Children's Orthopedics

What's the treatment for Sever's disease? Our eleven-year-old daughter was just diagnosed with this. They say she will have to give up her gymnastics for awhile. What else?

Sever's disease, also known as apophysitis of the os calcis is a condition seen most often in gymnasts. Let's breakdown the terms first. Apophysitis refers to a tuberosity (bony bump) that is stressed when an attaching tendon pulls on it repetitively.




My 13-year-old son is growing like a weed. Besides growing pains, he seems to be accident-prone. First he had Osgood's disease. Now he has an injured hamstring muscle. Is there any way to help prevent some of these problems? He's very athletic so all these injuries took us by surprise.

Many young sports athletes are tripped up by their own skeletal system. Traumatic and overuse injuries affecting the physes (growth plates) can result in various injuries. The main reason is an immature skeletal system. The growth plates provide sites of injury that don't occur in older, fully mature teens and adults.




What can you tell me about posterior element overuse syndrome? That's what our daughter has been told that she has.

With posterior element overuse syndrome, too much spinal extension and rotation cause damage to the area where the muscles and tendons connect in the low back. The ligaments, spinal joints, and joint capsules at the level of the repetitive trauma are damaged.

The affected individual develops low back pain because the position of the low back is one of too much lordotic curve. The patient looks like there is a swayback position of the spine.




How do you know when a child is making up pain to get out of something or really hurting? Our 12 year-old son hasn't been doing well on his soccer team. Now he's suddenly developed back pain. He says he got kicked in the back in the last game but no one saw it happen. We think maybe he just doesn't want to go back. What should we do?

Back pain (in adults) is so common, eight out of 10 people will experience it at least once (and often more than once) in their lifetime. Most of the time, no one even knows what's causing it -- the condition is said to be idiopathic. It's nothing serious and treatment isn't even needed. The patient is told to stay as active as possible. Recovery occurs in seven to 10 days. But back pain in children is something else altogether.




Always Pay Attention to Back Pain in Children

Back pain in adults is so common, eight out of 10 people will experience it at least once (and often more than once) in their lifetime. Most of the time, no one even knows what's causing it -- the condition is said to be idiopathic. It's nothing serious and treatment isn't even needed. The patient is told to stay as active as possible. Recovery occurs in seven to 10 days. But back pain in children is something else altogether.




Injuries in the Growing Athlete

Many young sports athletes are tripped up by their own skeletal system. Traumatic and overuse injuries affecting the physes (growth plates) can result in permanent deformity. Undiagnosed, untreated, and neglected injuries to the physes can put an end to a budding career. These are the findings of a study from the Cincinnati Sports Medicine Research Foundation in Ohio.




Our baby was born with clubfeet. He's so very tiny but they are still insisting he will need treatment with casting and bracing. For now, we move his feet and ankles through the motion that he has. The hope is that we will be able to restore full motion without additional treatment. How does the doctor tell when the treatment has worked?

Clubfoot is a congenital condition that affects newborn infants. The medical term for clubfoot is Congenital Talipes Equinovarus. This condition has been described in medical literature since the ancient Egyptians.




I'm a grandmother now and my two-year-old granddaughter has clubfeet (both sides). I'm trying not to interfere but my daughter and her husband don't seem to be taking the treatment seriously. The little girl is supposed to wear a special splint at night. When we visited last week, I never saw them put it on her. They say she doesn't like it and screams all night. Do you have any suggestions?

Clubfoot is a congenital (present at birth) deformity that causes the feet to point down and turn inwards. Left untreated, this condition prevents normal foot and ankle motion needed for walking and running. The Ponseti method developed by Dr. I. Ponseti 50 years ago has become the standard of care for clubfoot deformity. It is used around the world.




Basketball season is just about to start. During the early practice season, I tore my left ACL and had surgery. If I go back too soon, will I risk reinjuring myself?

Many experts have encouraged players to wait at least six months before returning to full sports activity after anterior cruciate ligament (ACL) surgery. But there's some new evidence that waiting that long may not be necessary.




Physical Therapists Improve the Results of the Ponseti Method for Clubfoot in Children

When it comes to the nonoperative (Ponseti) treatment of clubfoot in children, does it matter if a physical therapist manages care versus the orthopedic surgeon?





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