Adolescent Injuries And Training

Children and adolescents are not just small adults. They have different anatomy and thus different injuries. In children, bones do not grow from the ends, but from an area called a growth plate in which there is a space of bone that is not fused and bone grows from above and below the unfused area. The unfused region is an inherently weaker area of bone. Sprains in adults are common and involve ligamentous injuries. Children with trauma to the ankle, for example, will often injure the growth plate causing a growth plate fracture before tearing the ligament itself. Treatment is similar to a true break or fracture of a bone using immobilization in a boot or cast to allow the bone to heal.

Because of the immaturity of bone, adolescents can sustain injuries at the site of muscle and tendon attachment. Repetitive stresses at these sites can cause a further spectrum of injury. Specifically there is Little Leaguer's elbow with adolescents who play baseball all year round rather than seasonally.   Treatment includes rest from throwing, checking mechanics, icing and rehabilitation.

Prevention and conditioning is key to avoiding many adolescent injuries. Continuing with the baseball example, pitching is not a "no pain no gain" activity. Strict pitch counts which include games plus practice are crucial. A rule of thumb for pitch counts is not to exceed a child's age x 10. Children should avoid certain pitches such as curve balls and sliders until they are fully mature.

A conditioning program including strengthening and stretching should begin a good six weeks prior to the season and continue during the season. Playing multiple sports throughout the year can also be beneficial in giving certain muscle groups much needed rest.

David B. Gealt, D.O.
Director Sports Concussion Program
Assistant Director of Sports Medicine
Cooper Bone and Joint Institute

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