The Running Doctor: What to watch out for in adolescent athletes
In many cases, there is a predisposition for injuries that occur in adolescent athletes. The following list are some telltale signs that may help to prevent future injuries to a child.
1. The child tends to stumble or even trip while walking or running.
2. One shoulder is lower than the other.
3. The hips are asymmetrical when walking or running.
4. The knees point inward or outward rather than straight ahead.
5. The feet turn in or out while walking or running.
6. There is an early heel-off with all the weight going to the ball of the feet.
7. When the child stands, the arches are very high or extremely flat.
8. The child complains of night cramps that wake him or her in the night or muscle spasms in the feet and legs.
9. The child has noticeable hammertoes, bunions, or bony enlargements in the forefoot or rearfoot.
10. The wear pattern on the child's shoes appears to be worn down on the outside or inside.
If some, or even a few, of these signs are present, the child should be professionally evaluated as prevention is the best form of treatment. It is the group of pre-teens and teens who play two or more sports that I am most concerned with as there is a greater chance of overuse injuries. There is also a greater chance of injury to the epiphysis, or growth center of bone. Injury to the epiphysis of the heel, knee, or hip can cause a disturbance in the bone formation. The growing pains of children are at times due to the pain of the apophyseal (heel growth plate) injury.
Many of the gait abnormalities can be helped by stretching and strengthening exercises, conditioning programs, ice therapy, cross training, and biomechanical orthotic shoe inserts which should control the problem and allow the child to continue with his or her respective sport.
Dr. Robert F. Weiss is a podiatrist specializing in foot and ankle surgery. He was a member of the Medical Advisory Committee of the 1984 and 1988 Olympic Marathon Trials. Weiss is a veteran of 35 Marathons, has a practice in Darien, affiliated with Stamford Hospital and is a member of Stamford Health Medical Group-Foot & Ankle Institute.