What to Expect If Your Child Has a Stress Fracture

What to Expect If Your Child Has a Stress Fracture

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.

Wellness in Youth Sports: Tips for Parents and Coaches of Young Athletes

Wellness in Youth Sports: Tips for Parents and Coaches of Young Athletes

In a medical education series, Jane S. Chung, M.D., and Taylor Morrison, M.S., R.D., CSSD, L.D., informed pediatric health care providers about the role of wellness in recovery and injury prevention. Health care providers are not the only ones to influence young athletes and their choices to prepare for and recover from sports. Tips for Parents and Coaches
  • Teach your athlete to listen to his or her body. Hunger, pain and fatigue are signs that the body is not prepared to tolerate training.
  • Encourage proper fueling for the activity. Consider the duration and intensity of the activity and give specific suggestions to meet appropriate pre-event nutrition needs.
  • Support proper hydration throughout the day, not just around activity.
  • Use positive language when talking about food and sport-specific bodyweight goals.
  • Speak up when performance declines. Talk to the athlete about sleep, eating habits and stress management so you can act quickly when you are concerned.
  • Listen without judgment.
More Tips for Coaches
  • Choose appropriate training load, intensity and duration. The physical and psychosocial demands of training need to be enough for growth and improvement, but not so much that it causes injuries or illness.
  • Integrate recovery into your schedule of training. Cross training and in-season rest days can support better performance and reduce time on the bench.
  • Learn, model and actively teach athletes positive coping skills to manage stress.
Learn more about training load, recovery and young athlete wellness in the summary of Chung and Morrison’s latest lecture.
Helping Young Athletes Manage Stress

Helping Young Athletes Manage Stress

For all kids, managing stress is important. However, young athletes have an added layer of pressures and our team is here to provide tips on properly managing those stressors. Pediatric psychologist Emily Stapleton, Psy.D., works closely with our young athlete population at our Frisco campus. As a former athlete herself, she has a passion for supporting athletes’ mental health for optimal performance, injury prevention and rehabilitation outcomes.

Below are a few tips to help parents, athletic trainers and coaches of young athletes manage stress.

CONNECT and help problem solve.
When overwhelmed, teens may struggle to break down a situation into manageable pieces. Talk to them and help them take one step at a time.

TIME your conversations wisely and keep it positive.
Let emotions from games or practices settle before talking about performance or outcomes. Waiting a couple of hours to discuss these topics allows athletes to reflect on their performance with less stress.

REFRAME success.
Expectations from parents and coaches can unknowingly increase pressure to perform and negatively affect self- confidence. Encourage athletes to focus on putting forth their best efforts and measuring personal progress rather than only focusing on end results or winning.

TEACH coping skills for life.
Coping skills can help an athlete learn to self-manage when stress starts to take over. Expose your athlete to yoga, taking walks, diaphragmatic breathing (i.e., deep breathing), progressive muscle relaxation (i.e., tensing/releasing muscles) and other techniques to relax.

MAKE ROOM for breaks.
Teach athletes the importance of down-time for rest and recovery. Helping athletes develop time-management skills and minimize over-scheduling will improve stress management.

ENCOURAGE life outside of sport.
Making time for other interests and hobbies apart from the primary sport, including fun activities and time with friends, helps create balance and build resiliency. Allowing athletes to have a breadth of interests and hobbies to draw from when experiencing distress.

PROMOTE healthy sleeping and eating habits.
Stress is easier to manage and less likely to build up with healthy habits in place. A balanced, sport-appropriate diet and quality sleep (at least eight hours for teens) support young athletes in academic, sport and social settings.

ASK for HELP when you need it.
Talking through stressors with a licensed psychologist or mental health counselor can be a healthy outlet for chronic stress and help athletes learn positive coping strategies to use in the future when experiencing negative stress.

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Learn more about pediatric sports medicine.

Pre-Exercise Fuel for Morning Training Sessions

Pre-Exercise Fuel for Morning Training Sessions

Many athletes avoid eating anything before early morning practices. This may leave them feeling slow and tired during practice and not eating anything until lunch, causing them to miss out on two key meals for the day: the pre-training meal and the recovery meal. The good news is that the stomach can be trained and there are ways to make sure the young athlete is not running on empty for that early morning practice.  
 
For the athlete just getting started with early morning fuel or who jumps out of bed and is at practice in 30 minutes, try small amounts of very simple carbohydrate foods to prevent upset stomach & cramping during practice.

