Summertime is rapidly approaching and for a pediatrician, this means lots of well visits as parents bring in their children to get a check up. Sometimes parents will call it the sports physical which is fine, but it is really an opportunity to assess the child and cover a variety of topics ranging from nutrition and injury prevention to discussing high-risk teen behaviors and depression. Quite often this is the one time a year I may see a healthy teenager, so there is a lot to cover.
Certain injuries and ailments are much more common than others and they vary by the sport the child participates in. During the growing years, a child’s bones grow faster than the muscles and ligaments, leading to some common overuse injuries. For example in a growing athlete playing soccer, it is quite common to see calcaneal apophysitis otherwise known as Sever’s disease. This is heel pain caused by repetitive microtrauma where the Achilles attaches to the calcaneus bone in the foot. Since prevention is always the goal, I will discuss the importance of maintaining good flexibility and wearing proper shoes with possibly a heel lift. This condition is closely related to another common one called Osgood Schlatter disease, which is caused by the same process, but to the knee instead.
Another hot topic these days is concussions. A concussion is a brain injury and all concussions are serious whether there was loss of consciousness or not. They happen when players fall or collide with each other or obstacles. Concussions are not just a football problem. Lacrosse, wrestling, girls soccer and girls basketball follow closely behind. Sometimes the signs can be mild such as feeling a little confusion, being forgetful, or not being able to recall events around the time of the head injury. Other more obvious symptoms may include a headache, dizziness, vision problems, nausea, vomiting, light sensitivity, feeling foggy headed, or difficulty concentrating. The most important treatment is REST. The brain needs time to recover. Athletes should never return to play the same day of the injury.
Washington State has a law (The Zachary Lystedt Law) that basically says that you will need to be given written clearance by a doctor in order to return to sports through a return to play protocol. This protocol is a stepwise symptom based one that allows a transition from no activities, to light aerobic exercise, then sport specific exercise like running non contact drills and then progressing to full contact training before returning to competition.