What We Treat
ACL or Anterior Cruciate Ligament Injury
The ACL is one of four ligaments in the knee that connect the upper and lower leg. It is also one of the most frequently torn ligaments in the knee.
The ACL provides support and stability to the knee joint, allowing it work properly as a hinge so you can walk, turn, bend, and run. A blow to the side of the knee, overextending the knee joint, landing hard after a jump, accidently twisting the leg, or abruptly pivoting or changing direction can overstretch or tear the ACL ligament. Soccer, basketball, football or snow skiing have the highest risk of this type of injury.
In the past, ACL injuries were rarely seen in young people, but with the rise of competitive year-round sports, it is more common. The most obvious symptoms are a popping sound when the injury occurs followed by pain and swelling. A torn ACL may or may not need surgery to reconstruct the ligament, depending on the extent of the injury.
Little League Elbow & Shoulder Injuries
Acute and chronic injuries to the elbow and shoulder are typically called "Little League injuries" because the throwing and pitching movements required during baseball can create instability, fractures and damage to the joint.
A tear in the main stabilizing ligament on the inside of the elbow joint, called the ulnar collateral ligament (UCL), is the most common elbow injury. It is most frequently seen in youth playing baseball, but can also occur in football and volleyball.
Little League shoulder is irritation and inflammation of the growth plate in the shoulder caused by repetitive throwing movements. The overhead arm movement of tennis and volleyball can also lead to this common sports-related problem.
Rotator cuff injury results from irritation and inflammation of the muscles and tendons that hold the shoulder blade to the upper arm bone. Repeatedly raising the arm in baseball, volleyball, tennis and swimming can contribute to rotator cuff injury.
Osteochondritis Dissecans (OCD)
OCD injuries in children happen when there is damage to the growth plate, the area at the end of the bone that is not yet closed in young people. Intense, weight-bearing activity that subjects a joint to repetitive trauma can reduce blood flow to the area and cause cartilage and a thin layer of bone to disconnect from the end of a bone. It most commonly seen in the knee, but can also affect the elbow, wrist and ankle.
Boys are more likely to develop the condition than girls. However, doctors are seeing an increase in this type of injury in the wrist, arm and hands of young women involved in competitive, year-round gymnastics. There is typically pain, swelling and some mechanical problems with the joint, such as a clicking or locking and loss of motion.
Arthroscopic surgery may offer relief for OCD. But the best treatment option is to recognize the early warning signs, modify activity, rest the injured area and when appropriate begin a regimen of physical therapy to promote healing and full rehabilitation.
The shoulder joint has the greatest range of motion and is very susceptible to traumatic injury from high-impact sports like football, basketball, hockey and wrestling. Falling onto an outstretched arm and colliding with another player are the two most common reasons for dislocating the shoulder. These types of injuries typically occur more frequently in boys than girls.
Depending on the extent of injury, surgery to stabilize the joint may be required, or a conservative, noninvasive approach can be attempted by immobilizing the shoulder, followed by physical therapy.
Dislocation of the patella is one of the most common injuries young athletes experience. It occurs when the kneecap pops out of its normal position due to a collision or fall. Sometimes the surrounding ligaments that keep the knee stable may also tear and small fragments of cartilage or bone may be knocked off the kneecap from the force of the impact.
Treatment usually involves gentle re-positioning of the kneecap, stabilizing the knee with a brace, restricting activity and strengthening exercises through physical therapy. More severe injury may require arthroscopic surgery.
Os Trigonum Syndrome
Persistent, acute pain behind the ankle may be a symptom of Os trigonum syndrome, also called posterior talar impingement syndrome, a condition that can occur with extreme, repetitive flexing or pointing of the toes. It can also be occur from an ankle injury or sprain.
Dancers standing on pointe, ice skaters performing jumps or athletes kicking the ball in soccer or football are at risk for this type of injury. So are runners.
Because the pain is in the back of the ankle, it can be confused with an injury to the Achilles tendon, but it is actually a tear or overstretching of the fibrous connection holding the Os trigonum in place. The Os trigonum is an extra "accessory" bone that some people have near the heel of the foot.
Torn Knee Meniscus
The knee has two menisci, a wedge-shaped piece of fibrocartilage that acts as a shock absorber and cushion for the knee joint. The meniscus also helps stabilize the knee.
A forceful twisting or rotating of the knee can tear the meniscus, causing pain, swelling and stiffness, as well as a sensation of the knee locking or catching. Sometimes this injury is referred to as a torn cartilage in the knee.
Nonsurgical treatment includes rest, ice and anti-inflammatory medication but a more serious injury may require arthroscopic surgery to repair and reconstruct the meniscus.
Anterior Knee Pain
Anterior knee pain usually occurs when the tendons holding the kneecap in place become irritated and inflamed or when there is a softening or breakdown of the cartilage. It is a common complaint of runners, skiers, soccer players and bicyclists - a condition sometimes called runner's knee.
Anterior knee pain in young athletes can be related to a number of conditions, including poor flexibility with tight muscles on the back and front of the thigh (hamstrings and quadriceps muscles) and from overdoing forceful activity that stresses the kneecap.
Girls tend to be more prone to this type of chronic, aching knee pain, which can also be related to improper alignment of the kneecap with the thigh.
Surgery is rarely needed. Usually rest, ice and anti-inflammatory medication can relieve symptoms, followed by physical therapy to strengthen and stretch the muscles in the upper leg.
*Source: Youth Sports Injuries: Prevention is the Answer
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