Examples include:

  • 4 to 8 ounces of juice
  • 4 to 8 ounces of sports drink
  • 1 small or 1/2 a large banana
  • Dried fruit (raisins, mango, apples, pineapple)
  • Slice of white toast or mini white bagel topped with thin spread of jam or honey
  • Snack-size baggie of low-fiber, low-fat dry cereal
    • Try to keep amount of fiber & fat per serving as low as possible (example: choose Cheerios vs. granola)
  • Fruit leather
  • Low fiber, low fat granola bars
  • Handful of pretzels

4 Key Points to Remember:

  1. As the athlete becomes used to these foods or drinks before practice, portions can be increased and a little more variety can be added, which will provide more energy for a longer period of time during his / her training session.
  2. If more time is allowed between the pre-training meal and the training session, then a little more food may be eaten.
  3. Different athletes may also be able to tolerate different foods because their training sessions are different. A football or baseball player may be able to tolerate a little more protein during the pre-training meal, whereas an endurance runner or sprinter will most likely want to limit protein and focus completely on easily digested carbohydrates.
  4. For the athlete that still has trouble with this pre-training meal, remember that the meal the night before can be helpful. Include a balanced dinner and, if dinner was early, include a bedtime snack with quality carbohydrate and some protein so that the athlete will not have to rely entirely on the morning fuel to carry him or her through training.

Ellen’s Healing Process is Going Swimmingly

Ellen’s Healing Process is Going Swimmingly

Ellen has always been a competitive person, especially in the pool. “Even when I first started swimming competitively in sixth grade, I would tell myself that no matter who was in the lane next to me, I was racing against them,” says Ellen. That fierce competitive spirit has always pushed her to be the best she can be in all that she does. When an injury forced her out of the pool and into surgery, Ellen competed with herself to be her best at physical therapy to get back to doing what she loves.

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When Ellen was 9, her favorite sport was soccer. After an injury on the field, she began swimming for physical therapy. She returned to soccer once she had recovered, but Ellen quickly went back to the pool because she realized how much she loved swimming. “I could tell Ellen was a natural swimmer from the second she hopped into the pool,” says Ellen’s mother, Bonnie. Ellen swam with a local club team in Southlake, the North Texas Nadadores, for a couple of years until pain began to slow her down. She spent about a year in and out of the pool, visiting different doctors, but there wasn’t a definite diagnosis until they visited Scottish Rite for Children.
Pediatric orthopedic surgeon Henry B. Ellis, M.D., diagnosed Ellen with labral tears in her hips. “Labral tears are not commonly associated with swimmers, but we are seeing more and more of this, and they may be underreported,” says Ellis. In addition, Ellis explains that hip impingement and labral tears like Ellen’s primarily occur in adults, but our team is seeing it more in young athletes. “We initially treated Ellen’s injury with physical therapy while trying to balance in-water training with cross-training and dryland exercises. Eventually, she took a break from swimming for a short time to help with the pain.” 

In some kids, like Ellen, non-operative treatment doesn’t allow the labral tears to heal. Because of this, Ellis and his team proceeded with surgery to fix the labrum and address the bone around the hip to prevent it from happening again. 

Ellen returned to physical therapy the day after her surgery. It was tough at first, but her competitiveness kept her motivated. “There was another kid about her age that was doing physical therapy at the same time, and Ellen was quietly competing with her in her head,” says Bonnie. “We worked with several physical therapists. We found that God provides what you need at the right time. We had perfect people for the different stages of healing that she was going through.” As physical therapy continued, Ellen joined the Grapevine Faith Christian School swim team. Just 13 months after her second surgery, she qualified for the Texas Association of Private and Parochial Schools (TAPPS) State Swim meet. She swam in the medley relay and individually in the 200 breaststroke.

Ellen says that she has learned a lot from her experiences. “I think, most of all, I learned that God has a plan for my life. Even when I didn’t understand why I was in so much pain, I grew in other areas and realized I could do more than sports,” she says. Ellen also loves art, and this experience has helped her to figure out her art style. “She’s being pretty humble when she says she loves art. She was at the VASE (Visual Arts Scholastic Event) regional art competition and qualified for state. She ended up winning a Gold Seal at the state competition, which is the highest ranking!” says Bonnie joyfully.

Ellen is now training with her team, and she is excited to swim in her junior year, but she also wants to continue with her art. “It’s been good to do something different since I used to just swim all the time,” she says. “That balance is good.” Ellen encourages other young athletes to find that balance and not to rush their physical therapy. “Be determined, but don’t hurt yourself from trying too hard, because that’s kind of what I did. I tried pushing through it, and it just made it worse. I’m not back to swimming as many hours a week as I used to yet, but I’m definitely healed.”

Bonnie shares that they loved their time at Scottish Rite. “The care and the love shown by everyone was amazing. As a mom, when the doctor looks straight at your child and really talks to them and takes the time to get to know them as a whole person, it makes the experience incredible.” Ellen adds, “Dr. Ellis was really good about telling me what was going on instead of just telling my parents. He helped me understand why we were doing all the things like injections and physical therapy, and why everything needed to happen, and he told me about how my surgery was going to be.”

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