Remember Children are not Little Adults. “In the young Beware”

This is micro blog an a reminder that children are not little adults when it comes to Musculoskeletal (MSK) injuries and Sports related injuries.

I have long had the motto ”In the young beware” it is a reminder to think beyond simple sprains and strains in children presenting to your clinic with sports injuries and MSK pain related presentations.

I often recommend a quick health screen of all presenting children by asking if they are ”eating, sleeping, drinking, peeing, pooping normally?” plus are they running a temperature or had a recent sore throat? this is a quick general systems screen.

it is important to remember, unlike adults, children do not suffer multiple sports injuries, even when playing and training at high levels. This paper https://www.jospt.org/doi/pdf/10.2519/jospt.1998.27.2.167?download=true is always a reminder of this.

When considering the type of acute MSK or sports injuries children will likely present with, it is important to remember that their connective tissues are a lot more elastic than adults and their tendons are able to withstand and absorb greater tensile stresses. The weak link in the MSK chain are the attachments of tendons to the bone where the apophyses are not yet fused. So when thinking of injury the Rule of Toos still apply but think ”anchor (apophysis) rather than rope (tendon) injuries.

It is important to remember,as Dr James Noake points out (follow him on twitter here @DrJN_sportsmed) think ANCHORS Adolescent, Not progressing, Cleared hip joint, High impact MOI, Origin pain and tenderness, Rope (tendon) intact clinically , Screen with x-ray in adolescent pelvic pain presentations.

I have also suggested similar in the past (and yep I realise that’s not Yoda ) In the case of young athletes this is enough evidence in the literature to suggest apophyseal traction injuries are common in young athletes.

This paper highlights the issue in young soccer players https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8796099/pdf/10.1177_23259671211065063.pdf

You can also access further reading on the subject here https://www.researchgate.net/publication/315511010_Lower_Extremity_Avulsion_Fractures_in_the_Pediatric_and_Adolescent_Athlete

As always thanks for reading and remember ”in the young beware”

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