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
A significant extreme of an overuse injury is a stress fracture. This too is a normal reaction to an abnormal stress placed upon a bone. While it is classified as a fracture, it is not the typical, broken bone fracture many of us envision. Rather, it is a fracture of a portion of a bone and there is no displacement of the bone. It can be visualized as trying to break apart a wet tree branch. While its integrity may be disrupted, it never quite snaps in half. A stress fracture usually develops over a period of time after accumulation and absorption of a series of externally applied stresses. For those afflicted, it first presents with local pain (pain directly in the area of the stress fracture); increased discomfort when ambulating or using the affected bone and it feels much better when resting. X-rays usually identify these approximately two weeks after they occur. An MRI (Magnetic Resonance Imaging) can identify it much sooner. Another tool to identify a stress fracture is a bone scan. This special test is very good in assessing injuries to bone.
Treatment is pretty straightforward; the child must refrain from weight bearing sporting activities for about 6-8 weeks. Non-weight bearing sporting activities such as swimming and riding a stationary bicycle are indicated and recommended. Depending upon where the stress fracture is located and the extent of the stress fracture, your physician may allow you to bear some weight on the affected limb while it is healing.
Sometimes, stress fractures recur. In this instance, further diagnostic evaluations are required. The first question is whether or not there was adequate healing of the first stress fracture. If the child did not follow through with reduction of weight bearing, healing may be delayed. Perhaps the child does not consume adequate calcium and Vitamin D. Two to three glasses of milk/day will certainly help this cause. Another possible etiology for recurrent stress fractures is biomechanical error. When the foot strikes the ground below, some people do not absorb the forces exerted onto the body by the ground very well. For instance, the stress load applied to the foot as it strikes the ground during ambulation must be absorbed into the foot. In some, these forces are excessive and these stress loads lead to stress fractures.
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