Issues in the pediatric athlete

Owing to an increase in children participating in competitive organized sports, there is a real concern for the health and well-being of the individual pediatric athlete. A knowledge of several aspects of the care of these children will not only make sports participation more enjoyable but also help to minimize injury. It should be remembered that children are not small adults. They not only have a different physiologic response to exercise but also have many cartilaginous growth areas that are susceptible to injury. Appropriate training in the pediatric athlete will help prevent injury. Conservative training programs, completed in a well-ventilated and air-conditioned area are important. In the prepubescent, efforts should be made to make training fun, with emphasis placed on skills important to the sport rather than monotonous repetitions and intensive conditioning. Because early detection and treatment of overuse injury and spondylolisthesis will help decrease morbidity and may prevent permanent injury, it is important to maintain a high index of suspicion for the development of early symptoms and signs. Knee injuries are very common and require appropriate evaluation that often includes stress radiographs and arthroscopy. Although isolated ligamentous injury usually has a good prognosis, injury to the ACL seems to cause significant morbidity in the long run. Reconstruction in the adolescent with significant symptoms and instability is reasonable. More research into ACL insufficiency in the child athlete, however, is required before the natural history and best method of management is established. Sport participation is to be enjoyed. Certainly, sports are much more fun when one is healthy. A knowledge of issues in the pediatric athlete will help maintain the health and happiness of these children.