Still the #1 injury in kids, ankle sprains commonly occur during sports. The ankle “twists,” (usually inward) and the bottom of the foot faces the other ankle. Pain occurs rather immediately
Not unlike their adult counterparts, injuries in kids come in many varieties and degrees.
While some are due to direct blows, such as falling from a bicycle and others are due to indirect causes such as a knee-twisting injury while running on a soccer field, the most common one I see today is due to overuse. Simply defined, overuse arises when one does too much. The dilemma, I subconsciously find gratification with some overuse injuries. Why in the world would a physician welcome injuries of any sort? Why would I find solace when a child suffers an injury? The answer is simple; we live in a world of sedentary children who are battling an epidemic of obesity. The ramifications of this sedentary lifestyle are battling tobacco usage as the #1 preventable cause of death in the USA. Not to mention the direct correlation of obesity with hypertension and diabetes. So if you read between the lines, my subconscious gratification is easy to understand. The child suffering with an overuse injury is likely pretty active. After all, overuse injuries are due to doing too much, not too little. Now the challenge becomes, find that meeting point where the number of overuse injuries and incidence of childhood obesity BOTH decline.
An overuse injury may actually be the bodies’ normal reaction to an abnormal stress placed upon it. Our body is the most integrated, finely tuned, efficient machine one could ever develop. It withstands a myriad of stresses and challenges, and maintains itself in an almost perfect state of equilibrium. It is not until an external challenge persists, that there comes a point of “breakdown.” Overuse injuries represent this point of breakdown.
The most common overuse injury is tendonitis. Tendonitis signifies inflammation of a muscles tendon or musculotendinous junction. A tendon is the end part of a muscle, the part that attaches directly to bone. It is usually very strong and resilient. However, with repeated stress, it can become injured and inflamed. This is usually manifest by local pain, soreness, and the inability to effectively use the affected limb or body part. Like in adults, this injury takes time to heal. Unlike adults, rather than four to six weeks, resolution can occur in three to four weeks. Frequent icing may help. I prefer to apply ice either directly onto the skin or through a towel placed over the region injured. Ice application should last approximately five minutes, after which time it is removed from the area for five minutes and then placed back on for five minutes. This sequence should be followed for a total of 30-45 minutes. Once improved, a program of strengthening and stretching (tight tissue) is recommended. Also, a 5-minute warm-up before exercising may help loosen tight tissue. This could be something as simple as a brisk walk or jogging in place. While there is great controversy related to the benefits, or not, of stretching, I strongly recommend it in the “growing” child. Young adolescent bones are elongating at a more rapid pace than their muscles can keep up with. Therefore, tight muscles may be the norm for adolescents. Please, when stretching, do NOT “bounce” the area you are focusing on. Rather hold the sustained stretch for approximately 30 seconds, and then return to your original posture. You also may find benefit from pre-warming the muscle to be stretched. Simply apply a warm towel for 5 minutes and this may ease the ability to stretch a tight muscle.
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