Hurt or Injured? Five Sports Injuries Kids Won’t Grow Out Of

When a child falls, the watchful parent wants to know: Are they hurt, or truly injured? Once this is determined, the right steps can be taken.

Pictured: High performance skater and ankle articular cartilage repair patient Hannah D. rehabbing from an injury sustained as a teen athlete

“Hurt” means in pain or emotional or mental distress, while "injured" typically implies physical damage to the body. A kiss, a hug and encouragement usually remedy the common hurts suffered by kids in all sports. Injuries with damage to critical tissues are where the dilemma comes in. Which ones can be treated with ice, time, and physical therapy, and which need surgical repair? 

Here are the top five we see that cannot be ignored, and that kids will not grow out of:

1. ACL injuries. When ruptured, the ACL does not reliably heal to provide a stable knee. It can... but it often doesn’t. No matter what age, when ACL ruptures are left alone, the knee degrades with damage to both the meniscus cartilage and the opposing articular cartilage. And no matter what age, the ligament should be repaired or reconstructed. The younger the patient, the more care must be taken to protect the growth plates — but it is even more critical that the ligament be repaired before further damage occurs.
2. Meniscus tears. Most meniscus tears fail to heal on their own and lead to abnormal force transmission in the knee joint. Similar to a car tire that is out of alignment, the torn meniscus leads to abnormal mechanics and eventual arthritis. The earlier the meniscus is sewn back together or fully replaced if missing, the better.
3. Kneecap dislocations. To dislocate the kneecap, the ligament on the side of the knee (the patellofemoral ligament) must be stretched or torn. If shown to be torn on an MRI, early repair and augmentation with a tendon graft leads to fewer future kneecap dislocations and cartilage damage.
4. Shoulder dislocation. Similar to the kneecap, dislocating the shoulder requires that the labrum or ligament complex be torn. While first time dislocations are often treated with physical therapy alone, early repairs are the safer route—especially if the patient is in a high-risk sport (such as surfing or white-water kayaking).
5. Articular cartilage injuries. Damage to the bearing surface of the joint rarely heals on its own. If there is an underlying disease, such as osteochondritis dissecans, a decision must be made about when and how to repair it. While some articular cartilage injuries will be tolerated during growth, and escape treatment, unstable lesions require repair

Each of these injuries is best diagnosed by a careful history, physical exam, X-ray and MRI. With kids, it is always tempting to say “they are young; they will grow out of it.” In reality, they are young and have a long life to live—potentially with damaged joints if the injury is not repaired. Celebrate their healing ability by giving their tissues a running start with anatomic repairs and exceptional rehabilitation programs. Their children will thank you for it.

A Young Athlete's Recovery from Traumatic Ankle Sports Injury

Hannah traveled to San Francisco where Dr. Stone repaired the dead bone and cartilage in Hannah's ankle with a cartilage regeneration procedure that he personally developed: the articular cartilage paste graft. Years later, we continue to successfully treat Hannah and help her maintain a full athletic lifestyle outdoors and on the ice.