Injuries seen in children are different than those seen in adults due to the nature of the developing musculoskeletal system. The skeleton is forming, the joints are developing and the ligaments are more elastic. There is a higher ratio of cartilage to bone until the bones and joint mature which makes them less stable and more susceptible to injury with a given force. The area from which the bone grows is most susceptible to injury with trauma in a child. In the healthy adult, the bones are stronger and more stable, so injury occurs more commonly where the ligaments attach to the bone. Contrary to popular thought, many musculoskeletal injuries sustained in childhood persist as a weakness into adulthood and are one of the reasons why some people develop chronic pain.
One contributing factor to injuries in children is the specialization of training in one sport early on, training all year round and training competitively before the musculoskeletal system is developed.
Children are more susceptible to injury during a growth spurt and training needs to be adapted during this period to avoid a permanent injury. Injuries to the discs are common in children and seen among more often among athletes with high impact sports and sports with repetitive bending and twisting.
(Hebert et al. Eur Spine J. 2019. Pubertal development and growth are prospectively associated with spinal pain in young people (CHAMPS study-DK).
It is of critical importance to make a correct diagnosis in the injured child, treat them appropriately and modify activities.