25 February 2018

"Children are not just small adults" - how often have you heard this bandied around? But it is true!

There are specific injuries and illnesses that occur in children that do not occur in adults and vice versa. Thus when having your child evaluated for a sporting injury or ongoing pain issue, these need to be taken into account. Common adult issues are uncommon in children (until their late adolescent years) e.g. rotator cuff injuries, plantar fasciitis etc.

Many times parents come to me stating that they thought the pain their child was having was related to "growing pains". Certainly children can have pains which are non-specific during their growth years but these tend to be intermittent and generally not affect their functioning at sports. Some children that are "double jointed" or very flexible will also have these non-specific pains. Ongoing pain and particularly associated with swelling or inability to complete their sport should be evaluated.

Children do have issues related to their growth - because as they grow they generally become stiffer and less flexible. Their bones grow faster than their ligaments and muscles and thus where the muscles / tendons insert onto the bones, this can cause pulling and thus pain. The common conditions around this process is Osgood Schlatters (insertion of the tendon just below the knee) and Severs (insertion of the Achilles into the heel bone). There are a number of other areas that can be affected as well (e.g around the hip, knee and foot). These conditions are generally seen when the child is going through their growth spurts (e.g. severs 8-12 yrs and OS 10-16 yrs). These conditions will cease to be a problem when the child stops growing. The main stay of treatment is an accurate diagnosis and explanation.

Concussion is an evolving issue in sport and particularly among children. It is important that if children are diagnosed with a concussion that they have a graduated program of returning to school and sport and clearance prior to returning to sport. Royal Children's Hospital fact sheets for parents explain this process and are based on expert guidance and world processes. There will be an App coming in the next few months which will incorporate this process for trainers and parents - HeadCheck 2.0 - Due for release in April 2018. If you are concerned that your child is not recovering as you might expect then evaluation is essential so that a tailored process can be undertaken to return them to sport and school. Going back too early is the cause of ongoing issues.
Issues of Bow legs, Knock knees, intoeing, flat feet etc are all normal aspects of growth and generally do not need intervention such as orthotics and braces. Evaluation around why the child's structure of their legs looks abnormal is important to make sure that intervention is not required. Generally if the structure seems to be getting worse then evaluation by a paediatric musculoskeletal specialist should be considered. They will generally reassure you about the growth or organise follow up in the future.

I wish your children all the best in their sporting activities and at Alphington Sports Medicine Clinic we aim to diagnose your child's problem and implement a treatment program if required.

Dr Peter Barnett, Paediatrician

For more information on Dr Peter Barnet visit our Practitioner Page and call us on 9481 5744 if you'd like to make an appointment with him.