Sports Injuries of the Lower Limb in Children and Adolescents By David Wong – Podiatrist

Differences between Child and Adult Sports Injuries

The young sportsperson is not a smaller version of an adult. Treating children, teenagers, and adolescents for sports related injuries requires expert knowledge about the patient’s development. Children’s bones, muscles, tendons, and ligaments are still developing, making them more susceptible to injury. In addition, there are substantial differences in coordination, strength, and stamina between children and adults. The treatment supplied may look the same or similar to treatment delivered to an adult with a similar injury, but there is more at stake for a growing body than just the injured ligament or joint.

Children, teenagers, and adolescents injure themselves in many different ways, although 40% of all youth injuries are sports related. When an injury is sports related, we categorize them into two types of trauma;

  1. Micro – due to repetitive actions or over-use
  2. Macro – due to a single traumatic event

Kids are inspired to play sport because it’s fun and it helps build many different physical and social skills. But children will be put at a higher risk of injury if parents or coaches demand too much. Often children are encouraged to “Toughen up and play through it” or “You’ll be right”. This approach is not in the best interests of our children for the following details:

  • It can lead to a delay in healing and therefore a delay in returning to sport
  • It can lead to further damage and turn an easily treatable injury into one more complicated
  • It can sometimes lead to more permanent damage, that prevents future sports involvement

Accurate Diagnosis

An accurate diagnosis with appropriate treatment is essential.

While medical investigations such as x-ray or ultrasound, or other special tests can be helpful, I can usually make an accurate diagnosis without them; by taking a thorough history of your child’s injury, previous medical history as well as their sports obligations and by performing a detailed examination of the injured joint or area.

The age and gender of your child, as well as their level of participation in sports are essential to their risk of injury and types of injuries sustained. A description of how the injury occurred is valuable or if there was any audible sounds that occurred during the injury such as a “pop”. Other things to note would be if there is swelling, a previous history of injury in the area, family history of similar injuries, locking, or giving way in the joint, level of pain or any other signs or symptoms.


Treatment depends on the diagnosis. But when you are on the field and your child suffered a soft tissue injury, a strain or a sprain, or even a bone injury, the best immediate first aid is RICER.

  • Rest
  • Ice
  • Compression
  • Elevation
  • Referral to health professional

Referral to a health professional, particularly if any injury is severe. A severe injury is defined as having an obvious fracture or dislocation of a joint, prolonged swelling, or severe or continued pain. Treatments can include orthotics, strapping, crutches, immobilization, or referral to other medical specialties.

Common Sports Related Injuries

Strains and Sprains

A strain is an injury to either muscles or tendons. (A muscle is a tissue composed of bundles of specialized cells that produce motion. A tendon is a tough, fibrous cord of tissue that connects muscles to bones)

A sprain is an injury to a ligament. (A ligament is a band of tough fibrous tissue that connects bones to joints and prevents excessive motion of the joint. Ankle sprains are the most common sporting injury.)

Growth Plate Injuries

The growth plate is the area at the end of long bones where they grow in children. If any of these areas become injured, it’s important to seek professional help. Common growth plate injuries are Severs disease (pain in the heel), or Osgood Schlatter’s disease (pain in the knee).

Repetitive Motion Injuries

Painful injuries such as stress fractures (a hairline fracture of the bone that has been subjected to repeated stress) and tendonitis (inflammation of a tendon) can occur from overuse of muscles and tendons (growing pains are an example of this). For some overuse injuries, the child may want to be picked up or carried due to tired aching feet, ankles or legs, or tire easily from walking or exercise. Some of these injuries are not always revealed on x-ray, but cause pain and discomfort.  Of course RICER usually assists in recovery.

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David Wong, Podiatrist