Why More Kids Are Getting Hurt

Whenever you have kids running, jumping and throwing things, there is always the potential for skinned knees and maybe a broken bone or two. Over the past few years, however, orthopedic surgeons have begun reporting a disturbing new trend in sports injuries. More and more, they say, they are treating young patients for strains, sprains and stress fractures that arise from overuse of still-developing muscles, bones, tendons and ligaments. In some cases, the damage is permanent, increasing the risk that the kids--some of them as young as 9--will suffer crippling arthritis or require extensive surgery as they get older.

Part of the problem, doctors say, is that children are specializing in sports at a younger age. Then they simply overdo it, playing in three or four soccer leagues instead of just one, for example, or stressing the same parts of the body year round with very similar sports--like swimming, water polo and volleyball.

That constant repetition is particularly brutal on joints and growth plates--the areas of developing bone tissue that are the weakest parts of a child's skeleton because they haven't completely ossified. Young athletes who use their shoulder joints a lot often get into trouble by exercising the muscles in front more than those in the back. The unequal tug-of-war winds up pulling the whole joint painfully forward. Growth plates can be either compressed or pulled apart, sometimes shortening the bone's eventual length.

Some injuries tend to cluster at different ages. Doctors report seeing a lot of heel problems in kids 9 to 12 years old, elbow problems in kids 10 to 12 and knee injuries in kids 12 to 14. Gender also seems to play a role. Girls, for reasons that are not clear, are more likely than boys to tear their anterior cruciate ligament (ACL)--a tough ribbon of tissue that holds the knee together. "Twenty years ago, it was rare for someone under age 15 to have ACL surgery," says Dr. Daniel Green, a pediatric orthopedic surgeon at the Hospital for Special Surgery in New York City. "Now it's commonplace."

Most overuse injuries don't lead to permanent disability, provided they are correctly treated and not aggravated for several months. (Many parents are surprised to learn that a couple of weeks' rest is simply not enough.) See a doctor if your child suffers pain during exercise or experiences tenderness over a bone when you push on it directly. By all means, encourage your kids to play sports and move around a lot. But a little variety goes a long way. --By Christine Gorman