What is Little League Elbow?

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Article featured on Nationwide Children’s

Little league elbow is a painful inflammation of the bony bump on the inside of the elbow.

This spot is the attachment site where the tendons of the muscles that bend your wrist and fingers are located.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

 

Back Pain in Kids and Teens

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Article featured on Spine-Health

There are several unique aspects to consider when back pain occurs in a child or teenager. In rare cases, back pain may be a sign of a serious underlying condition that requires prompt medical attention.

Back pain in children and adolescents may increase with age and typically affects girls more than boys.

This article provides comprehensive information about back pain in children and teens, including the probable causes, diagnostic considerations, and available treatment options, to help parents and caregivers understand and support kids with this symptom.

Common Risk Factors for Back Pain in Kids and Teens

The most common risk factors for back pain in children and teens include sports participation; obesity; a sedentary lifestyle; and a family history of lower back pain, smoking, and/or psychological stress. For example, children and teens with a positive family history of lower back pain are almost twice as likely to experience back pain in childhood or adolescence versus their counterparts with no relevant family history. Evidence suggests that those with lower back pain in childhood are at higher risk of developing lower back pain in adulthood.

School-age children who complain of back pain typically also have high levels of psychosocial difficulties, such as emotional distress and problems with behavior and/or everyday functions.

Typical Characteristics of Back Pain in Children and Adolescents

Depending on the underlying cause, pain may be restricted to a localized area of the back or may include the entire upper and/or lower back region. The common, benign causes of back pain in kids and teens generally have the following characteristics:

  • In the initial stages, back pain in childhood and adolescence typically occurs with low intensity, and the pain commonly lasts for less than a week.
  • There is usually a high rate of recurrence of back pain within this specific age group.
  • When the pain recurs, it typically resurges with greater intensity.

There may be limitations in carrying out daily activities, missed school days, and the reduction of or hesitancy in performing physical activity.

Types of Back Pain in Kids and Teens

Based on the underlying cause, a few types of back pain experienced by children may include 1 :

  • Acute pain. A sharp, stabbing, and/or shooting pain may occur in event of an injury, trauma, fracture of the vertebra or vertebral growth plate, or herniated disc.
  • Chronic pain. A constant ache, pain that comes and goes, or posture-related pain may occur due to inflammatory spondyloarthropathies, psychological issues, or developmental problems, such as Scheuermann’s disease.
  • Pain that worsens with spinal movement. Flexion (forward bending) increases pressure on the front part of the spinal bones, aggravating pain from conditions such as a herniated disc, discitis, osteomyelitis, or vertebral body tumor.Extension (backward bending) of the spine increases the strain on the posterior part of the spinal bones, including the facet joints, pars interarticularis, and pedicles. A lesion or injury, such as an osteoid osteoma, osteoblastoma, or spondylolysis, in this area can cause pain while bending backward.
  • Night-time pain. Frequent pain that occurs at night and awakens the child is typically associated with tumors or infections, such as osteomyelitis, discitis, osteoid osteoma, osteoblastoma, eosinophilic granuloma, aneurysmal bone cyst, leukemia, Ewing’s sarcoma, or spinal cord tumors.

Night-time back pain in children and teens warrants immediate medical attention.

Backpacks and Back Pain

There is some evidence to suggest that heavy backpacks may cause back pain in children.

  • Habitually carrying heavy backpacks over one shoulder may cause the muscles in the area to strain in order to compensate for the uneven weight, resulting in localized or one-sided pain in the shoulder and upper back.
  • Heavy backpacks may strain the neck muscles, contributing to or worsening existing back pain, shoulder pain, and arm pain.
  • Improperly loading a backpack and stooping forward while walking can distribute weight unevenly within the bag, causing strain on the back muscles.

The American Academy of Pediatrics’ most recent non-evidence-based guidelines recommend that the optimal weight of a child’s backpack may be restricted to 10% to 20% of the child’s body weight. Certainly if a child or teen complains about back pain after carrying their backpack, it is reasonable to try reducing the weight of the backpack, use a rolling pack, or explore other remedies.

