Overuse & Pediatric Injuries

Wednesday, May 22nd, 2019


By Dr. Tommy Gerschman
Qubecore, Pediatric Sports

Do Kids get the same Sport Injuries as adults?
Although there can be similarities, the injuries we see in children are often quite different than those seen in adults. One of the main contributors to these differences is the maturation of the bones and the skeleton. Bones in children differ in a few ways. Firstly, a child is not born with all of their bones fully formed but instead we see some bones appear and develop throughout childhood as cartilage is turned into bone. Secondly, bones are not as strong as adult bones due to the process of ossification. Bones gain strength and mass throughout the first two decades of life. This is contributed by calcium and also weight-bearing exercises – an important reason for kids to keep active throughout the week and into their twenties and beyond. Finally, bones are growing larger from areas known as “growth plates”. These growth plates are susceptible to direct injury and also to “overuse” injuries – particularly where the muscles attach to the bone in an area called an apophysis.

What are Overuse Injuries?
Overuse injuries in children are more common than in adults. In part, this is because the bones and muscles are still developing strength and maturity. Common overuse injuries in children are located at the area where muscles attach to areas of the bone called an apophysis. In children, these are still growing and maturing. Therefore, these areas of the bone are not able to keep up with the metabolic demands of the forces the muscles exert on the bone. The result is often fragmentation of the bony area, irritation, swelling, and pain. Common areas include the heel (Sever’s), knee (Osgood Schlatter), and lateral foot (Iselin’s). Similarly, throwing athletes can develop an overuse injury of the medial elbow (Little League Elbow).

How do you manage Overuse Injuries?
Fortunately, most overuse injuries will heal without long-lasting damage. When treated appropriately, these are usually self-limiting and resolve with time. As the bones mature and the growth plates “close”, the bones become strong enough to be able to deal with the forces exerted on them. We typically advise a period of activity modification that can range from complete rest for a short period of time to adaptations in volume, intensity, or type of activity – this is known as “relative rest”. Symptoms can take anywhere from a few months to a year to settle down depending on how the individual child’s bones mature. Sometimes, shoe modifications, bracing, and technique adaptations can also improve symptoms. A physiotherapist or chiropractor can help manage acute pain and provide exercises for ensuring movement techniques are optimized and muscles are not overly tight.

What do I need to do in order to have my Child booked to see a pediatric Sports Medicine Doctor?
To have a consultation with a pediatric sports medicine doctor, such as Dr Tommy Gerschman, please discuss with your family doctor or pediatrician if a referral is appropriate for your child. If so, it can be faxed to 604-210-6825. Consultations are covered by MSP with a referral.

To book with Dr. Gerschmann, please call 604-210-4736 or email clinic@drtommy.ca

QubeCore Sports & Rehab offers pediatric rheumatology, exercise and sports medicine in North Vancouver with Dr. Tommy Gerschman.


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