Stress Fractures in Young Athletes

Teen girl holding ice pack on shinCompetitive sports can give some young athletes an edge over their peers. When fun, teamwork, and good sportsmanship are the top goals, sports can improve young kids’ physical and emotional health, self-esteem, and even their relationship skills. Unfortunately, young athletes must also compensate for still-growing bones, tendons, and muscles. Sometimes sports injuries happen.

The most common type of sports injury is an overuse injury such as a stress fracture. Overuse injuries are becoming more common in young athletes Playing sports year-round without time off doesn’t give young bodies enough time to rest and recover.

How stress fractures happen

Stress fractures happen when muscles are too tired to take on the impact of exercise, and the bones absorb the added stress. When those bones become too strained, they develop a tiny break known as a stress fracture.

 

Most stress fractures affect the bones in the lower leg. Stress fractures are also common in the feet.

These are the most common causes of stress fractures:

  • Increasing the frequency or intensity of exercise too quickly
  • Suddenly changing the workout surface
  • Getting sudden and significantly more playing time
  • Using or wearing gear that doesn’t offer enough support, such as shoes that are worn out
  • Insufficient periods of rest between practice or events

Stress fractures can happen during any number of sports, but they tend to be most frequent in young athletes who participate in sports that involve running and jumping, such as basketball, gymnastics, and track and field. These sports involve repetitive movements that strain the muscles and bones. This increases the risk for a stress fracture.

Preventing stress fractures

Parents and coaches can do many things to help reduce the risk for stress fractures in growing bones. Make sure that your young athletes follow these guidelines:

  • Eat a balanced, nutritious diet rich in calcium and vitamin D for strong, healthy bones.
  • Participate in conditioning practice for sports.
  • Do cross-training (alternating types of physical activities).
  • Stick to sports that are age-appropriate.
  • Always warm up before practice or games and cool down afterward.
  • Get a complete physical exam before participating in sports.
  • Wear athletic shoes (and any other needed gear) that are appropriate for the sport and that offer plenty of protection and cushioning.
  • See a healthcare provider for any persistent pain or limp.
  • Drink plenty of fluids and stay hydrated for practices and games.
  • Don’t resume sports or exercise too quickly after a stress fracture or other injury.

Also, make sure that your child’s coach is aware of the signs of stress fracture. This may be milder in nature than a more severe sports injury. Pain, particularly pain that gets better when the child is allowed to rest, is the most common symptom of a stress fracture.

Stress fractures typically heal with rest alone, but injured athletes may need to take off from their sport for as long as 6 to 8 weeks to properly recover. If your child complains of any pain that persists during sports, schedule a visit with your child’s healthcare provider.

Health Tip: Reduce Your Risk of Hip Fracture

Health Tip: Reduce Your Risk of Hip Fracture

Hip fractures are serious injuries, especially in seniors. Falls are a prime cause.

The American Academy of Orthopaedic Surgeons offers this advice on reducing your risk:

  • Keep your home clear of clutter, making sure it is well lit. Install grab bars in bathrooms.
  • Get regular exercise to strengthen bones and muscles, and improve balance.
  • Each year, get an eye exam and a complete physical.
  • Discuss all medications with your doctor, as some drugs can have side effects.
  • Know your risk factors for bone loss and fractures.
  • Eat a healthy diet rich in vitamin D and calcium. If needed, talk to your doctor about medication to improve bone health.
  • Maintain a healthy weight.
Even a Little Exercise Can Help With Arthritis, Study Says

Even a Little Exercise Can Help With Arthritis, Study Says

Just a little physical activity seems to go a long way toward helping older adults with arthritis remain able to do daily tasks, a new study finds.

Older adults with arthritis-related joint pain and stiffness need to keep moving to remain functionally independent. But only 10 percent of older Americans with arthritis in their knees meet federal guidelines of at least 150 minutes of moderate activity a week, the researchers said.

However, this Northwestern University study found that doing even about one-third of that amount is still beneficial.

The study involved more than 1,600 adults 49 or older who had arthritic pain or stiffness in their hips, knees or feet.

Those who did a minimum of 45 minutes of moderate activity — such as brisk walking — a week were 80 percent more likely to improve or sustain physical function and gait speed over two years, compared with those who did less activity, the researchers found.

“Even a little activity is better than none,” said study first author Dorothy Dunlop.

“For those older people suffering from arthritis who are minimally active, a 45-minute minimum might feel more realistic,” said Dunlop, a professor of rheumatology and preventive medicine at Northwestern’s School of Medicine in Chicago.

She said the federal guidelines are important because the more you do, the better you’ll feel and the greater the health benefits.

“But even achieving this less rigorous goal will promote the ability to function and may be a feasible starting point for older adults dealing with discomfort in their joints,” Dunlop said in a university news release.

The study was published online recently in the journal Arthritis Care & Research.