Back Pain in Children and Adolescents Must Be Evaluated at the Earliest

Any complaint by a child or teenager about acute back pain or chronic back pain is taken seriously by pediatricians and is usually followed up with a detailed consultation that will include a review of the child’s medical history, an in-depth physical exam, and a psychological evaluation, if warranted.

If the medical history and physical examination suggest an underlying condition, a series of tests may be conducted. These tests typically include blood tests and radiographic imaging studies, with a possible referral to a specialist for further examination and diagnostic tests.

When Back Pain in Kids and Teens May Be Serious

Back pain, specifically severe pain in the lower back region in children under 10 years of age and particularly in those younger than 4 years, should be considered a red flag for serious underlying pathologies, which may include:

  • Vertebral fracture
  • Spinal tumors
  • Infectious diseases
  • Cauda equina syndrome

Spinal tumors and fractures may be associated with additional symptoms, such as fatigue, stiffness in the spine upon waking in the morning, weight loss, loss of appetite, fever, and/or local tenderness on the spine. Night pain, pain that awakens the child from sleep, and pain at rest may be specific to tumors.

Mild to moderate back pain in kids and teens may occur due to a sudden, direct hit to the back or as a result of a fall (such as while playing on a playground or participating in sports), and usually resolves within a few days with self-care and/or over-the-counter medications. Persistent, progressive, and/or severe back pain may indicate a serious medical condition and it is advisable to get medical help right away.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

7 Most Common Injuries and Accidents During Back to School

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Article featured on HealthPartners

Whether your kiddo is a little daredevil or just a bit klutzy, accidents happen.

The good news is that most mishaps result in minor injuries that can be treated with a dab of antibacterial ointment, a little rest, and lots of hugs and kisses. But the reality is that every tumble has the potential to be “the big one” – an injury that has you speeding toward the nearest hospital.

But it’s a fine line. What kinds of child injuries really raise the boo-boo bar? When is a trip to urgent care enough? And when might you need to seek highly-specialized emergency care at a pediatric trauma center?

1. Falls: The most common cause of injury for kids of all ages

Falls are the leading cause of injury among children. In fact, the Centers for Disease Control and Prevention (CDC) says that roughly 8,000 children are treated in U.S. emergency rooms for fall-related injuries every day.

When and where are falls most likely to happen?

Playgrounds, especially slides and monkey bars, are some of the most common causes of injury. Other common fall hazards include:

  • Stairs
  • Beds without railings
  • Windows
  • Elevated landings
  • Baby walkers
  • Slippery bathtubs
  • Cluttered pathways

Also, while falls are the most common injury for kids of all ages, babies and toddlers are especially fall-prone. Little humans simply don’t have the same movement control and balance that older kids and adults do. Of course, there are numerous child fall prevention best practices that can help reduce the chances of a serious injury. But falls can still happen in a flash.

What types of fall injuries may need specialized trauma care?

Head, neck, back or spine injuries, and broken bones top the list. More specifically, these injuries can often need the highest level of trauma care – or what’s often called Level 1 trauma care. Why? These kinds of injuries can be more complex, which may require expert care from a range of specialists.

In addition, we suggest that you bring your child to a trauma center right away if they’re experiencing any of the following symptoms after a fall:

  • Difficulty breathing
  • Possible broken bones – especially if the potential fracture is located in areas like the head, face, neck, back or pelvis, or if a bone has pierced through the skin – ligament tears or a spinal cord injury
  • New or worsening bleeding or swelling, headache, nausea or vomiting
  • Loss of consciousness or memory loss surrounding the accident

Learn more about what to do if your child falls and hurts themselves.

2. Being struck by or against an object: Accidental impacts

Most kids get bumped into on a regular basis – especially if they play sports (or have older siblings). Usually these run-ins are minor accidents caused by playing a little too hard or getting distracted.

But according to CDC and NEISS All Injury Program data from 2000-2018, the frequency of emergency department visits after being struck by or against an object is second only to falls, especially for kids aged 0-14.

When and where are kids most likely to get struck by or against an object?

These types of childhood injuries can happen anytime and anywhere. Here’s just a sampling of some of the accidents that fall into this category:

  • Walking into a wall, door or piece of furniture
  • Being hit by an object such as a baseball or a falling storage box
  • Getting hit and hurt by another player during a football, soccer, lacrosse, softball, baseball or other sports game
  • Being pinned under a piece of furniture or an appliance that tipped over

What types of “struck by or against” injuries may need trauma care?

