A 14-year-old gymnast with a stress fracture in her lower back. A 12-year-old who tore his ACL in a soccer game. A 16-year-old runner with a leg stress fracture. A 15-year-old who tore his meniscus playing basketball.
A single morning's patients for Harvard's Dr. Mininder Kocher provides a window into a troubling trend: Injuries once seen mostly in adult athletes are becoming distressingly common in youth athletes -- not just in high school, but in Little League and Pee Wee Football.
These aren't simple injuries. In the past decade, "Tommy John" surgeries to repair elbows blown out playing baseball -- an operation named for a famous baseball pitcher -- have almost tripled among adolescents at a high-profile Alabama clinic, a meeting of sports medicine specialists will be told by researchers this week.
Worse, some injuries don't have good treatments for young patients. The surgery that fixed the torn ACL in Tiger Woods' knee, for instance, can thwart the growth of a young child's leg.
Kocher, an orthopedic surgeon at Children's Hospital Boston, is about to begin a government-funded study to figure out the best treatment for children who tear that anterior cruciate ligament while growth plates around the knee still are active.
But no matter how well certain injuries heal for now, Kocher worries about the longterm consequences for little joints.
"I wonder what these kids are going to be like 20 to 30 years down the road," he says. "Will we have a whole generation of middle-aged adults with early arthritis?"
Why the sudden influx? Orthopedic surgeons say that today's youth sports are more intense, with players often picking just one to specialize in as young as 8. And they can play and train in some sports virtually year-round -- with a school team, recreation league, travel league, summer camp.
"Youth athletes are not the same as small adults," says Dr. E. Lyle Cain Jr. of the Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala. Certain types of injuries "can cause permanent damage that affect their future growth."
More than 3.5 million children 14 and under receive medical treatment for sports-related injuries each year. Along with the typical sprains and strains are a lot of overuse injuries -- stress fractures, tendonitis, cartilage damage.
Kocher has some easy advice: Try old-fashioned play, like jumping rope, playing hopscotch, climbing trees. High school teams now are trained to avoid ACL tears with core-body conditioning and tips on bending knees for jumping -- things younger kids can learn on their own just by having fun.
"A lot of the stuff kids used to do in free play was ACL prevention," he says. "Now they don't get that, and they jump into high-level soccer."
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