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Safe Pediatric Play and Training

With the warmer days of spring ahead, adults look back back fondly on childhood days filled with active games, playgrounds and the beginning of the spring sport season. While we often remember playing outdoors with friends until waning daylight signals that it's time to go home, carefree days can be marred with injuries that can have a lasting impact on a child's health and development.

Children keep us busy in the orthopedic office. Many of the patients that I see are children who tend to be much more active than adults and more prone to injury.

As one of the orthopaedic trauma surgeons at Advocate Condell Medical Center, I am frequently on call when a child is injured. A good number of children we see suffer a fracture after falls from playground equipment or during play with friends. While the broken bone temporarily compromises a child's lifestyle, they usually heal uneventfully with the proper treatment and care.

Since Advocate Condell assumed Level 1 trauma status a few years ago, we're seeing the more severe pediatric injuries - those that could potentially have a permanent impact on a child's health. Since the doors opened to the Condell Pediatric Emergency Department in 2011, 24-hour emergency care is now available. As a parent and a professional, I'm grateful to have such a tremendous resource available.

Certain basic steps can keep children safe. I would say that the greatest number of orthopedic injuries occur on playground equipment or with bike riding. Many of the injuries are bruisies, but fractured arms and wrists are common. The importance of helmet utilization cannot be overemphasized - broken bones pale in comparison to the irreversible impact of a head injury. The helmet requirement should really extend to any type of rolling sport. Scooters, skates and skateboards can all have the potential to cause a sudden fall with a significant amount of impact.

The playground is fun but can be a dangerous place for children. Spring is the time we start seeing an increase in the number of playground injuries from a fall off equipment onto an outstretched arm. Our body instinctively tries to break the fall, and we extend a hand forward. The impact frequently results in a fractured wrist. Close supervision of young children is important as they may not have the physical skills required to safely navigate the equipment.

One of the greatest contributors to pediatric injuries that I've seen in recent years has been backyard trampolines. While trampolines are undoubtedly fun, the safety nets can give a false sense of security. A good portion of trampoline-related fractures that I see come from kids colliding into one another when they're bounding, not from falling off the trampoline.

It's not just the playground that's bringing pediatric patients into the office. In recent years, we've begun to see a significant increase in overuse injuries in children - in many cases associated with sports-related activity. With the growing popularity of organized youth athletics, the pressure to compete has led to children "specializing" in one sport at an early age. While we changed sports with the seasons in past generations, it is not uncommon for children to play just one sport year-round.

I often explain to parents that pediatric patients are not "small adults." Because young athletes are still growing, they are at a greater risk for injury than adults. Overuse injuries occur gradually when an athletic activity is repeated often and the same muscle groups or bones are stressed and unable to have time for recovery. I frequently see young athletes for foot and heel pain, anterior knee pain and elbow and shoulder pain with diagnosis that ultimately lead to the culprit being an overuse syndrome.

The most common overuse injuries involve the knee and foot. Muscles, ligaments, tendons, bones and growth plates can be affected. In children, these structures are still growing and developing. Bones grow first, pulling at tight muscles and tendons. This makes younger athletes more prone to muscle, tendon and growth plate injuries. Growth plates are the areas of developing cartilage that allow pediatric bones to grow and lengthen. The areas of cartilage tend to be weaker than the associated ligaments and tendons. Repetitive stress can lead to fractures of the growth plate.

Many overuse injuries can be prevented by not overdoing a single sport and giving growing bodies adequate rest between games and seasons. Cross training is key to avoiding excessive strain on one set of muscles or bones and to developing other skills and preventing injury.

Despite a certain amount of orthopedic risk, there is nothing like active outdoor play and team sports - even in the cold, winter months. With a little prevention, parents can help make play and sports a fun, injury-free experience for their children.

Gregory G. Caronis, M.D. is a board-certified orthopedic surgeon with Advocate Medical Group Orthopedics. His practice specialties include disorders of the foot and ankle, fracture care and general orthopedics. Dr. Caronis is currently accepting new patients in his Lincolnshire and Libertyville offices. For more information or for orthopedic questions, he can be reached at drgregcaronis@gmail.com or at AMG Orthopedics (847) 634-1766.

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