The truth about overuse: how to prevent injuries before you need an orthopedic surgeon

Mar 5, 2013 -  As a parent you are always looking for ways to keep your kids healthy. From combating the common cold to getting more exercise, there seems to be an ongoing list of ways to keep you and your family going strong. But even some of your most well-intended efforts can be thwarted if you aren’t careful.

Soccer, ballet, yoga, football, biking—the more active you are, the better, right? As long as you can stay away from injuries and skip the need for an orthopedic specialist, or even worse, orthopedic surgery. With an increasing number of boys and girls playing recreational and organized sports, there is a rise in the number of overuse injuries seen among children and adolescents. The majority of sports and overuse injuries are due to minor trauma involving soft tissue injuries—injuries that affect the bone, muscles, ligaments, and tendons.

Common overuse injuries in children
Kids grow fast—it’s what they are supposed to do, but when it comes to overuse injuries, that doesn’t do them any favors. Rapid growth of bones in children can contribute to stress on tendons and joints. Here are some common overuse injuries you might see in your children.
  • Jumper’s knee/patellar tendonitis – tenderness in the upper shin area or just below the knee, usually due to repeated pulling on the patellar tendon in the knee joint
  • Osteochondritis – pain and swelling in the knee, caused by a piece of cartilage that has separated from the knee joint
  • Sever’s disease – heel pain and limping, due to running or jumping repeatedly, which pulls the Achilles tendon where it attaches to the heel
  • Shin splints – pain and tenderness in the shins, caused by too much running, or running on too hard a surface, or running in shoes that are worn down and don’t provide enough cushioning
  • Sinding-Larsen-Johansson disease (SLJ) – knee pain, especially at the bottom of the kneecap, caused by inflammation or fracture of the kneecap due to repetitive stretching of the patellar tendon – this can be made worse by growth spurts, when the bones grow faster than the tendons
  • Spondylolisthesis- A stress fracture in one of the spinal joints caused by in the back slipping forward, caused by excessive flexing and extending of the lower back. Often plagues football linemen, gymnasts, and ice skaters.
Overuse injuries heal quite quickly in children and generally don’t require the skills of orthopedic surgeons. However, if your child should become injured, it is important that your child stick to the activity restrictions and stretching and strengthening rehabilitation programs your orthopedic specialist outlines.

Adults can get overuse injuries too
Don’t discount yourself. Parents can get overuse injuries too. But because our bodies are different, our injuries are different. Here are some common overuse injuries in adults.
  • Knee injury – pain in the front, inside, or outside of the knee; this can be caused by normal wear and tear over time, or an acute injury
  • Sprain – stretched or torn ligament (which holds bones to joints), can be caused by a fall or blow to the joint
  • Strain – twisted, pulled, or torn muscle or tendon (which holds muscle to bone), caused by a muscle/tendon stretching or contracting more than normal
  • Tennis elbow – pain over the outside area of the elbow, or with wrist movement, usually caused by repetitive strain on the tendons in the elbow (so named because it happens often with racquet sport players); tennis elbow can also happen in children
Treatment of an overuse injury by an orthopedic specialist or doctor
If you think you or your child has an overuse injury, it’s important to get evaluated right away. Because overuse injuries can also lead to stress fractures, in both children and adults. Stress fractures are weak spots or small cracks in the bone caused by continuous overuse.

Specific treatment for an overuse injury will be determined by your doctor based on:
  • Your age, overall health, and medical history
  • Extent of the condition
  • Type of condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
The goal of treatment is to control the pain, promote healing, prevent complications, and restore normal use of the injured area. Initial treatment for overuse injuries includes R.I.C.E. (rest, ice, compression, and elevation). Be sure to consult your child's doctor if there is a prolonged, visible deformity of the affected area, or if severe pain prevents use of the arm, leg, wrist, ankle, or knee.

Other treatment options may include:
  • Medications
  • Activity restrictions
  • Splint or cast
  • Crutches or wheelchair
  • Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons)
  • Surgery (especially if the injury is reoccurring, there is persistent pain, or if a muscle, tendon, or ligament is badly torn)
Finding the right care for your injury: when to see an orthopedic surgeon or specialist
Recovering from an injury or surgery often requires rehabilitation services such as physical, occupational or speech therapy to promote healing and restore function. Your doctor or orthopedic specialist will help you coordinate care to help you or your child get back on your feet in no time.

In eastern Connecticut, ECHN's numerous rehabilitation centers provide evidence-based treatment for orthopedic and sports injuries like overuse injuries with a variety of convenient locations throughout eastern Connecticut. Our dedicated team of orthopedic surgeons, rehabilitation specialists and doctors work together to develop a comprehensive plan for recovery and beyond. We offer flexible scheduling, Monday-Friday, with appointments available early in the morning and in the evening.

How to cut down on overuse injuries: conditioning and preventing
Of course the best thing is to never have the injuries in the first place. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) says that injury rates could be reduced if all athletes—professionals and amateurs—followed essential safety, conditioning, and preventive strategies. Many sports injuries can be prevented with proper conditioning and training, wearing appropriate protective gear, and using proper equipment.

Other methods of lowering risk of injury include warming up and cooling down muscles and joints before and after sports, training to strengthen areas that will be under stress in a particular sport, use of appropriately sized and well fitting sports equipment, and use of proper technique in play

Online Medical Reviewer: Berry, Judith, PhD, APRN
Online Medical Reviewer: Luks, Howard, MD

Last Annual Review Date: 1/6/2012

© 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

Online Medical Reviewer: Jones, Niya, MD
Online Medical Reviewer: Walton, Olivia, PA-C, MPAS

Last Annual Review Date: 7/4/2011

Copyright Health Ink & Vitality Communications

Online Medical Reviewer: Luks, Howard, MD
Online Medical Reviewer: Ziegler, Olivia Walton, MS, PA-C

Last Annual Review Date: 1/16/2012

© 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

Online Medical Reviewer: Bass, Pat F. III, MD, MPH
Online Medical Reviewer: Finke, Amy, RN, BSN

Last Annual Review Date: 10/22/2012

Copyright Health Ink & Vitality Communications


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