Roentgen examination of the deformed foot

Abstract

The number of children and adolescents involved in organized sports has increased dramatically over recent decades. Participation in organized sports is now regarded as a “common rite of childhood in the United States.”29 The benefits to health and social development from youth participation in sports are debated but are generally accepted. However, more participation has led to more sports-related injuries. The increase has been in both acute (macrotrauma) injuries and, even more, in overuse injuries.Overuse injuries result from repetitive submaximal musculoskeletal loading during efforts to build and sustain strength and endurance. The injured tissue is otherwise normal. Many contributory factors (training errors, anatomic variants and abnormalities, and environmental factors such as hard running surfaces or worn-down shoes) are the same in children and adolescents as in adults. Certain causative factors are unique to young athletes, however. Factors related to ongoing growth are particularly important. Bone growth is a primary phenomenon. Muscles, tendons, ligaments, and joint capsules grow in response to bone growth. As a result, bone often grows faster than the surrounding muscle tendon unit and flexibility decreases. In combination with increased muscle strength, this produces muscle–tendon imbalances that predispose to injury. The relative weakness of cartilage at physes, apophyses, and over epiphyseal surfaces also renders these structures vulnerable, particularly during periods of rapid growth.This review emphasizes sports-related injuries that are either usually or exclusively encountered in children and adolescents.