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What to Expect If Your Child Has a Stress Fracture

What to Expect If Your Child Has a Stress Fracture

by | Jan 8, 2024 | Sports Medicine

If you have a young athlete in the family, you probably know that bumps and bruises are part of the game. A more severe injury, like a stress fracture, however, can be worrisome for any parent. Being informed about the nature of stress fractures and how to help your child heal can ease your mind.

What Causes Stress Fractures in Kids?

A stress fracture, sometimes called a hairline fracture, is a tiny crack in a bone caused by physical stress. This type of injury often occurs when a specific muscle or joint is overused or strained, known as an overuse injury.

Stress fractures commonly occur when a child performs the same movements over and over again, for example, running, jumping or throwing a ball.

Telltale Signs of a Stress Fracture 

Stress fractures develop over time, and one of the first signs you may notice is your child frequently complaining of pain after playing or practicing their sport. 

Your child may experience other symptoms, including:

●      Pain during exercise that doesn’t always go away with rest

●      Redness

●      Swelling

●      Tenderness

Swelling or bruising may develop around the bone in the early stages of the injury when it’s considered a “bone stress reaction.” As the injury worsens, it develops into a stress fracture, causing a crack or tiny break in the bone.

Stress Fractures Commonly Seen in Kids

Stress fractures are most common in the weight-bearing bones in the legs and feet, including the tibia bone (shinbone). However, young athletes can experience stress fractures in many other parts of the body. 

Gymnasts, for example, can develop stress fractures in the wrist, while softball and baseball pitchers may experience stress fractures in the arms or shoulders. Stress fractures affecting the lower extremities are common in nearly all sports since most activities place stress on the legs and feet. Rarely, stress fractures can develop in the spine or ribs.

How Are Stress Fractures in Kids Diagnosed and Treated?

If your child has symptoms of a stress fracture, check in with a medical provider. A sports medicine specialist can help determine the cause of your child’s discomfort and provide a treatment plan.

To diagnose an injury, the provider will first gather your child’s medical history and then conduct a physical examination, focusing on the area of discomfort. If the provider suspects a stress fracture, he or she may order imaging tests, such as an X-ray, CT scan or MRI, to confirm a diagnosis.

The primary treatment for a stress fracture is rest. Because the injury is most often the result of overuse of a bone and the surrounding muscles, taking the stress and strain off that part of the body is essential. Your child should take a break from activity, and if the injury is in the lower body, your child may also need to wear a boot or use crutches to take weight off the injured bone.

In rare cases, bones that don’t heal after a long period may require surgery to heal correctly.

Prevention 101

To reduce the risk of a stress fracture, have your child avoid repetitive movements as much as possible. Also, encourage cross-training. Having your young athlete do activities that require different muscles and movements not only limits stress on a single joint, but it can also strengthen other muscles and improve their performance in their primary sport.

You can also help your child prevent stress fractures by having them prioritize rest between games and practices, using proper sport-specific equipment and eating a balanced diet rich in vitamin D and calcium. Finally, teach your child never to play through pain.

Think your child may have a stress fracture? Call 469-515-7100 to schedule an appointment with one of Scottish Rite for Children’s sports medicine specialists.

Apophysitis of the Hip or Pelvis

Apophysitis of the Hip or Pelvis

by | Mar 1, 2021 | Sports Medicine

The professionalization of youth sports has led to an epidemic of overtraining. With that comes an increase in injuries caused by overuse. Unlike injuries from overuse in adults, like carpal tunnel syndrome, pediatric overuse injuries occur at areas of the bones called growth centers. These areas are vulnerable to injuries. Pediatric orthopedic surgeon Henry B. Ellis, M.D., says, “Rest and activity modification is crucial for these conditions.”
With an interest in studying and treating conditions in the hip in athletes, Ellis informs families that other treatments are unlikely to work if the aggravating activity continues. He encourages athletes to listen to their bodies and learn to properly stretch and to speak up if there is activity-related pain.

What is apophysitis of the hip or pelvis? 

Tenderness in specific bony areas of the hip and pelvis is called apophysitis. This typically occurs in adolescents ages 10- 19 who have “tight” hip and thigh muscles.

What causes apophysitis in hip or pelvis?

Muscles of the hip attach on the pelvis and upper leg bones. In growing children, several tendons attach to apophyses (growth plates). On the pelvis, these include the iliac crest apophysis and the ischial tuberosity apophysis and on the hip, the greater trochanter apophysis. These areas are made up of soft cells called cartilage. These weaker cells are at a higher risk of injury.

The most common cause of the pain is repeated pulling of the tendons on the apophysis causes apophysitis (painful inflammation). This commonly occurs during periods of rapid growth or increased activity. Overuse in these areas occur in activities such as dance, gymnastics and those that include running and sprinting.

What are the symptoms of apophysitis?

Apophysitis causes pain or tenderness at the muscle attachment that worsens with activities such as sports or running. Some experience swelling, others feel or hear a pop or snap.

How is it diagnosed?

A thorough history and physical examination are used to diagnose apophysitis. In some cases, X-rays may be ordered to evaluate the growth plate and rule out other issues.

How is it treated?

This is a self-limiting condition where rest is recommended, but kids may participate in activities that do not cause painful symptoms. Treatment includes modifying activities and providing comfort as needed. Learning to properly stretch and strengthen the muscles attached to the apophysis will reduce the tension.

A gradual return to sports is recommended when pain is improved. Symptoms will resolve with completion of growth in this area. In time, stronger bone cells replace the soft cartilage cells, but pain may come and go for months to years. If symptoms persist and cannot be managed with rest, it is important to see a medical provider with experience treating growth plate conditions in young athletes. Physical therapy may be recommended.

Physical therapy for apophysitis

Since the condition requires rest and removal of aggravating factors, more exercise is not an appropriate solution. After a formal evaluation, a physical therapist will provide a custom exercise plan to promote improvements in lengthening of tight muscles and tissues, strengthening of weak muscles and alignment of the body during movement and functional tasks. In many cases, core conditioning, strengthening of the abdominals and other trunk muscles, is a foundational component of treatment.

How can apophysitis of the hip/pelvis be prevented?

  • Apophysitis of the hip/pelvis may be difficult to prevent.
  • Proper warm-up and stretching exercises will reduce the stress on the apophysis.
  • Limit or vary physical activities to avoid overtraining and overuse.
  • Rest when sore or having pain.

Watch Ellis describe this condition in a series for pediatricians and primary care providers on our YouTube playlist for medical professionals.