During the child and teenage years, everyone experiences those days or weeks where you feeling aches throughout your body. You are always told that they are just growing pains and they will pass. However during out adolescent stage of life we are more susceptible to a unique group of injuries. The reason being that: as children, our bodies are continually growing; and for this reason an adult is not susceptible to these types of injuries.
The most common condition since throughout childhood is an apophysitis, an imbalance between bone and muscle/tendon growth. During growth spurts, bones tend to lengthen before muscles and tendons are able catch up. This imbalance can lead to muscle/tendon injuries and an avulsion fracture. An avulsion fracture occurs when a muscles breaks a small amount of bone without fully separating. The bone re-grows in this separated position and usually has little implication for the child. The most common apophysitis injuries are Osgood Schlatter lesion and Sever’s Disease. Osgood Schlatter lesion occurs at the tibial tuberosity (top on the shin bone), and is due to repeated contraction of the quadriceps/patella tendon. Sever’s disease occurs at the calcaneal (heel bone) and occurs with repeated contraction of the calf/Achilles tendon. The onset of pain is usually due to a high level of physical activity during periods of growth. Symptoms usually include tenderness and swelling around the tendon and increase in pain with activity. These injuries will fully resolve, though it is dependent on the child reducing, or completely ceasing activity to allow healing. Treatment also consists of icing the area following an activity that aggravates symptoms, stretching tight muscles and addressing any movement abnormalities.
The next most common injury among growing children is back pain. While mostly back pain in children can be associated with tightness in their legs or poor postures, there are two conditions that primarily associated with adolescents. These areSpondylolysis/Spondylolisthesis and Scheuermann’s lesion.
Spondylolysis/Spondylolisthesis are similar injuries as they both involve a stress fracture within a vertebra, a back bone, however spondylolisthesis also involves a slipping forward of the vertebra. The adolescents who are more susceptible to this type of injury are those who regularly hyper-extend their backs combined with rotation (twisting) like cricket, dance, diving and gymnastics. They will generally complain of an ache in the lower back and pain with arching backwards. Often the slip of a vertebra can be felt on palpation and is evident on an x-ray. Treatment includes resting from activities, improving the lumbar spine stability while also adjusting any biomechanical issues.
Scheuermann’s lesion is a condition that affects the thoracic spine (mid-portion of the back) due to irregularities in the growth of the spine. The most obvious symptoms are an increased curve in the thoracic spine known as a kyphosis. Diagnosis is usually confirmed with an X-ray that will show wedging (narrowing) of a few vertebras. Management of Scheuermann’s lesion is aimed at preventing further progression by encouraging thoracic movement while improving the support structures of the spine.
Finally, a much less common condition that affects adolescence is Osteochondrosis. This injury affects the growth plates of the child’s bones and predominantly found in the lower limb. Main symptoms of a joint with osteochondrosis are joint pain with significant restriction (an occasionally locking of the joint). Generally the condition can avoid surgery with good management, which includes resting and correcting biomechanical issues.
A growing concern among children and adolescents population is the use of tablets, laptops and smart phones. As these products become more accessible, and cheaper, they have started to become a bigger part of their lives. This has led to an increase in back pain, either lower back or mid spine, and neck pain among children and adolescents. This is largely due to the sustained poor postures these devices tend to encourage.
At Coastal Physiotherapy we are experienced in assessing the growing body of children and adolescents, and able to determine if any serious condition is affecting your child. Ultimately the conditions listed above are not common but without an early and skilled assessment these conditions can worsen and lead to further, more complicated issues.
For more information on these issues, or to book an appointment for yourself or your son or daughter, talk to your friendly Gold Coast Physio today on (07) 5574 4303.