With the fall sports season in full swing, and winter teams gearing up, athletes of all ages are sustaining the inevitable bumps and bruises and sometimes more serious injuries. Pediatric orthopaedic surgeon Angielyn San Juan, DO, helps young athletes and their parents sort out the common strains from the more severe injuries and everything in between.

“One of the most important things to consider when looking at injuries in pediatric patients is that children are not little adults,” said Dr. San Juan. Children have open growth plates, which often makes their injuries and treating them very different than a similar injury for an older teen or adult.

“As adults, we have muscles and tendons attached to our bones, but our growth plates are closed,” said Dr. San Juan. An injury on an open growth plate, even if it’s not a fracture can continue to be painful until the patient is skeletally mature if it’s not allowed to heal. On average growth plates close in girls around age 14, and in boys around age 16, added Dr. San Juan.

Over-use injuries are among the most common conditions Dr. San Juan sees, especially at the start of a new season when athletes are beginning a new sport. Just because a child or teen was active in the off-season, doesn’t mean they are ready to jump into a challenging, competitive regimen. “Running around a playground with friends is much different than running and cutting on a soccer field,” explained Dr. San Juan.

Pre-season strength and conditioning and a gradual increase in intensity are important strategies to prevent injury, stressed Dr. San Juan. “It’s important for the parents, coach, and child to come to an understanding before the season is fully underway,” she added. “Happily, I think the culture of sports is changing a bit, the old notions of playing through pain or ‘if it doesn’t hurt you are doing it wrong’ are not as prevalent as they once were.”

Some common injuries like jammed fingers in basketball and other ball sports are best treated with the tried and true rest, ice and elevation—while other more traumatic injuries like fractures that are often the result of collisions or getting knocked to the ground in sports like football and hockey require medical attention.

If an athlete can walk or use their arms normally and there is no obvious deformity following a fall or collision, rest and icing may be a logical response, but if there is an obvious malformation, extreme pain or an inability for the athlete to put weight on the limb it’s always important to have the injury checked out right away.

“It’s often better safe than sorry with child athletes,” said Dr. San Juan. “I am much happier telling parents that an exam and x-ray are normal than giving them the news that we need an MRI as I think there is a problem.”

Some common injuries like torn ACLs in soccer are a clavicle fracture in hockey can just be a stroke of bad luck and will obviously require medical treatment and in some cases surgery to repair the damage.