child & adolescent pain

are not just 'Mini Adults' - their skeletons contain growth tissue which is not present in an adult and  the location where natural growth occurs is also an area of potential weakness and injury for a period of time.  Some 40 percent of sporting children will suffer some sort of injury: accurate diagnosis and good management is key.  

PFO treats children and adolescents from 8 years of age with musculoskeletal problems, under 16 years old we require a legal guardian to be present.

are very common usually felt at night NOT during activity and most commonly below the knees.

Hip - Perthes Disease (3-10 years) is a disorder which affects the head of the femur (the ball of the ball and socket joint of the hip). In Perthes disease the blood supply to the growth plate of the bone at the end of the femur (called the epiphysis) becomes inadequate. As a result the bone softens and breaks down, a process called necrosis. 

Symptoms: The condition usually begins with hip or groin pain, or a limp. Sometimes knee pain is the first symptom. The pain persists and there may be wasting of the muscles in the upper thigh, shortening of the leg and stiffness of the hip, which can restrict movement and cause problems with walking.

X-ray is required to confirm diagnosis and management tends to be conservative with a reduction in impact activities

occurs when the upper epiphysis of the thigh bone (femur) slips sideways off the end of the shaft. It tends to affect children in their early teens when they are growing rapidly. During this time, the forces and stresses put on the upper part of the thigh bone increase and can pull it or twist it. If these forces are big enough, they can actually make the epiphysis move, and the epiphysis slips. In children who are overweight or obese, an extra strain is put on the upper thigh bone by their body weight and so slipped capital femoral epiphysis is most common in these children. It can be a gradual or acute onset.

These presentations need to seek medical assistance.  If you notice your child limping then they will require an X-Ray.

Other hip presentations are: 

• Dysplasia (often detected at birth) 
• Transient synovitis (irritable hip) peaking at 3-8 years.
• Septic arthritis - any age (peaking at 0-6 years).
  

 occur in adolescents, usually  between 7 to 15 years and most commonly 10-14 years. It presents as pain at the points where tendons attach to bones, causing a traction on the bone following overuse. This can lead to local tiny avulsion fractures (where small pieces of the outer part of the bone are pulled away) resulting in a swelling at the point of insertion of the tendon which is often at an ossification site, the point at which the bone grows.  

The commonest sites for the condition are at the insertion of the patella tendon into the tibial tubercle below the kneecap (Osgood Schlatters disease), at the insertion of the  achilles tendon into the heel bone (Severs disease), at the bottom of the kneecap (Sinding-Larsen Johansson syndrome).

 is  an inflammation of the heel bone or the ‘calcaneous apohyseal’ joint and growth plate, the condition is also known as Calcaneal apophysitis It is the most common cause of heel pain in young athletes and often due to be repetitive micro-trauma as the Achilles tendon pulls against the growth plate.  It commonly hurts during or after sport, particularly sprinting and jumping and again, may coincide with a sharp increase in sport and/ or a growth spurt

 What can I do? 

•  Rest from unnecessary activity that aggravates your pain for a couple of days
•  Ice or heat can help with pain relief 
•  Elevate your heel as often as possible 
• Seek specialist physiotherapy assessment and advice on how to modify sporting activities and to design a stretching and strengthening exercise programme
  

The pain usually resolves with physiotherapy treatment and advice within 6 months​