Younger patients have many of the same injuries as adults. However they are prone to unique types of problems due to the structure of growing bones. During rapid growth periods, bone lengthens before muscles and tendons are able to stretch. During these stages the tendons may pull on bony growth plates leading to conditions such as Osgood Schlatter’s at the knee, or Severs apophysitis at the heel. In children, traumatic injuries may result in fractures of the long bones, and an incomplete break is referred to as a greenstick fracture.
Low back pain can have similar causes in younger patients as adults (see Back Pain). Younger patients may also develop stress fractures due to repeated movements of ballet, gymnastics, diving, volleyball, fast bowling in cricket or serving tennis. Biomechanical factors such as leg length differences, poor muscle strength or increased foot pronation (flat feet) may also indirectly affect back pain and may require correction by physiotherapy. Physiotherapists also assess adolescents for ‘curvatures’ of the spine, especially at puberty, before rapid growth spurts.
There are different conditions affecting the hip bones that typically occur at specific ages, causing a low grade ache in the hip or knee. Perthes Disease between 4 to 10 years, and a Slipped Capital Femoral Epiphysis, between 12 and 15 years. These are best treated with early diagnosis. Knee pain can also be caused by muscle imbalances around the patella or from ‘sporting’ injuries (as in adults)
Physiotherapists are trained to assess the musculo-skeletal system, and design a treatment program that may include:
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