Reducing knee injury risk in young athletes

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Young athletes benefit from playing sports in a variety of ways — from better fitness and overall health to higher self-esteem and improved academic achievement. But with this participation comes the risk of injury.

While some injuries build up over time and cause pain that is often ignored, others may be random and unexpected. Dr. Dennis Kramer, a sports medicine orthopedic surgeon at Boston Children’s Hospital, explains what may put an athlete at risk for an overuse injury and how to minimize the risk of traumatic injuries, such as an ACL tear.

Sports specialization and overuse injuries

As sports specialization continues to rise in youth athletics, kids and teens who focus primarily on one sport may be at a greater risk for overuse injuries. “We tend to see more overuse injuries in patients who do the same sport most of the year,” says Kramer, “whereas traumatic knee injuries can happen to anyone at any time.”

In 2015, a collaborative study involving the Sports Medicine Division at Boston Children’s and co-authored by Dr. Lyle Micheli, concluded that highly specialized young athletes could be at a greater risk of sustaining an overuse injury than their unspecialized peers. Constant stress on certain parts of the body, coupled with overall exhaustion, can lead to wear and tear that eventually results in pain and an overuse injury.

Common injuries of the knee

Athletes often come to Boston Children’s with overuse injuries of the knee. These include kneecap pain, Osgood-Schlatter disease, osteochondritis dissecans of the knee and patellar tendinitis.

Acute traumatic and structural knee injuries can also leave a young athlete in pain and worried about their future in sports. Some of the more common traumatic knee injuries may end up needing surgery, such as ACL tears, meniscus tears, and kneecap dislocations.

“Most of the severe injuries come from twisting mechanisms associated with a ‘pop’ sound and swelling,” explains Kramer. “The more benign injuries are usually the ones that come from direct impact and don’t result in swelling.”

Getting care quickly

With both overuse and traumatic knee injuries, patients and their families often have a lot of concerns regarding treatment of the injury. Seeking the care and expertise of an orthopedic specialist can help answer important questions and start your child on the road to recovery.

When a knee injury occurs, it can be difficult to determine its severity immediately on the field or in the training room. A full evaluation and imaging will need to be done in order to assess any damage — even if pain has subsided, and especially if noticeable swelling occurs.

A physical assessment along with x-ray or MRI imaging can provide an orthopedic specialist with the information needed to determine treatment options and recovery time. Together, the orthopedic specialist and the family can decide on the best course of treatment for the young athlete.

“Some injuries need to be treated more urgently than others,” says Kramer. “Certain knee injuries require surgery within 10 to 14 days, so it’s important to evaluate those injuries as soon as possible.” Even if surgery isn’t necessary, an injury that requires physical therapy, bracing or other treatment should still be evaluated quickly to determine the best plan for treatment.

Minimizing risk of injury

Injuries can never be 100% preventable — accidents happen and our bodies accumulate wear and tear over time. But the risk of certain injuries can be minimized if a young athlete takes the right precautions.

Cross-training is an important component of being a complete athlete, and also gives parts of the body time to rest and recover. Additionally, it’s important to balance strength and flexibility. “If your child is very muscular and strong, they probably need to work on their flexibility,” advises Kramer. “And if they are more loose-jointed and flexible, they probably need to work on their strength.”

By helping your child identify the type of athlete they are and what their physical strengths and weaknesses may be, they’ll be able to work on areas of their game that leave them prone to injury.

No one plans on getting injured, but we can all plan ways to minimize the risk and help make young athletes healthier and stronger.

For fast access to orthopedic appointments at our various locations, call the Boston Children’s Orthopedic Urgent Care Clinic at 617-355-6021.