Bouncing Back from Injury
Active children can be the most resilient. but of late, local doctors are seeing an increase in repetitive sports injuries in kids with packed athletics schedules. The good news? These injuries are totally preventable. By Meg Russell
William Kolman is a typical 10-year-old boy. He loves sports and plays quite a few: football, hockey, lacrosse and baseball, in addition to year-round squash. That all started to change in March, when he developed consistent knee pain. Soon enough, Kolman had trouble walking. After meeting with physicians, he was diagnosed with osteochondritis dissecans (OCD). Simply put, his bone was dying from a loss of blood, a result of his intense activity level. Kolman is now walking with crutches and resting his knee in the hopes of avoiding surgery and resuming his active lifestyle.
Kolman’s case is extreme, but it isn’t totally isolated. Physicians say they have seen a marked growth in the number of sports-related injuries in children in the last 10 years. Dr. Katherine B. Vadasdi, an orthopedist at Greenwich-based Orthopaedic & Neurosurgery Specialists, says that while there is always a risk for traumatic injury with contact sports such as football and soccer, she has seen an increase in patients as young as six being treated for sports-related overuse injuries, most commonly associated with tennis, baseball, swimming, gymnastics and track. “I am seeing young kids who are not necessarily doing one sport intensely but are active all day, every day,” says Vadasdi. “They’re playing tennis, they’re playing golf, they’re doing PE in school, they’re on the local soccer and T-ball teams. Every day, they are constantly doing at least one significant activity.” All those hours are adding up and taking a toll on young athletes’ growing bodies.
Dr. Jordan Metzl, a sports medicine physician at the Hospital for Special Surgery in Old Greenwich and Manhattan, has seen dramatic changes in youth sports in the past decade as well, most notably an increased level of competitiveness and a trend in focusing on one sport year-round. While ballet dancers and gymnasts need to specialize at an early age if they want to achieve a significant level of success, the vast majority of kids do best when they are playing different sports throughout the year, says Metzl. This schedule encourages strength in varying muscle groups, mitigating abuse to a single part of the body.
The growth plate, an area of developing cartilage tissue at the ends of long bones in the arms and legs, is generally the weak link in the system, says Vadasdi. When children are playing various sports many times a week at high intensity and without rest days, they are at risk for damaging the delicate growth plate, which can affect how those bones develop into adulthood. The child who is focusing on only one sport and is playing that sport several hours a day, every day, is at an even greater risk.
“We try to do everything we can to allow them to get better without having to pull them out of their sport,” says Vadasdi. “We do everything from stretching and strengthening exercises to decreasing the duration or the frequency of their activity to making sure they take a day of rest each week. We also try bracing techniques, icing and anti-inflammatory (medications) if the injury allows for it. If the pain gets severe enough, we have to pull them out.”
Rick Stebbins, a Greenwich-based physical therapist and personal trainer, works with athletes of all ages to maximize their ability on the field while minimizing the risk of injury by teaching proper body alignment from the first session. (He usually asks new patients to start by skipping across the room. If the patient can’t skip properly, it’s most likely that he can’t run correctly, either.)
“I see it as a pyramid,” says Stebbins. “Fundamental movement skills are on the bottom; as you get better and better at that, you can pinpoint your focus to a sports skill.” Unfortunately, kids are honing in on one specific sport long before they have established healthy and strong movement patterns, jeopardizing the quality of movement and creating a perfect scenario for chronic injury. Stebbins says that if children learn how to build a strong foundation based on basic human movement patterns, they’ll avoid injury, and benefit in their sport as well as in daily life.
“The competition to make the team is so great that kids are worried if they aren’t out there and are missing games and practices, they can’t catch up,” says Dr. Kerry Miller, a chiropractor at Greenwich Sports Medicine who treats young athletes who’ve suffered from injuries such as hip labral tears and ACL tears. “They push through their injuries.” As a result, doctors and physical therapists are encouraging parents to remind their children to stretch before and after playing sports and get proper rest.Children should have at least one day off each week from formal sports, maybe using that day to play more informally in the yard with family or friends.
Metzl’s rule of thumb for parents is that if a child’s pain is limiting his or her ability to do the sport, get it checked out. Vadasdi agrees, noting parents’ observations offer the best chance for early diagnosis and quick recovery. “Parents know their children best and can detect subtle changes in their behavior,” she says. “The goal is to diagnose injuries early and make sure that children can enjoy their sport of choice for five more years or for 50 more years.”