Common Painkillers Don’t Ease Back Pain, Study Finds

Common Painkillers Don’t Ease Back Pain, Study Finds

Painkillers like aspirin, Aleve and Advil don’t help most people with back pain, a new review finds.

The researchers estimated that only one in six people gained a benefit from taking these nonsteroidal anti-inflammatory drugs (NSAIDs).

Meanwhile, previous research has suggested that another common painkiller, Tylenol (acetaminophen), isn’t very useful either, the study authors added.

The findings raise the prospect that no over-the-counter painkillers really ease back pain, at least in the short term, and some may raise the risk of gastrointestinal problems.

“There are other effective and safer strategies to manage spinal pain,” said review author Gustavo Machado. He is a research fellow with the George Institute for Global Health in Sydney, Australia.

Back and neck pain are the leading cause of pain worldwide, the researchers said.

For the review, the investigators examined 35 studies on the use of NSAIDs to treat back pain. The studies most commonly examined the drugs ibuprofen (Advil), naproxen (Aleve), cox-2 inhibitors (but not Celebrex) and diclofenac (which is available in the United States, but not widely known).

The studies, which tracked about 6,000 people, “showed that commonly used NSAIDs have only small effects on pain relief and improvement of function,” Machado said. “Moreover, these small effects may not be perceived as important for most patients with spinal pain.”

The researchers also found that participants taking the drugs were 2.5 times more likely to experience gastrointestinal side effects, compared with those who took inactive placebos.

The review only included studies of people who took the drugs for an average of seven days.

“Unfortunately, there are no studies investigating the effects of NSAIDs for spinal pain in the medium-term (three months to 12 months), and the long-term (more than 12 months),” Machado explained.

Dr. Benjamin Friedman is an associate professor of emergency medicine with Albert Einstein College of Medicine and Montefiore Medical Center in New York City. He estimated that the painkillers might be even more ineffective than the review suggests, with fewer than one in 10 patients getting substantial relief.

What should patients with back pain do? Friedman said he often recommends the drugs even though they’re not likely to provide benefits.

“The happiest back pain patients I know are the ones who have found relief with some type of complementary therapy such as yoga, massage or stretching,” Friedman noted.

Study author Machado said, “Patients should discuss with their doctors whether they should take these drugs, considering the small benefits they offer and likelihood of adverse effects.”

As for whether opioid painkillers — such as Oxycontin — might work, he suggests that patients avoid them for back pain since research by his institute’s team has suggested they aren’t very effective either.

However, Friedman said they’re often prescribed for very brief periods for unbearable pain, along with physical therapy.

As for other suggestions, Machado points to guidelines that recommend patients with back pain remain active and avoid bed rest.

“There is also evidence that physical therapies and psychological therapies — such as cognitive behavioral therapy — bring benefits to these patients,” he said.

Also, Machado said, “people should focus on preventing back pain in the first place. Having a healthy lifestyle and engaging in physical activities is a very important way of achieving this.”

The review was published online Feb. 2 in the Annals of the Rheumatic Diseases.

Joints That Make Those Popping or Cracking Sounds

Joints That Make Those Popping or Cracking Sounds

If you’ve ever heard a loud pop as you bent down to pick something up, you’ll be relieved to know that it’s normal for your joints to make popping and cracking noises.

These sounds can be caused by a number of things, including when soft tissues — such as tendons and ligaments — rub or snap over other tissues and bones, explained Dr. Aman Dhawan. He is an orthopedic sports medicine specialist at Penn State Health’s Milton Hershey Medical Center.

“Our joints are mobile, so there are a lot of things that slide over or run past each other. When they move, there is the potential for anatomy to intersect,” he said in a Penn State news release.

The sounds can also be caused by pockets of nitrogen gas within the fluid that helps lubricate joints and provides nutrition to cartilage, Dhawan added.

According to Dr. Robert Gallo, another orthopedic sports medicine specialist at Hershey Medical Center, the only time you need to be concerned about noisy joints is if you also have swelling or pain.

There’s no link between joint sounds and arthritis, both doctors agreed. And cracking your joints does not make them swell up or become arthritic, they added.

“Joint sounds are not really an indicator of health or lack of health,” Dhawan said. He pointed out that the cracking or popping sounds “may be irritating to the listener, but that’s a separate issue. There is really no evidence that it causes any damage.”

Some people believe chondroitin and glucosamine supplements or injections help lubricate joints. But there is little evidence to prove they are effective, Gallo said.

Your joints can benefit from stretching and strengthening exercises, low-impact workouts (such as swimming and bicycling), maintaining a healthy weight and not smoking, the doctors advised.

“There is good data to support getting rid of excess weight because it does improve pain in the joints of the lower extremities, as well as decreases your risk of getting arthritis or of having it progress,” Dhawan said. “The joints carry the weight of our bodies, so the less stress you put on them, the longer they will stay healthy.”