What is it?
A common cause of knee pain in children, Osgood-Schlatter Disease is micro-trauma and inflammation to the growth plate at the top of the shin bone caused by repetitive traction from the patella tendon. Jumper’s knee (aka. Sinding-Larsen-Johansson Syndrome) is the same however pain presents at the bottom of the knee cap rather than the top of the shin.
They commonly present in children engaged in sports with repetitive running or jumping demands such as athletics, soccer, gymnastics and basketball. Often beginning around a growth spurt period, in girls at 8-13 years old and a little later in boys around 10-15 years old.
How to identify it.
Your child may complain of pain at the front of their knee without any traumatic episode occurring (tibial tuberosity pain). It may or may not be swollen over the front of the shin bone just below their knee cap, this area will likely be tender or painful to touch. Their pain will feel worse with sports and physical activity, which may lead to a limp.
How we treat it.
Osgood-Schlatter Disease and Jumpers Knee are self limiting conditions, meaning the pain will eventually go away once the child stops growing. This is encouraging, however during their growing phases it will require management to modulate pain levels and enable your child to continue their sports with enthusiasm and at their best.
We will discuss with you and your child what their activity schedule looks like and work with you to identify times where activity may need to be altered slightly. We will provide a personalised rehab regime, hands on treatment when necessary and educate you both in how to manage the pain at home, during training and sports, and on competition days.
Heel pain: Sever’s Disease (different to achilles tendinitis!)
What is it?
A common cause of heel pain occurring in active children caused by repetitive traction stress placed upon the calacneal growth plate from the achilles tendon resulting in painful inflammation and soreness at the achilles tendon. Sever’s Disease is an irritation of the bone, while achilles tendinitis is inflammation of the tendon that attaches to that bone. Sever’s Disease only occurs in children, occurring around the pubertal growth spurt or at the start of sports season and common in children playing sports with repetitive running and jumping such as football, basketball and athletics.
How to identify it.
Pain at the heel that is worse with weight bearing, walking, running or jumping. Your child’s pain may not be present when they wake in the morning but get worse as they start moving around. You may notice your child limping at the end of physical activity due to pain and discomfort.
How we treat it.
Your child’s pain will certainly end once they finish growing, in the meantime we will work with you and your child to create a plan to minimise their pain and enable them to continue the activities they love as much as possible. This plan will include treatment to reduce their pain and improve their movement, monitoring and periodically adapting their training loads when necessary to minimise flare ups in pain, exercises to help them keep their pain lower, moving at their best and enjoying their activities.
What you can expect from each chiro appointment:
- 1 on 1 appointments only.
- We have longer appointment times to allow us to go through every step
- Clear diagnosis and plan. We explain everything.
- We don’t do any treatments you don’t wish. We treat everyone individually.
- We will help reduce your pain, get you back moving and achieving your movement goals.
Stress fractures including shin splints
What is it?
Stress fractures, aka hairline fractures, are structural fatigue or damage to bone caused by repetitive strenuous activities, these include common conditions such as shin splints. They’re most common in the lower leg and foot, but can happen elsewhere. It occurs when the mechanical load placed on the bone outweighs the required time for new bone tissue to be laid down to create stronger bones, overtime resulting in unrepaired microtrauma or if further left untreated stress fractures
How to identify it.
A gradual onset of pain related to activities and sport is typical of these injuries, pain can often settle with rest but will return as soon as activity with the affected area is commenced. Pain will often increase over time and may be accompanied by swelling and tenderness over the area.
How do we treat it?
Depending on the stage of bone injury, the location of injury and your child’s individual circumstances, we will modify aggravating activities or advise a period of rest and immobilisation (such as a boot for stress fractures in the foot) as needed. We will work with you and your GP to provide pain modification if required in early stages. Once we have allowed adequate healing time we will work through exercises targeting mobility, stability, strength and finally return to play protocols to ensure your child builds the required bone strength and tolerance to return to their sports and activities safely and at their best.
