CARING FOR ATHLETES
“Is it Just An Ankle Sprain?”
Special Care Must Be Taken Regarding Growth-Plate Injuries in Young Athletes
Ankle sprains are the most prevalent of all injuries in young athletes. It is not uncommon for parents and coaches to grossly observe an athlete’s injured ankle and assume the athlete has suffered a sprained ankle. Medical personnel routinely evaluate ankle sprains to determine which ligaments are involved and how severely. The apparent sprain of the pre-pubescent and adolescent ankle, however, may not be an injury to the ligaments, but may actually be an epiphysial (growth-plate) separation or fracture separation of the lower leg.
It is important for parents, coaches, and medical personnel to take a close look at ankle sprains that occur near bone growth-plate centers. Special care must be taken to prevent abnormal growth patterns from disruption of a bone’s growth center. A bone’s growth center may be aggravated by failure to identify the specific nature of the injury. Allowing the athlete to continue in sports activities, and/;or participate in an aggressive rehabilitation program, could result in detrimental bone growth patterns.
Parents, coaches, and medical personnel should always assume that trauma that would result in a sprain or dislocation to an adult, frequently will result in a growth-plate injury in a child. Adolescents are particularly susceptible to growth-plate injuries because of periods of rapid growth that occur during a time of increased competitive athletic activity.
Research shows us that of all injuries that occur to long bones during childhood, approximately 50% are to the growth-plate. It is important that a great majority of these injuries are recognized as such and result in no disruption of normal growth patterns. The type injuries that may change growth may result in cessation of all or part of the growth-plate, resulting in bone length differences, or in slightly accelerated growth with little or no length differences.
Another common condition that may be associated with an ankle sprain, or may occur independently, is the slipping of an important tendon on the outside portion of the ankle. This condition, known as a “subluxing peroneal tendon” can frequently be confused with an ankle sprain because it may give the athlete a feeling of instability, as well as, producing tenderness and swelling over the outside portion of the ankle. By overlooking this condition and allowing an athlete to continue to participate in sport, more serious consequences could develop that could necessitate surgery.
In summary, the lower leg, ankle, and foot of growing children are frequently injured in sports; caution must taken regarding an assumption that the athlete has suffered a minor ankle sprain. Knowledgeable attention must be made to these injuries, so as to protect the young athlete from further harm and inappropriate treatment.