Head, neck, back or spine injuries, and broken bones are often top trauma priorities for these types of accidents, too. Also, if your child is injured after being pinned under or against something, internal injuries can be a concern.

We suggest heading to a pediatric trauma center if your child is experiencing any of the following symptoms:

  • Difficulty breathing
  • Possible broken bones – especially if the potential fracture is located in areas like the head, face, neck, back or pelvis, or if a bone has pierced through the skin – ligament tears or a spinal cord injury
  • New or worsening bleeding or swelling, headache, nausea or vomiting
  • Loss of consciousness or memory loss surrounding the accident

3. Motor vehicle accidents: The most common injury for teen drivers and riders

There are millions of motor vehicle accidents every year. Next to falls, these accidents are the most common causes of nonfatal injuries among teenagers.

When and where are motor vehicle accidents most likely to happen?

Whether your child is cruising in your family car or riding an ATV at the cabin up north, motor vehicle accidents can happen anytime. And teens between 16 and 19 are at a higher motor vehicle crash risk than any other age group, according to the CDC.

Why? One reason is because teens are less experienced drivers or they’re riding with less experienced drivers.

The CDC says that the crash risk for teen drivers is especially high during their first few months of licensure. In addition, the presence of other teen passengers increases crash risks.

When may trauma care be needed after a motor vehicle accident?

Motor vehicle accidents can cause a range of injuries – some obvious and some subtle. And even low-speed accidents can leave kids with an injury.

After any motor vehicle accident, we suggest getting your child checked out. Some injuries may or may not present themselves right away. Urgent care can be a good choice for minor bumps, scrapes or bruises.

If an ambulance arrives and paramedics say a trip to the ER is recommended, we suggest you follow their advice and ask to be taken to the nearest pediatric trauma center.

In addition, we recommend seeking pediatric emergency care if your child has any of the following injuries or symptoms:

  • Difficulty breathing
  • Visible or possible head, neck or back injuries
  • Possible broken bones – especially if the potential fracture is located in areas like the head, face, neck, back or pelvis, or if a bone has pierced through the skin – ligament tears or a spinal cord injury
  • New or worsening bleeding or swelling, headache, nausea or vomiting
  • Loss of consciousness or has memory loss surrounding the accident

4. Cuts and puncture wounds: Injuries that are more than a little scratch

Whether they’re playing with friends or helping you in the yard, a lot of kids accidentally cut or poke themselves with something sharp. Most wounds will sting and throb, but once they’re cleaned and patched up they typically heal pretty quickly.

But more serious lacerations or piercings are relatively common, especially for kids between 5 and 14 years old.

When are cuts and piercings most likely to happen?

Usually, most deep cuts or piercings occur after another common kid injury occurs – namely a bad fall or being hit by something. But other household accidents involving machinery like yard tools, kitchen appliances or cutlery can be the culprits, too.

When may trauma care be needed for cuts and piercings?

If your child has any lacerations or puncture wounds that occurred after a fall, being hit by an object, or may involve a broken bone, head to the nearest trauma center. Multiple injuries will likely require care from multiple specialists.

If a cut or puncture is the primary injury, get emergency pediatric trauma care if your child’s injury is:

  • Bleeding heavily or the bleeding hasn’t decreased after five to 10 minutes of direct pressure
  • Causing numbness or inability to move fingers, toes, arms, legs, joints or other parts of their body
  • Deeper or longer than ½ inch
  • Located on your child’s head or face, or close to an eye
  • Caused by a dirty or rusty object
  • Embedded with dirt, gravel or other debris
  • Has ragged or separated edges
  • Caused by an animal or human bite
  • Extremely painful
  • Showing signs of infection (e.g. increased warmth, redness, swelling or drainage, or foul odor)

5. Bites and stings: Wounds caused by animals, insects and humans

The vast majority of bites and stings are minor – requiring little to no medical treatment. But according to the previously mentioned CDC and NEISS All Injury Program data, bites and stings are the third most common reason for ER visits for kids aged 0-9.

When and where are bites and stings most likely to happen?

