Skip to content

Surgery Door
Search our Site
Tip: Try using OR to broaden your
search e.g: Cartilage or joints
.

Adolescents

In contrast to children, adolescents are typically less flexible but muscularly stronger. This situation poses different problems from the point of injury occurrence and prevention.

Growth is usually gradual during childhood but it also occurs in 'spurts' - particularly during teenage years. Children's bones grow mainly from cartilage layers near the ends of the bones and these soft areas can be a site of pain in the active teenager. This is most frequently seen at the top of the shin bone where the tendon from the knee cap attaches and at the heel where the Achilles tendon inserts. Both of these tendons take heavy strains when jumping and running.

When the lower leg tendons bear heavy strains, particularly during a growth spurt, the bones can become sore. In the case of the knee, the condition is known as 'Osgood Schlatters disease' and at the heel as 'Severs disease'. A similar condition in the back is known as 'Scheurmans disease'. Although called 'disease' by the medical profession, these conditions should be looked on as being entirely 'normal' responses to exercise. The majority of sporting teenagers will from time to time experience discomfort at these growth sites until their bones have stopped growing and have matured. The discomfort needs no specific treatment or management other than a sensible approach to training and playing duration, frequency and load.

During and immediately after growth spurts, adolescents frequently exhibit weakness of certain muscle groups and a decrease in flexibility. An often-overlooked problem linked with growth spurts is lack of proper coordination. The 'clumsy teenager' is a well known phenomenon and this clumsiness is probably a product of the body's nervous system coming to terms with limb, muscle and nerve length increasing over short periods. Due to the growth spurts, adolescents may go through periods of relative weakness, reduced flexibility and poor coordination.

Either alone or together, weakness, lack of flexibility and poor coordination could increase the risk of injury - so it's important to take some simple steps to prevent injury. Carry out regular checks of height to chart the onset, duration and end of growth spurts. During and just after growth spurts children should avoid training on hard surfaces and avoid training and playing for too long and too often. This will reduce the discomfort from - and the risk of flaring up of - a case of Osgood Schlatters, Severs or Scheurmans.

Around the time of growth spurts, it's also important to do regular flexibility exercises and low level strengthening exercises - but to avoid exercise that involve heavy weights / strong resistance - because this will compensate for the tendency to become stiff and weak due to the changed body shape. To counter the problems of diminished coordination it's helpful to introduce some simple balance training exercises. These could include slow-speed and low-impact walking and jogging drills that involve changes of direction.

There are wide variations in the amounts and timings of growth spurts amongst adolescents, which makes comparison and screening of this age group difficult. Adolescents of the same age are often markedly different in physical development - meaning that a training and playing load may be fine for one teenager but may be too much for another. Similarly, adolescents of the same age need to be individually screened for physical peculiarities - like lack of strength or flexibility - which make them prone to injury. There can also be great differences in biological development amongst adolescents of the same age. Remember these differences when grouping adolescents together in age groups, particularly for contact team sports as the 'skilled big ones' will probably come out on top, at least as far as incurring less injuries are concerned than the 'skilled little ones'.