Kids are very active these days. Between soccer, gymnastics, football, baseball, dance, cheerleading, basketball, and everything else, there's a huge strain put on the foot and ankle. There's little wonder why many kids experience foot and ankle injuries.
The most common injury I see is an ankle sprain. An ankle sprain occurs when the foot rolls in on the ankle. The problem I see with ankle sprains is that they're so common, people think they're just not a big deal. But they are. When you roll your ankle, you injure the ligaments on either side. That's what a sprained ankle is, a tear of the ligaments.
The best way to treat an ankle sprain, after an x-ray to make sure nothing is broken, is to immobilize it in a walking boot. This will provide stability to the ankle, and allow the ligaments to heal in a more stable way. You can expect your child to be in a boot for about two weeks. Even after he comes out of the boot, I still recommend wearing a good ankle brace, especially when he's playing sports. If your child has recurrent sprained ankles, that's another reason to get checked. We may need to control the motion of the foot and the ankle with a prescription orthotic to prevent persistent sprains.
The second common injury seen in young athletes is shin splints. Shin splints are an inflammation of the muscles that attach to the front of the leg. Shin splints are an overuse injury. The muscles are contracting too much, which is what causes the inflammation. If you've had shin splints, then you know how painful it can be and it seems like will never go away. Initially you can treat your child's shin splints with oral anti-inflammatory medication and ice. That will help to control the inflammation. But the true culprit that makes shin splints so insidious is your child's foot mechanics.
Even though the inflammation is being controlled, the muscles are still working too hard. The way to get the muscles to work less is with the use of a custom orthotic. This will reduce the pull of the muscles to the point where your child no longer needs to take anti-inflammatory medication.
The next sports injury I'd like to discuss is a stress fracture. For child athletes, it's common to have a stress fracture in the metatarsal bones because of the excessive load during running and playing. In fact, this is one of the greatest dangers of playing on a harder surface. A stress fracture is a break in the bone that is not displaced.
A stress fracture needs to be immobilized and your child needs to stop participating in sports and running. If he continues to play or it doesn't properly treat a stress fracture, then it will become displaced and, at best, will require a longer recovery and, at worst, will require surgery to properly repair the broken bone. Your child can expect to be immobilized for six to eight weeks with a stress fracture. Even so, he won't go back to running or participating in sports until at least 12 weeks after the injury. I need to know the bone is strong enough to support him when he's running and playing.
The final sports injury is exclusive to young athletes. It's a condition that's responsible for pain occurring on the back of the heel. It's called Sever's disease. It's a condition where the pull of the Achilles tendon causes the growth plate on the back of the heel to become inflamed. Sever's disease affects active kids ages nine to 14. It's considered self-limiting. What that means is that if you do nothing to treat it, it will go away on its own. I don't know about you, but if my child is in pain, I'm not going to wait until his growth plate closes for him to be pain free.
The good news is there are ways to treat Sever's disease. A good start is applying ice and taking an anti-inflammatory medication. If the pain continues, it's time to come to the office. I'll take an x-ray to confirm it Sever's disease. We can actually see some changes to the growth plate because of the tension on it. I'll likely use a medical grade insole to lessen the pull of the Achilles tendon on the growth plate. I also may recommend a stretching splint to be worn at night. This will help to stretch the Achilles tendon. I may also refer you to physical therapy to help reduce the inflammation. Depending on how your child responds to treatment, I may recommend a custom orthotic. That will make the feet work in a more stable way. It will also reduce the pull of the Achilles tendon on the heel.