing, it is more vulnerable to injury. A growing child’s body goes through many changes. The body and mind are adjusting to new limb length, coordination and changing center of gravity. The weight and pressure going through the feet are continually increasing.

1. Growth plate conditions

In growing children, the growth plates (soft bone tissue) and ligaments of their bone are lots flexible. As a child matures, their growth plates are replaced by hardened bones. The growth plate can be injured in sports accidents or damaged slowly over time by repeated trauma and stress. This condition is known as osteochondroses or commonly referred as growing pain.

Such condition can occur in any growth plate in the body but especially the foot and leg

Sever’s disease (Heel)

Have you ever heard your child complaining of painful heel? It is so painful that it can stop them from participating in their favourite sports and it makes you wonder why.

Sever’s disease is an inflammation of the growth plate in the heel which occurs in children and adolescents generally aged between 8-14 years old. It is so common in children who are active in running and jumping sports such as soccer, basketball, and netball. Such high impact motions can create repeated stress on the heel growth plate and often coincides with a period of a rapid growth spurt. Children with Sever’s disease will often complain about sore heel and may limp. The pain generally increases with activity and reduces after periods of rest.

Osgood-Schlatter’s disease (Knee)

Similar to Sever’s disease, Osgood-Schlatter’s disease affects the growth plate of the knee, the upper part of the shin bone. It occurs in children up to age 16 who are very active in sports that involve kicking, running and jumping. It is caused by repeated use of muscles in the thighs. Pain will be felt on the shin bone, just below knee cap.

Such “growing pain” commonly will not resolve on its own. You may find your child withdraw from sporting activities and stop complaining. However, as they resume activity, the pain will often return. In such situation, help is needed to accelerate the process and prevent any possible lower limb complications. Various management options such as strapping, stretching, orthotic therapy and footwear may be offered depending on the severity of the condition. 

2. Strains and Sprains

Injuries to the soft tissue can occur when the tissues are stressed beyond their physical capacity. Strains and sprains are common in kids, and usually, involve the ankle or big toe joint. A strain is an injury to the tendon or muscle and a sprain is an injury to a ligament. Most minor injuries generally heal over time and only require protection, rest, ice and support. However, in cases of severe injuries where the child cannot bear weight or a minor injury that has persisted over 2 weeks, it is best to visit a podiatrist for further evaluation and management. 

3. Overuse Conditions

Children suffer from overuse conditions just as adults do. When running, jumping or pushing on the foot during sports, the foot adapts, and the foot pronates (rolls inward) and supinates (rolls out). When this happens, the leg bones twist inwards and outward as well. This twisting movement results in activation of the muscles, joints, and ligaments in the foot, ankle and knee. These motions are a normal part of walking and moving, but when this action is repetitive or excessive, physiological changes start to occur.

Feet, ankles and legs pain generally occurred due to such repetitive motions and poor biomechanical alignment. Common overuse conditions seen in children are shin splints, tendonitis, and plantar fasciitis. As every child is different, the treatment may vary based on their lifestyles and the severity of the condition. It is best to seek help earlier to identify potential risk factors and prevent further foot complications.

4. Skin and nail injuries

Blisters

Blisters are weakened areas in the skin that usually has a bag of fluid accumulates underneath. These are caused by the shearing rubbing of the skin and shoe. Management of such condition can include dressings, paddings, strapping, shoe fit, socks, and orthotics.  

Nail bruising and ingrown toenails

When a nail pushes against the shoes, it can be damaged. Pressure on the nail can cause a bruise under the nail, leading to a blackened or thickened nail. The pressure of the nail on the nail grooves can cause the nail to irritate and puncture the adjacent skin, resulting in painful and inflamed ingrown toenail.  

Temporary treatment may consist of soaking the foot in the warm salt water, following by application of betadine or antibiotic cream. The offending nail border must be removed to resolve the condition. This can be done conservatively through a visit to a podiatrist or through a short procedure where the nail border is removed permanently under local anaesthesia to prevent recurrent ingrown toenail.

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What can I do to help prevent these injuries?

Prevention is always better than cure. Here are some recommended tips:

• Wear quality and sport appropriate exercise shoes.

• Sports shoes should be replaced every 6-12 months as the support and shock absorption diminishes.

• Perform warm-up and stretching exercises.

• Enroll your child in an organized group with trained coaches and ensure the program is suitable for the age level and physical maturity.

• Monitor the frequency, duration, and intensity of the training and competition.

• Pay attention to your child’s foot and leg complaints.

• Visit a podiatrist to identify any risks of injury relating to foot and lower limbs

How to treat foot pain related to sports injuries?

For the first 48-72 hours following an injury treatment, one should restrict activity. Paying the PRICE: Protect, Rest, Ice, Compression and Elevation. Do not HARM: no heat, alcohol, running or massage.

Podiatrists are foot experts in the field of the lower leg and foot health. A podiatrist will assess your child and create a plan to help them recover and return to activity. Depending on the condition, a podiatrist may provide the following management options such as:

• Physical therapies – strapping, stretching, exercises and soft tissue release

• Medical care for injuries such as blisters, damaged nails and bruises

• Foot orthotics and insoles

• Footwear assessment and advice