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Children are being encouraged to take up sports earlier and earlier, on multiple teams and at greater levels of intensity. This pattern can lead to stress factors, finds a prospective seven-year study of more than 6,800 adolescent and preadolescent girls.
If recognized too late, stress fractures pose a risk of true fracture, deformity or growth disturbance requiring surgical treatment, say researchers Alison Field, ScD, of Children's Division of Adolescent Medicine, and Mininder S. Kocher, MD, MPH, associate director of Sports Medicine at Children's.
The most significant predictors of stress fractures were high-impact activities, particularly running, basketball, cheerleading and gymnastics. Adjustment for age, later menarche and family history of osteoporosis only strengthened the association with high-impact sports. Fractures were twice as likely in girls pursuing high-impact activities eight hours per week versus four or fewer. Each extra hour per week increased stress fracture risk by about
8 percent.
"The youth athlete is specializing in a single sport at a younger age," says Kocher. "This does not allow for cross-training or relative rest, as the athlete is constantly doing the same pattern of movement and impact. Small injuries are being made in the bone with greater cumulative frequency than the body can handle."
Recognized early, most stress fractures heal fully with activity restriction, he adds. "Kids should not play through pain." (Archives of Pediatric and Adolescent Medicine, April 4)
More information: on.chbos.org/pv0611fracture |
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