Like any injury, bites and stings can happen anytime, anywhere. Among children, dog bites are some of the most common injuries we see.

When may trauma care be needed after a bite or sting?

After any bite or sting, seek emergency pediatric trauma care if:

  • The wound (or wounds) is bleeding heavily or the bleeding hasn’t decreased after five to 10 minutes of direct pressure
  • The wound (or wounds) is showing signs of infection (e.g. increased warmth, redness, swelling or drainage, or foul odor)
  • Your child is having difficulty breathing or showing other signs of an allergic reaction such as swell hives, wheezing or trouble swallowing, rapid pulse or dizziness

Specifically for animal bites, seek emergency care if:

  • The animal that bit your child is wild
  • The bite or bites are deeper or longer than ½ inch – especially if they’re located on your child’s face and/or near an eye
  • The bite is from a venomous snake or spider
    • Venomous snake and spider bites are rare in the Midwest, and Minnesota and Wisconsin have just two species of poisonous snakes
  • The bite is from a bat (which is uncommon in Minnesota and beyond, but requires fast care)

6. Foreign bodies: When something is where it shouldn’t be

It’s safe to say that every kid experiences a “foreign body” at some point during their childhood. Whether it be a splinter in their finger or a sweet pea in their nose, curious kiddos get things stuck.

But more serious cases happen. In fact, it’s the fourth most common reason for an ER trip for kids between 1 and 4 years old.

When and where are foreign body injuries most likely to happen?

Most of the time, the child will inhale or ingest something on their own. This can happen during a mealtime or during playtime, when there are a lot of choking hazards around.

When may trauma care be needed for removing a foreign body?

Most foreign bodies can pass through their gastrointestinal track without issue, but sometimes they become lodged in the throat, stomach or soft tissues. Choking and bowel obstructions are the biggest concerns, and require emergency medical care.

If your child appears to be choking, take action by using choking first aid techniques like back blows or the Heimlich maneuver to dislodge the object. If you don’t know how or your efforts aren’t working, call 911.

If your child has swallowed something and you’re unsure if it can be passed naturally, call your doctor. Go to a pediatric trauma center if you notice any of the following symptoms of a possible bowel obstruction:

  • Severe abdominal pain, cramping or swelling
  • Vomiting
  • Bloating
  • Loud bowel sounds
  • Inability to pass gas
  • Constipation

7. Burns: Injuries that aren’t only caused by fire

Whether a curious hand grabs for a hot pan or repeated sunscreen applications didn’t get the job done, mild burns are pretty common for kids.

But only a little amount of time – sometimes just seconds – is needed for burn injuries to worsen.

When and where are burns most likely to happen?

Thermal burns – burns caused by coming into contact with flames, or hot metals, liquids or steam – are the most common among children. But other types of burns include:

  • Chemical burns caused by acids or solvent cleaners (e.g. bleach, ammonia, paint thinner)
  • Electrical burns after coming into contact with an electrical current
  • Radiation burns (aka sunburn)
  • Friction burns such as road rash or carpet burn
  • Cold burns such as frostbite

When may trauma care be needed for burn injuries?

If a burn has caused any damage below the epidermis – the outer layer of the skin – some degree of specialty care may be needed. Blisters signal a second-degree burn that’s gone deeper, and any charring or whitish marks are a sign of the most severe third- or fourth-degree burns.

The more severe or widespread the burn, the higher degree of specialty care that is needed and suggest that kids get specialized burn care if:

  • Burns are located on the face, ears, hands, feet or genital area where permanent damage is a risk if not treated properly
  • Burns appear deeper than first-degree and/or cover a large area of the body (e.g. larger than the size of your palm)
  • There are signs of infection (e.g. increased warmth, redness, swelling or drainage, or foul odor)
  • Pain, irritation or discoloration worsens

For the worst kid injuries, get the best possible trauma care

Accidents happen. And the worst ones can result in injuries that need highly-specialized care from pediatric trauma experts.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

5 Common Summer Injuries for Kids and How to Prevent Them

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Article featured on MedStar Health

Along with all of the outdoor fun comes more opportunity for activity-related injury, especially if your kids have been less active while stay-at-home orders were in place.

