Recurrent and over-use injuries in children

Is your child complaining of recurrent heel or knee pain with no specific cause and it gets worse with activity? Aisling Dolan, one of our physiotherapists here at Milltown Physiotherapy, has a special interest in treating and managing such injuries, having done a recent thesis on this topic as part of her Masters.According to her review of recent research, the rise in children participating in organised sports has brought about an overall increase in over-use injuries. With this increased participation rate, there is also a growing pressure on children to perform at high levels and this can lead to inappropriate levels of training intensity, frequency and duration.“Calcaneal apophysits”, (more commonly known as “Sever’s disease”) is the lead cause of heel pain in children. This condition causes intermittent pain where the Achilles tendon joins the heel bone at the growth plate. When the load at this junction has exceeded its tolerance level, it can cause an inflammatory response. Other common symptoms can include tenderness on palpation of the back of the heel, swelling and pain provoked by activities such as jumping and running.The growth plates can be weak links and prone to this injury due to an increase in muscle tightness which occurs during growth spurts and increased levels of sport and activity. Aisling’s research reported that physiotherapy modalities are commonly used to manage these types of overuse conditions. Successful physiotherapy management includes activity modification, manual therapy and a home stretching programme specific to each child’s needs.Preventative strategies for these type of injuries include monitoring growth spurts, muscle tightness and ensuring that sport participation is managed appropriately with these variables.