Thursday, November 12, 2009

Overuse Injuries

Achilles Tendonitis

Achilles tendonitis is an overuse injury seen rarely in children under age 14 but seen with greater frequency as skeletal maturity approaches. It is characterized by pain with activity, particularly jumping sports in the region of the Achilles tendon. Rest, activity modification, a stretching program, shoe change, icing, and the use of an anti-inflammatory medication will usually promote healing and the ability to return to sports. The Achilles tendon should never be injected with cortisone, as rupture due to weakening can occur.

Sever's Disease

Sever's disease is a pre-skeletal maturity condition resulting from inflammation of the calcaneal (heel bone) growth plate near where the Achilles tendon attaches. The treatment is similar to Achilles' tendonitis, with the addition of a heel pad or heel cup. Occasionally this condition will plague a youngster off and on for 2­3 years until the growth plate closes. Casting to completely immobilize the ankle joint may be required.

Plantar Fasciitis

Plantar fasciitis is an inflammation of the plantar (sole of foot) fascia (a tough band of ligament-type tissue that runs along the bottom of the foot). Again, treatment is directed at relieving inflammation and gently stretching the involved tissues. Arch supports also help here to support the foot and decrease pain. While injection is occasionally indicated in the adult, it is typically not done in the younger population.

Stress fractures

Stress fractures are sustained as a result of repeated "micro trauma." A sudden change in training intensity is the classic cause of these injuries that typically involve the metatarsals (the bones in the mid-part of the foot). Stopping the activity that is causing the problem and casting are the mainstays of treatment. If the activity continues prior to healing, these micro fractures can become "real fractures".

Please contact Dr. Vail for an evaluation of your child's feet - especially if you notice any of the problems mentioned above. Prevention is the key to helping your child to develop properly.


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