In addition to nature-related injuries and illnesses, such as tick bites and sunburn, summer activities present more chances for broken bones, concussions, and other bumps and bruises. As sports medicine physicians, here are some of the most common summer injuries we see in warm weather months and how you can help prevent them at home.

Common summer injuries.

1. Bicycle injuries

Bike accidents are one of the most common summer injuries because the warmer weather presents more chances for you and your kids to ride together. But, a fall from a bike accident can be dangerous, resulting in cuts, scrapes, fractures, or concussions. If vehicles are involved, a bike crash could even be fatal.

Tips to prevent bicycle injuries: You can prevent severe head injuries from bike crashes by wearing a helmet. In fact, the Bicycle Helmet Safety Institute suggests that wearing a helmet can reduce the risk of head and brain injury by up to 88% for both adults and children. Other protective gear, such as knee and elbow pads, can also help to minimize injury from falls. And, a properly-fitted helmet and padding can reduce your risk of injury from skateboard and scooter accidents as well.

2. Playground injuries

More free time on summer vacation means more time spent visiting the local park or backyard playground. Unfortunately, monkey bars, slides, and swings commonly cause fall-related fractures and head injuries over the summer, even if the equipment is properly maintained.

Tips to prevent playground injuries: Playground falls are inevitable, but choosing a playground built over soft surfaces can minimize the risk of severe injury. Avoid playgrounds on concrete or gravel and instead look for playgrounds that hover soft surfaces, like rubber or wood chips. Active supervision is also important, as you may be able to help prevent a fall if you’re within arms reach.

3. Trampoline injuries

Concussions and fractures are also common in the summer months as a result of jumping on a trampoline. Bloody noses, bumps, and bruises may not be as serious but they’re also a concern.

Tips to prevent trampoline injuries: Many trampoline injuries involve a collision between two or more people, so one of the best ways to minimize the risk of injury is to only allow one person to use the trampoline at a time. It’s also a great idea to attach a net around the outside of the trampoline to minimize falls.

4. Water injuries and drowning

Swimming in a pool, lake, or ocean is great exercise but water-related injuries can be fatal. Drowning is the second most common cause of death by unintentional injury from kids between the ages of one and four, according to the Centers for Disease Control and Prevention (CDC). And, even good swimmers can get injured in and around water-related activities like diving, water sports, and boating.

Tips to prevent water injuries and drowning: Adult supervision is the most effective way to prevent drowning accidents, whether you’re at the pool or in open water. Stay within arms reach when your kids are in or around the pool. If the pool is not fenced in, be sure to cover it when it is not being used. If your family is on a boat participating in or watching water sports, make sure everyone wears a Coast Guard-approved life jacket, even if you’re a good swimmer.

5. Overuse injuries

While school sports may take a break from practices during the summer, travel teams or sports camps are in full swing. Overuse injuries, such as tendonitis or Osgood-Schlatter disease in the knee, can be painful and prevent your kids from fully participating in their sports. Shoulder and elbow overuse injuries are especially common in baseball players and pitchers because of the repetitive throwing motion.

Tips to prevent overuse injuries: One of the best ways to minimize overuse injuries in kids and teenagers is to encourage them to play more than one sport. Cross-training can help prevent common ligament injuries in the knee, shoulder, and elbow. Additionally, if your child has been sedentary, it’s important to help them gradually return to their sports by slowly increasing the frequency and duration of their participation.

When to see a doctor for a summer injury

If you suspect a head injury of any kind, call a medical professional to determine if they need additional care. It’s always better to seek care sooner rather than later.

If your child had an activity-related fall, you should seek medical care if they are:

  • Limping
  • Unable to put use full range of motion in an extremity (e.g. arm or leg)
  • Experiencing pain or tenderness when pressure is applied to a joint
  • Having headaches or drowsy, as these could be signs of a concussion

Have a safe, injury-free summer!

