Pediatric Sports Medicine: Protecting Young Athletes


Patellar subluxation: Overview

A subluxation is a partial dislocation. The kneecap (patella) can move out of its normal position more easily when the thigh muscles are weak or when the patella is not firmly held by the tendons and ligaments. This can also happen when there is a problem with the alignment or structure of the knee bones.

A patellar subluxation feels like the kneecap is shifting or jamming out of place. Usually, the kneecap returns to its normal position by itself. But if this keeps happening, it can damage the supportive tissues in and around the knee.

What are the symptoms of osteochondritis dissecans?

Osteochondritis dissecans (OCD) may not cause any symptoms, or symptoms may begin suddenly, develop gradually, or come and go. The condition may be discovered by accident if an X-ray is taken for another reason.

Symptoms of OCD may include:

  • Pain.
  • Swelling.
  • Grating in the joint.
  • Decreased joint movement.
  • Locking of the joint.

Symptoms that begin suddenly may be caused by a piece of bone or cartilage that has broken loose and moved into the joint. Degenerative arthritis may develop in the area affected by OCD.

Meniscus Tears

Meniscus healing zones and types of meniscus tears

Where a meniscus tear occurs is one of the most important things that affects healing. Tears at the outer edge (red zone) tend to heal well because there is a good blood supply. The inner area (white zone) lacks a good blood supply and therefore does not heal well.

The type of tear often determines whether a tear can be repaired. Longitudinal tears are often repairable. Radial tears may be repairable depending on where they are located. Oblique (flap) tears and another type called horizontal tears are generally not repairable.

Osgood-Schlatter disease in children: Overview

Osgood-Schlatter disease is a common problem for older children and teenagers. It usually happens when a child is growing a lot and their leg bones get longer.

This problem causes pain and swelling in the shinbone below the knee (patella). It can happen in one or both legs. The pain may come and go. In some cases, it lasts more than a year. It usually stops when your child stops growing a lot. After it stops, your child may have a painless bump on their bones.

There are things your child can do to feel better. Ice may help. So can limiting sports and activities that put pressure on the knee. Your doctor may also recommend pain medicine, leg stretches, or a pad to protect the painful area.

Helping your child avoid sports injuries

Most sport-related injuries are from impact, overuse, or poor body mechanics. But there are things you can do to reduce your active child's risk of injury.

  • Make sure that your child learns proper form and technique.

    This can be from a class, a coach, or an athletic trainer. If you can, help your child build skill and strength before the sports season starts.

  • Teach your child to take pain and tiredness seriously.

    Don't let your child ignore or "play through" it.

  • Avoid high-risk activities.

    Some activities are so high-risk that child health experts warn strongly against them. These include boxing, jumping on a trampoline, and driving or riding on motorized bikes and vehicles.

  • Give your child the proper safety gear.

    Safety gear helps protect your child. Before your child starts a new activity, get the right safety gear. Teach your child how to use it. Replace it as your child grows. Set a good example for your child. Always use safety gear for your own activities, such as a helmet for bike riding. You don't have to buy all new gear. Check out low-cost or loaner sports gear options like secondhand sports stores, schools, or community centers. Depending on the sport or activity, your child may need some of these items:

    • Helmets help protect against injury to the head, brain, and face. Use a helmet for any activity that can cause a fall or an impact to the neck or head. These include bike riding, football, baseball, ATV riding, skateboarding, skiing, inline skating, and horseback riding. Make sure the helmet fits and hasn't been damaged.
    • Shoes help protect feet from injury. Sandals and flip-flops are not safe for bike riding. Some sports require special shoes for support and safety.
    • Mouth guards help prevent mouth and dental injuries. Use a mouth guard for sports such as basketball, football, wrestling, ice hockey, field hockey, and soccer.
    • Eye protection can be prescription or nonprescription. You can use polycarbonate lenses, or try goggles or a face shield.
    • Padding includes football and hockey pads, shin guards for soccer, athletic cups, and sliding shorts for baseball and softball.
    • Braces include wrist guards for snowboarding and inline skating, knee pads for volleyball, and knee-savers for baseball and softball catchers.