Musculoskeletal Conditions Among Youths: Top 2 Conditions Experienced by Youths

• Did you know that musculoskeletal aches are not exclusive to adults? Youths can experience musculoskeletal conditions as well. In this article, we cover the top 2 musculoskeletal conditions among youths.
• The top 2 musculoskeletal conditions experienced by youths are Osgood-Schlatter’s Disease and Sever’s Disease. Continue reading to find out more

Youths are not immune from musculoskeletal conditions

Adolescents have the benefit of youth on their side, requiring shorter recovery time between exercise sessions. However, many children, due to being skeletally immature, may experience some form of growing pain. Children often experience a growth spurt. When this happens, the bones and muscles grow at a disproportionate rate. Bones grow faster, causing the shorter muscles to pull on their bony attachments. Over time, this constant tugging on the apophysis (growth plate) can cause inflammation, and therefore pain, over the area. This is known as apophysitis and it can be worsened if the child is very active without adequate rest.

While it is true that most musculoskeletal (MSK) conditions are more forgiving to youths, it does not mean that children can or should turn a blind eye to any aches that they may be facing. This article aims to shed some light on the 2 common musculoskeletal conditions among growing children & youths.

2 Common Musculoskeletal Conditions Among Youths

Osgood-Schlatter’s Disease

When youths complain of pain below the kneecap, Osgood-Schlatters Disease (OSD) must be considered. OSD occurs when the femur grows faster than the quadriceps, causing the muscle to become short relative to the bone. The tight quadriceps transmits a constant pulling force onto the tibia tuberosity via the patellar tendon, which can result in apophysitis. Inflammation is an indication for the child to rest and allow the area around the tibia tuberosity to recover. In some cases, the body reacts by promoting bone growth over the tibia tuberosity, resulting in the classic hump of OSD. 

Prevalence of OSD among youths

OSD seems to happen more often among the young male population around the age of 10-15 years old. Females around the age of 8-13 years old, though less susceptible than males, are also at risk of developing OSD. The risk of this condition increases if the child regularly participates in activities that requires running and/or jumping.

Symptoms of OSD among youths

• Swelling below the kneecap
• Tibial tuberosity is painful to touch
• Pain when running, jumping, and climbing stairs
• In some cases, an increase in the size of the bony protuberance is visible

Sever’s Disease

The mechanism of Sever’s Disease is identical to that of OSD. In the case of Sever’s Disease, it is the tibia and fibula that grow faster than the calf muscles (comprising the gastrocnemius and soleus muscles). The short and tight calf muscles cause the Achilles tendon to exert a constant pull on the heel bone. Over time, this pull causes pain and inflammation over the heel bone, and extra bony growth may occur.

Risk factors of Sever’s Disease

Risk factors include repetitive running and/or jumping, poor choice of footwear and tight calf muscles. It has also been suggested that biomechanical factors such as genu varum (bow leg) and pes planus (flat feet) are correlated to the likelihood of developing Sever’s Disease.

Symptoms of Sever’s Disease

• Pain with weight-bearing, running and/or jumping
• Tenderness when pressing over the heel
• Limited ankle dorsiflexion range, which may be pain provocative

Treatment for musculoskeletal conditions among youths

Treatments for musculoskeletal conditions among youths follow the same rationale. Non-steroidal anti-inflammatory drugs (NSAIDs) may be given to help reduce inflammation and pain. More importantly, the child would need relative rest from the aggravating activity. In more severe cases, complete cessation of the activity may be required. Icing can help reduce symptoms temporarily. Deep tissue massage can help to reduce the tonicity of the relevant tight muscles, reducing the pull of the muscle on the apophysis. Athletic taping may also help to offload the painful location. 

Physiotherapy treatment for musculoskeletal conditions among youths

Apart from these passive treatments, appropriate exercises will also benefit the child greatly. Low-intensity isometric exercises has been shown to have analgesic effects for these conditions. As symptoms reduce and functions increase, the exercises should be progressed to higher intensity isotonic exercises.

Ample time is key, not only for muscles to catch up with the growth of bones, but also to allow the inflammation to subside. Coupled with an individualised exercise programme,  those with OSD  and Sever’s disease can expect to return to their sport pain-free in a couple of months. Give us a call or drop us a message to book an appointment with our team of physiotherapists for a complete assessment and treatment plan.