#1 Ranked Children’s Hospital by U.S. News & World Report
MyPatients provides referring primary care providers with secure access to their patients’ information.
Boston Children's has launched the world's 1st program dedicated to offering hand transplants to children who qualify.
Innovation insider is a semi-monthly e-newsletter analyzes innovations at Boston Children’s, other academic medical centers and from industry.
Read the latest blog by a Boston Children's doctor, clinician or staff member.
There are many ways you can help children and their families get the care they need.
If your child or teen has developed a stress fracture, it will comfort you to know that Children’s Hospital Boston’s Orthopedic Center has a tremendous amount of experience treating this injury, developing therapies for healing and conducting research that leads to better care.
Organized sports are very important and help kids—not just in the sports themselves, but in academics and social situations—and they’re good for children’s overall development and growth. The downside is that “overuse syndrome,” where the kids repeat the same drill over and over, causes overuse injuries.
Stress fractures are an overuse injury caused by repetitive stress—usually to the shin bone (tibia) or foot bones but also to the hip (femoral neck)—over a period of time without enough rest to give the bone enough time to heal.
Muscles adapt to stress—that’s how they become stronger. But they also need to rest and rebuild between the episodes of stress. When a muscle gets repeatedly overtaxed with the stress of impact (running, quick cutting, pivoting), it can transfer that stress to the bones of the foot or lower leg.
Stress fractures can occur if a runner or athlete:
• is experienced but is overtraining (often occurs late in the sports season)
• resumes hard training too soon after a lay-off
• increases the duration or intensity of training too quickly
• trains on hills
• is a novice who begins training too hard before she’s conditioned
• runs on surfaces that are too hard or uneven
• runs in improper or outworn footwear
• has flat feet (fallen arches), which unevenly distribute the stress from impact
• has poor running mechanics
• has tight muscles
• is an anorexic individual, whose bones are already deprived of nutrients, brittle and vulnerable to injury; this
profile occurs often in runners and gymnasts
Pain and/or inflammation in the foot or lower leg can be symptoms of stress fractures. The pain tends to intensify in stages:
• At first, the injury may hurt mildly when the child plays her sport.
• As more trauma occurs, the child will experience constant pain when she’s playing.
• At the end stage, the child has constant pain in her foot or lower leg, even when she’s not playing. At that
point, the affected area will have sustained a significant amount of damage.
Occasionally, an adolescent girl runner or gymnast (or other athlete) might have an eating disorder, which will result in a cascade of problems. An anorexic or bulimic girl can lose her period (amenorrhea) and suffer bone density loss (osteopenia or osteoporosis). Her bones can become brittle and thus vulnerable to injury and fracture. It’s important for teenage girl athletes to maintain healthy, vitamin D- and calcium-rich diets.
Youth and teen participation in organized sports has grown to about 35 to 40 million kids across the United States. Not surprisingly, the incidence of sports injuries has also grown—and statistics suggest that 30 to 60 percent of student athletes will have an overuse injury at some point in time. In one Sports Medicine practice at Children’s, for example, at least half of the young patients have an overuse injury.
Parents and coaches have a great deal of influence—for better or for worse. Parents and coaches should emphasize moderation in training and should restrain the zeal with which they push youth and teens.
• become certified
• learn and use proper training techniques
• avoid assigning too many repetitive drills—the overwhelming cause of overuse injuries
• teach proper running mechanics and other sport-specific motion techniques
Physical education departments should make sure that the surfaces of tracks and fields are in good shape, and that proper equipment, footwear and protective gear are used for each sport.
• warming up and stretching before practice
• resting at least one day a week
• cross-training/alternating sports: It is usually unwise for a child or teen to specialize in just one sport. Multi-sport
athletes tend to get fewer overuse injuries than those who specialize in just one sport.
• alternating exercises during practice: By alternating exercises, the athlete is less likely to experience an
injury—and over the long term, her muscle memory will actually improve.
The American Academy of Orthopaedic Surgeons (AAOS) has issued comprehensive guidelines for helping to prevent sports injuries. Below is an excerpt from the AAOS recommendations:
Use proper equipment.
• Replace athletic shoes as they wear out.
• Wear loose-fitting clothes that are light enough to release body heat.
• In cold weather, dress in removable layers.
• Warm up to prepare to exercise, even before stretching.
• Run in place for a few minutes.
• Breathe slowly and deeply, or gently rehearse the motions of the exercise to follow.
• Stretch slowly to the point of muscle tension.
• Hold each stretch for 10 to 20 seconds, then slowly release.
• Inhale before each stretch, exhale on release.
• Do each stretch only once.
• Never bounce on a fully stretched muscle.
• Drink enough water to prevent dehydration, heat exhaustion and heat stroke.
• Drink 16 ounces (one pint) of water 15 minutes before exercising, another 16 ounces after cool-down.
• Drink water every 20 minutes or so while exercising.
• Cool down for twice as long as warm-up.
• Slow down motion and lessen intensity for at least 10 minutes before stopping completely.
• Schedule regular days off from exercise, and rest when tired.
• Fatigue, soreness and pain are good reasons to not exercise.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”