12 Pediatric Sports Injury Questions Every Parent Asks—Answered by a Pediatric Orthopedic Expert

Loaded question but I think majority would say football. Regardless of the sport, the focus should be on teaching/learning the fundamentals as well as using the appropriate equipment and safety precautions. When kids and coaches/parents are all on the same page I think it makes for safer and more FUN sports in general. 

2. Break vs. fracture vs. sprain vs strain: what’s the difference?

A break or fracture are words used interchangeably to describe an injury to a bone. After I tell parents/patients that they have a fracture a common response I get is, “Oh, it’s a fracture, so it’s not broken!” Which I typically respond with, it’s the same thing. We go further into describing/classifying fractures based off of other things such as the location of the fracture and it position on an X-ray.

A sprain describes an injury to a ligament, tissue that connects a bone to another bone. Sprains are common in the fingers and ankle and can range from “overstretching” to different grades of tears.

A strain describes an injury to a tendon, tissue that connects muscle to bone. Strains are common in thigh and back muscles and can range from “overstretching” to different grades of tears.

3. How can I help my child with Severs Disease (heel pain)?

Sever’s disease or calcaneal apophysitis is a common diagnosis in our orthopedic clinics. Usually, kids around the ages of 10-12 complain of heel pain with activity/sports particularly during sudden increases in volume and intensity as well as during rapid phases of growth. Since this is something that can ebb and flow until their growth plates close, consistency is very helpful. Every kid may have a different formula of what works for them and by sticking to it they have a better chance of avoiding recurrent flare-ups.

Simple interventions that I recommend separate from activity modification and rest are:

• Using gel heel cups in daily and athletic footwear
• Encouraging proper stretching and warmup routine both before and after activity 

4. My child walks with feet turned inward or outward. Is that normal? 

In-toeing and out-toeing are developmental variations of the legs related to intrauterine (in the womb) positioning. They are commonly a result of rotation of the thigh bones or shin bones rather than issues with their feet. In-toeing tends to improve over time as kids develop and grow. Out-toeing doesn’t tend to correct as much but it doesn’t typically affect kids' function or require treatment/intervention. 

X-ray’s may be necessary for including but not limited to:

• The injury itself looking "serious”
• Visible swelling or bruising
• Your child not being able to walk or move the limb after the injury
• Persistent pain even when your child is resting

When in doubt, schedule a walk-in or same-day appointment at Connecticut Children’s.

6. What are the most common orthopedic injuries you see in active kids—and how can we prevent them?

The most common traumatic injuries I see are:

• Clavicle (collar bone) fracture - fall from a height (Ex. Playground, bed, counter stool)
• Wrist fractures - fall from standing height or from a bike/scooter, contact/sports injuries
• Ankle sprains  - twisting injuries during daily life and/or sports/activity

The most common overuse injuries I see are:

• Knee pain
• Elbow pain
• Heel pain

Here are some of my common prevention tips:

• Wear sport/activity specific footwear – play basketball in basketball sneakers, not crocs
• Limit weekly formal training hours to child’s age
• Avoid year-round specialization in one sport – take summers “off”, incorporate other sports and movements
• Emphasize fundamentals and allow kids to progress at their individual pace

7. How long should a child use crutches or a boot? 

This depends on multiple factors including but not limited to: extent of injury, location of injury, age, activity level. Also, recovery time and need of crutches/boot vary from kid to kid. For example, a simple ankle sprain may require a walking boot for 1-2 weeks and +/- crutches whereas certain ankle fractures may require non weight bearing in a cast and crutches for several weeks.
 

8. When should kids stretch: before or after sports?

I could spend all day on this topic! Short answer:

• Before sports: focus on dynamic stretching/warmup (e.g., high knees, lunges, light jogging). You want your tissues to be “warm” and in the ready position before you stress them with sprinting, jumping, etc. on the field or court.
• After sports: proper cool down which can be simple as walking around the field or track after you are down competing until your body adapts as well as static stretching major muscle groups to bring them back to resting position.
   

Your pediatrician is a first step for common orthopedic concerns. You may receive a referral from them to see a pediatric orthopedic specialist for issues that are more specialized. If you have any questions regarding appropriate conditions feel free to check our website or the call the office.

We offer scheduled appointments for new patients/new problems as well as same-day and walk-in visits for urgent injuries Monday – Friday. You can conveniently book online for a same-day appointment. For injuries that happen after hours or on the weekends, our pediatric urgent care in Farmington, CT and pediatric emergency department are staffed by pediatric trained experts.

10. Do kids with flat feet need orthotics or special shoes?

Flat feet are a common concern for parents, but they don’t usually cause pain or any functional issues for kids. I usually recommend kids wear appropriate fitting footwear. For example some kids have feet that are wider, narrower, taller, etc. Start by finding footwear that is right for them. Local established shoe stores and running stores can be good resources. Some kids may benefit from insoles as well, but it is not always necessary. There are many good over the counter insoles nowadays that can be helpful and more affordable than custom orthotics that tend to be more rigid and that kids grow out of quickly.

11. Can physical therapy prevent future sports injuries?

Working with a physical therapist is vital for successfully recovering from many common sports injuries as well as preventing recurring or new injuries. They are also there to make sure kids are ready to return to their sport well before getting back on the field or court.

12. When is it safe for kids to use weights? And what is the best way to start?

It really depends more on maturity than age. Before kids even pick up a weight, they should be able to follow directions and show proper form. I typically suggest starting with body weight and/or resistance bands for kids as they start strength training.