Dr. Ryan Price, Pediatric Orthopedic Surgeon at Tallahassee Memorial
One of the biggest reasons parents bring their children to my office is for aches and pains that occur with increased activity. The complaints are not typically severe, but they persist over a period of weeks to months. These complaints are more frequent in children who participate in youth sports, particularly in kids who play the same sport year-round. These complaints are often regarding the child’s foot, ankle or knee. Pain in the shoulders and elbows is less common overall, but often tied to throwing sports.
This pain is produced from overuse activity, the root cause of which is usually tight muscles. In children, muscles naturally attach near weak areas of the bone, mainly the growth plates. When kids do repetitive activities, such as running, jumping or throwing, they create moments of tension in these tight muscles and it causes tugging on the growth plate. Such tugging overwhelms the area, creating inflammation and irritation leading to pain.
Why does this happen to kids in particular? Simply put, they are outgrowing their muscles’ capacity to stretch. Ideally, muscles’ maximum tension should not be reached with routine activities; there should be reserve. However, highly active children with tight muscles are repeatedly causing strain because the tight muscles cannot compensate. Their bones are growing rapidly and the connective tissue around the muscle does not grow at the same rate, so the system gets too tight. Ultimately, it is similar to overstretching a rubber band to the point of failure at a weak spot. Kids experience pain prior to this scenario, so they stop their activity until the pain goes away. As their activities continue, the tension and inflammation gets worse and worse.
The answer is to stretch the muscles every day. It seems so simple, but why doesn’t stretching seem to work? The short answer is that kids are not stretching appropriately and consistently. In my patients, the problem tends to be two-fold:
1) They have to understand the need for stretching.
2) They need to develop a habit and the discipline to do it regularly.
Most people are only taught to stretch as if they are warming up for an activity. The stretching required for tight muscles should be done daily and with long static holds for at least minute. Over time, the muscle will elongate and put less stress on the attachment site of the muscle’s tendon.
Once a problem develops and causes pain, a plan of action should be created and stretching should begin immediately. After six to eight weeks of daily stretching, your child should feel better, although often not completely pain free. There is a large stretching debt to overcome, but regular stretching until the child reaches skeletal maturity will correct this. This is particularly important for athletes in competitive sports. Daily stretching can keep growing athletes on the field instead of spending time on the sidelines or in my office.
To learn more about the pediatric orthopedic surgery program at Tallahassee Memorial HealthCare, please visit TMH.ORG/KidsOrtho.