Sports Injury

Dear Lisa,

I have an eight year old daughter who has begun to love swimming for her swim team. She swims year round and it is hard to get her out of the pool. Recently she has complained of popping and slight pain in her elbow when swimming free and back and knee popping when swimming breast. Is this just a growing thing or should I be concerned. Are there exercises she can do to strengthen these areas?

“Daughter on the Swim Team”

Dear “Daughter on the Swim Team”,

Younger children normally are flexible with the movement of their joints. As children mature they naturally lose this flexibility and their muscular strength increases. (1) Because they are so flexible, children may be able to move their joints in such a manner that it makes a popping sound.

Some children have loose ligaments which also lends itself to popping of the extremity with movement. If the ligaments are too loose and the child has too much laxity, a joint may be subject to injury due to the inadequacy of the supporting structures around bone and muscle. (1) Therefore if you notice popping sounds and/or joint instability it is a good idea to have it evaluated by a Health Care Professional.

In some children, maturity alone is all that is needed to alleviate the symptoms. In others stretching, muscle strengthening exercises or both are needed to rectify the situation. (1) Your daughter’s Primary Care Physician will be able to asses your daughter’s musculoskeletal condition, strength, flexibility and joint stability and determine if she needs further intervention. A referral to a Pediatric Orthopedic Specialist or Physical Therapist for an evaluation may be necessary. In some cases the expertise of a Sports Medicine Doctor is indicated when a child encounters musculoskeletal injuries or complaints during their sport. (1)

What starts out as normal movements in a flexible child can turn into a habit. Some children discover that their body can move in such a manner and continue to force the movement to occur out of habit. You may want to observe your daughter to see if the popping occurs as a result of her purposeful movements, or if the frequency increases during a specific activity or stress. This would be important information to relate to your daughter’s Doctor. It would also be a good idea to ask your daughter if she has control of her movements. If she does you should reinforce the need to stop this activity.

It is wonderful that your daughter has developed such a great interest in a sport. Her continued participation not only will benefit her physically, but the lessons of Camaraderie and working in a team will be carried with her for the rest of her life. As with any sport, it is important to always follow measures that prevent injuries. These measures include; proper warm-up, stretching, conditioning, appropriate protective equipment that is the right size for the athlete and participation at the appropriate level. (2)

By following these measures, keeping open communication with your daughter’s coach and maintaining yearly physical examinations by your Primary Care Physician you can ensure that your daughter experiences a healthy and safe sports environment. Some parents prefer not to have their child participate in organized sports because they are fearful that they will get hurt. It is reassuring to know that statistics show that children younger than 10 years old sustain more fractures and catastrophic injuries in recreational activities than they do in organized sports. (2)

Good luck on the Swim Team!

References:
(1)Schwartz M, Charney E, Curry T, Ludwig S. Pediatric Primary Care. A Problem Oriented Approach. 2nd Ed. Littleton, Mass:Year Book Medical Publishers, Inc. 1990:140.
(2)Setphenson M. Pediatricians play an important role in sports injury prevention, treatment. Infectious Disease in Children. 2006. May:46.


Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

Pediatric Advice About Keeping Kids Healthy