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

6 Tips for Parents With Kids Who Have Osgood-Schlatter’s Disease

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Article featured on Orthogate
Anterior knee pain is a common complaint of young athletes participating in sports. As a teenager, most of the aches and pains disappear as fast as they show up. However, when the pain doesn’t go away it can be frustrating and scary to deal with as a parent. Osgood-Schlatters Disease (OSD) is one of the common ailments that cause pain in the front of knee particularly in teenage athletes ranging from 12-15 years old. Injuries at this age can be a challenge, as kids of that age have difficulty communicating their pain, understand their diagnoses, and can get frustrated with the missed time on the playing field.
Osgood-Schlatters also tends to linger and stay longer than any teenager would like. That’s when you decide to see a doctor. However, OSD is just common enough and not serious enough that some doctors might brush it off as unimportant. What’s a parent to do? Here’s a guide to help you and your growing teenager get through it and maintain the sanity of your household through the process.

What is Osgood-Schlatters Disease?

First, the word disease can be a little misleading. Osgood-Schlatters Disease is less of a disease and more of an overuse injury involving the patella tendon. OSD is most common during the adolescent growth spurt as the bones are maturing. The pull from repetitive movement such as jumping causes tension through the patella tendon on Tibial Tuberosity. This traction injury can cause inflammation, tenderness to the touch, and formation of a painful bony bump to form on the front of the shin.

Risk Factors for Osgood-Schlatters Disease?

The primary risk factors for Osgood-Schlatter disease are repetitive movements during a certain age range. Other risk factors include:

  • Age – OSD is most common during puberty and large growth spurts. The typical range for boys is 12-15 and girls from age 10-13
  • Gender – OSD occurs more frequently boys but the incidence is increasing in young girls as more young ladies are participating in sports
  • Sports – Most commonly found in sports with high force production in the legs such as running, jumping, and cutting. Basketball, hockey, and soccer are the most common sports associated with OSD.

Top Tips for Patients To Help Recover from Osgood-Schlatter Disease

Create a Schedule

This might be the most important tip to consider. Recovering from OSD requires consistency and a schedule can help. Create a daily schedule to ice the tendon, to stretch the quadriceps, and to even perform self-massage can speed up recovery. Also, schedule some downtime to allow the knee adequate rest. Kids tend to have a really hard time understanding the importance of treating their injuries seriously. For good time management skills try writing out daily, weekly, and monthly recovery goals.

Take Active Time Off

OSD is an overuse injury from repetitive patellar tendon tension. If the young athlete continues to play and practice without adequate tendon rest it could re-injure the tendon. This can prolong the recovery timeline and cause more frustration. The tendon needs proper time to heal and this can be difficult during the middle of the season, especially for a teenager. Try to help them understand that active movement and activities such as walking and biking are good but they need to take a break from jumping, running, and sports. Figure out other ways they can be involved with the team while they heal as OSD can take up to 6-8 weeks to heal in severe cases.

Brace it

For mild cases and athletes returning to their sport, a brace may help with pain and prevent a recurrence. A brace for Osgood-Schlatters changes the location of tension from the Tibial Tubercle to the brace. The tendon is allowed to heal with less tension but yet your athlete is still able to participate. This may also stop the progression of new cases of OSD before they become severe and help them get back to sports sooner.

Emphasize Proximal Hip Strengthening

The knee is a slave to the hip and ankle. The knee joint bends forwards and backward but the rotation of the knee is controlled from the joints above and below it. One of the best ways to stabilize the knee focuses on the lateral hip muscles through exercises such as the side-lying clamshell and the single-leg deadlift. The stronger the hip gets, the more stable the knee will become and it will be able to handle more stress. These exercises also won’t aggravate OSD, so they are safe to start at any time.

Talk about Expectations

Taking 4-6 weeks off during the middle of the season may seem like an eternity for a 13-year-old but it’s important to talk about expectations and timelines. The younger teens may not understand the importance of healing now to prevent future complications. They shouldn’t be running or jumping while at school. Take time to talk to them about how they feel about missing playing time. The young athlete may be seen apprehensive about losing their starting spot in the lineup or worry that they will be forgotten by their teammates. Feeling depressed about their injury is fairly common.

Prevent it with Cross-Training

One of the best ways to prevent OSD from returning or starting in the first place is through cross-training. Specializing in one sport has been shown to increase the injury rate in young athletes. The demands of participating in different sports change the repetitive trauma to the muscle, tendons, and ligaments. By playing multiple sports over the year it promotes well-rounded muscle development, better movement quality, and needed rest between seasons. Kids need to be well-rounded athletes before they can specialize.