Tendinopathy: tendinitis and tendinosis
What is it?
Tendinopathy relates to the pain and cellular response in a tendon caused by injury. Tendinitis is an acute inflammatory response acommonpanied by pain, warmth and swelling often after an obvious injury. Tendinosis is a chronic degenerative response without any inflammation commonly due to repetitive actions and overload. The pain in tendinosis will often come on gradually over time and no obvious injury is remembered.
How to identify it.
Tendinosis pain can be dull and achy in nature or sharp in certain positions, it starts gradually over time and often feels worse after activities or first thing in the morning when your child has not moved much for a longer period of time. Pain can sometimes feel better once they get moving and further into an activity but then will come back worse after their activity finishes.
How we treat it.
In early stages we will provide manual treatment to assist with reducing their pain and discomfort and restore more range of movement. We will work together with you to alter any activities as needed to allow the tendon time to recover and adapt whilst we are beginning the rehab process. The rehab process will involve providing individualised exercises that will build tolerance and strength in your child’s tendon to avoid reaggravation of their injury.
Sprained ankle
What is it?
A common sporting injury in children and adults alike, this is when one or more of the ligaments that support the ankle joint are partially or completely torn. Poor management of a first time ankle sprain often results in a higher chance of recurrence of this injury. Ankle sprains can be graded depending on the severity as a grade 1 ankle sprain, grade 2 ankle sprain or grade 3 ankle sprain.
How to identify it.
Your child will describe pain that comes on suddenly in and around the ankle, it will usually follow an incident such as stepping in a ditch in the grass or them explaining they rolled over their ankle while playing or competing. You may notice swelling, redness and sometimes bruising depending on the severity.
How we treat it.
In the short term we assist in protecting your injury from aggravation and keep your child comfortable while their injury undergoes the inflammatory process, this process is a necessary and a helpful component of healing. We will also assist in gradually regaining their joint range of motion and load bearing in a safe and comfortable manner. Doing this early, whilst guided by your child’s pain, helps to get the greatest outcomes in their overall care. Further on we will provide a personalised rehab exercise program to get their proprioception, stability, strength and athletic capabilities back up to where they need to be in order to play, compete and have fun with a reduced risk of re-injury long term.
Concussion in Kids
What is it?
Concussion is a minor traumatic brain injury that occurs when the head collides with another person, object or the ground or when forces placed upon the body transmit to the head and brain. Due to the developing brain and reduced musculature to that of an adult, children and adolescents are at a greater risk of secondary injuries if not managed correctly and require a prolonged recovery time compared to adults.
How to identify it.
Often there will be an incident, such as a fall, collision, tackle, ball to the head etc. The following concussion symptoms may be seen in your child:
- confusion or difficulty with memory and attention,
- headache or pressure in the head,
- irritability or mood changes (withdrawn, angry, anxious),
- nausea or vomiting,
- blurred vision or sensitivity to light,
- dizziness or balance problems, and
- lethargy or loss of consciousness.
If in doubt, assume they have a concussion, remove them from their sport or activity immediately and have them seen by a medical professional as soon as possible. Concussion symptoms may be tricky to recognised as they can be mild and delayed for hours or days. Be aware that even if they do not have symptoms immediately they should be monitored over a few days.
How we treat it.
Treatment involves reassuring your child and educating you in concussion, modification of their activities and slow reintroduction of physical activity over time that is guided by their symptoms. Concussion in Sport Australia recommends that children do not return to sport for at least 14 days due to their susceptibility to reinjury and prolonged symptoms. The focus during this time should be first on returning to day-to-day tasks without aggravation of symptoms, they can also slowly begin some non-contact activity in a progressed manner once they are symptom free. We will guide you through this process and help create a plan so that your child can safely and happily return to sport. While this process can be frustrating and feel long for your child, our focus is on the best health outcomes for your child long term.
