Protecting Your Child’s Bones is No Joke

If your child has orthopaedic needs, finding the right doctor can impact the rest of their lives. Children with sports injuries, spine or limb deformities, neuromuscular conditions, gait abnormalities, congenital deformities, or trauma need specialized treatment for their growing bones and muscles. Certain challenges and considerations are unique to treating young patients.

“Very young children can’t verbalize the location, degree, and type of pain they’re experiencing, which makes some diagnoses more difficult,” said Dr. Stephen Stricker, a pediatric orthopaedic expert.

Dr. Stricker frequently treats children with clubfeet, scoliosis, fractures, and leg-length discrepancies. He speaks with their concerned parents, who often wonder if they did something wrong and if their child’s condition could have been avoided. They want to help prevent future injuries and issues for their child.

Pediatric orthopaedics myths

Many musculoskeletal conditions carry a genetic predisposition, and many assumptions about children’s bone health are misguided, says Dr. Stricker.

Some misconceptions include:

• Braces and casts can cause muscle atrophy and joint stiffness, but these effects are only temporary.
• Wearing a heavy book bag can cause your child back pain, but it will not cause permanent or progressive spine deformity.
• Lifting weights will not stunt your child’s growth.
• Sitting with poor posture does not cause permanent spine deformity or scoliosis.
• Flat feet do not cause crooked knees or back pain.
• Custom arch-support orthotics or orthopaedic shoes.does not correct flat feet

Parents also might be surprised to learn that bent bones and growth-plate fractures only occur in children, and they can be difficult to see on X-rays.

If a major growth center of a young child’s leg bone is damaged by trauma or infection, it can be very challenging to maintain equal leg lengths. And, surgery on tiny, premature infants can be difficult due to their small size and frailty.

If your child needs surgery

Surgery on bones can be painful, so pediatric patients need narcotic medications during recovery. Parents may be concerned about giving their child prescription-strength pain management, but Dr. Stricker says that children only need these medications for a few days following bone surgery.

“Quickly weaning your child to over-the-counter pain medications can help prevent addiction and side effects like constipation.

“On the plus side, children heal faster than adults,” Dr. Stricker said. “Their bones can remodel and straighten out if fractures heal a bit crooked. And, surprisingly, children’s bone growth is not stunted by wearing casts and braces for prolonged periods.”

What can parents do to protect their child’s developing bones and muscles?

Most children in the U.S. are vitamin D deficient. Dr. Stricker says it’s a good idea to give your child supplemental, over-the-counter vitamin D to help prevent fractures. Ask your pediatrician for advice about the daily dose.

If your child is passionate about a single sport, be aware of the risk for overuse injuries due to over-training. “Encourage your child to participate in multiple sports to stay healthy, both physically and emotionally,” Dr. Stricker said. 

Also, keep your child benched from strenuous activities and sports when:

• he/she is in significant pain
• has weak muscles and stiff joints (such as right after an ankle sprain or a cast removal)
• is ill or dehydrated
• has heart problems, brittle bones, or certain other medical conditions

Start with the right doctor for your child

“Your pediatrician is the best advocate for your child’s physical and emotional needs,” Dr. Stricker said, “and your primary care physician can help advise you when your child needs to see a specialist, such as a pediatric orthopaedist.

“As part of the University of Miami teaching faculty, I take the extra time to be very precise about my diagnoses. I recently took care of a child who bumped her elbow then developed chronic debilitating pain in the entire upper extremity. Several physicians had missed the uncommon diagnosis of reflex sympathetic dystrophy. After I made the correct diagnosis, I prescribed nerve-block treatment, and the child’s pain resolved completely within a few days.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: bones, Dr. Stephen Stricker, joints, orthopedic care in Miami, pediatric orthopaedics