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As Much As We Want To Protect Our Children, They Do Get Hurt
“Hey dad, I hurt my knee during basketball today!” my son announced as I stepped home.
Knee injuries are common complaints that I come across often in my line of work as an orthopaedic surgeon, and I get similarly worried when I hear it from my son.
“So, can I go for martial arts training tomorrow?” my son quickly added.
“Whoa, hang on a second, son…. Let me first take a look at how badly you might be hurt!” I replied.
This exchange with my son made me realise the sports scene in Singapore has changed significantly over the last decade. Today, participating in sports has become a way of life for many Singaporeans. In the same way, children today are also exposed and encouraged to get involved in sports and games at an early age, which is good as it develops the children’s physique and general motor skills, and also serves as a platform for children to learn social behaviour and team-building.
However, as sports participation rates increase, so too do the number of sports-related injuries in children and adolescents.
While children do have an incredible ability to heal, there are some injuries that are not as benign as they seem.
Furthermore, as children take their sporting activities more seriously, they may experience increased pressure from coaches and fellow teammates for them to continue playing or training despite sustaining injuries.
In my medical practice, I frequently encounter the following situation. A young athlete comes to my clinic seeking medical treatment only after repeated injuries have occurred. And sometimes, permanent damage may have occurred as a result, requiring surgical intervention.
It is normal to want our kids to do well in their chosen sport. However, the incorrectly placed encouragement of “no pain, no gain” may sometimes do more harm than good.
So, when is a knee injury severe enough to warrant a visit to the doctor? Injuries in the child can often be divided into two broad categories.
ONE Repetitive Stress Injury
These injuries are often due to the training’s intensity. With adequate rest, most of these injuries would recover by themselves.
Repetitive stress injuries usually strike growing young athletes due to the presence of cartilaginous growth plates (the medical term for the area of growth in long bones), which are responsible for lengthening the bones and are also prone to repetitive stress and injury. As the young athlete grows older, these plates will slowly be replaced with bone.
Occasionally, repetitive stress injuries can affect a child’s bone growth, resulting in slight deformities that become more pronounced as the child gets older.
One such condition is Osgood-Schlatter disease, which is a prominent bony lump in front of the knee. While conditions such as these do not require surgery, the symptoms could possibly be decreased through early recognition of the condition and adequate rest.
TWO Acute Injury Involving Considerable Force
This injury usually occurs when the child is involved in a significantly acute event, such as an awkward fall. He or she will find it difficult to move the injured limb and there is usually pain and swelling.
When this happens, bring the child for a more detailed medical assessment to check for fractures.
Even if there are no fractures, it is still crucial to monitor the injured limb for serious soft tissue injury. One of the more common acute knee injuries is a tear of the anterior cruciate ligament.
A child suffering from this will have a swollen knee, and although there are no obvious fractures, the pain may be so debilitating that the child will have difficulty walking. Fortunately, the pain and swelling usually subside over a period of two weeks.
After the pain and swelling has subsided, it is best to bring the child for a repeat assessment by an orthopaedic doctor.
Home Diagnosis
Bring your child for a more detailed medical assessment if he complains of knee pain lasting more than three days, has a swelling in the knee or is walking with a limp. It is important to remember that some serious conditions that require surgical intervention may show signs of improvement with rest. However, this should not be mistaken as a minor injury.
Additionally, some serious conditions may be the result of repetitive stress even though there is no major trauma. When in doubt, always be safe and have the injury evaluated by a professional.
Luckily for my son, he was able to walk without pain and was also able to demonstrate to me that he could run and jump. As such, he did go for his martial arts training the next day but earned himself a bruise on his arm as a result of a poor fall. But of course, that’s a story for another time.
Dr Sean Leo works as an orthopaedic surgeon in Changi General Hospital. His field of work includes managing general orthopaedic conditions and injuries with special focus on regeneration, repair and resurfacing of the joint. During his free time, Dr Leo is an endurance sport enthusiast and enjoys distance running, cycling and downhill skiing. He frequently participates in mixed martial arts training with his son, and bonds with his children through interactive sport. He is also a food lover and delights in bringing his lovely wife and two children for unique meal experiences.
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