Conclusion:

Osgood-Schlatters can be a frustrating and scary injury to deal with as a parent. However, with a solid game plan, proper communication, and maintaining active rest,  your young athlete will be back on the field in no time.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Bone, Joint, and Muscle Infections in Children

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Article Featured on AAOSChildren can develop infections in their bones, joints, or muscles. Often referred to as “deep” infections, the technical names for these conditions are:

  • Osteomyelitis (bone infection)
  • Septic arthritis (joint infection)
  • Pyomyositis (muscle infection)

This article covers the most common types of deep infections in children and includes the ways doctors identify and treat them.

Cause

Infections are usually caused by bacteria that are present in our normal living environment. The most common bacteria causing bone, joint, or muscle infections in children is Staphylococcus aureus (often referred to as “Staph” infections).

Bacteria can get into the body in a variety of ways. They circulate through the bloodstream until they reach a bone, joint, or muscle. Bacteria then leave the bloodstream and multiply in the bone, joint, or muscle tissues.

Description

Deep infections most often occur in the joints and at the ends of long bones where they meet to form joints. These include the hip, knee, and ankle joints of the leg, and the shoulder, elbow, and wrist joints of the arm.

The large muscle groups of the thigh, groin, and pelvis are the most common locations for deep muscle infections.

The reason infections occur in these areas is due to the way blood flows to these locations. There is a strong blood flow to the ends of bone near growth centers (called growth plates), the lining of the joints, and the large muscle groups. This allows bacteria to easily find their way to these areas.

The blood supply to the spine, pelvis, and heel is similar to that of the long bones, and infections often develop in these areas, as well.

Infections pose special risks to young children for a number of reasons:

  • Children under the age of three are easily infected. Their immune systems are not fully developed and they tend to fall down a lot, opening the skin to infection.
  • Infections spread quickly through a young child’s circulation system and bone structure.
  • Damage to bones and joints caused by infection can harm a child’s growth and lead to physical dysfunction. Infection of child’s hip joint is a surgical emergency.

Symptoms and Signs

Children who have infections of their bones, joints, or muscles often have the following:

  • Fever
  • Pain
  • Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Doctor Examination

Medical History and Physical Examination

Make sure to tell your child’s doctor the circumstances surrounding the symptoms, such as when the symptoms began, and whether there was a prior infection or injury.

After discussing your child’s symptoms and medical history, your doctor will examine the painful area. He or she may ask your child to move the affected area to see whether movement increases the pain.

Tests

Other tests that may help your doctor confirm a diagnosis and plan your child’s treatment include:

  • Blood tests and tissue cultures. Tests on your child’s blood, as well as fluid and/or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
  • Imaging tests. Tests, such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child’s doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision whether to treat the infection with antibiotics alone or to perform surgery to help resolve it.

Treatment

Antibiotic Treatment

Prescribing antibiotics is the mainstay of treatment for infections.

  • Intravenous. At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 1 to 2 weeks.
  • Oral. For many children, the antibiotic is eventually changed to a form that can be taken by mouth (oral) and given at home.
  • PICC line. Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced “pick”) line. This is a peripherally introduced central catheter (PICC).

The amount of time on antibiotics that is needed to resolve an infection varies from child to child but, in general, is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

It is very important to have your child take all of the antibiotics he or she is given, in exactly the way they are prescribed.

Surgical Treatment

In mild infections, antibiotics alone may resolve the condition. Many children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation and improve blood flow, which will make it easier for the antibiotics to reach the infected area. For most children, one surgical procedure is enough, but more severe infections may require two or more surgeries to help resolve the infection.

Infected biceps muscle

An infection in the biceps muscle has caused pus to accumulate in this child’s upper arm. During surgery, the pus will be drained so that antibiotics can effectively reach and resolve the infection.
Courtesy of Children’s Medical Center of Dallas

Outcome

Most children will completely recover from deep infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.

Methicillin Resistant Staphylococcus Aureus (MRSA)

In many communities, deep infections are more frequently being caused by a particular type of bacteria known as MRSA. This bacteria is more able to resist antibiotics that previously worked well to treat these infections.

Currently, there are several antibiotics that work very well against MRSA and are tolerated very well by the children who are treated.