General Health & Wellness • Jun 01, 2010

Kids’ Running Injuries | Prevention & Treatment

As parents, we are constantly encouraging physical activity in our kids to promote healthy lifestyles and reduce childhood obesity. Many of us have even carried those habits we learned as children into adulthood and still remain active today. Running is one of the most accessible and inexpensive activities available to all. It has become an ideal first step, rapidly increasing in popularity in the past 20 years. But like any activity, running is not without injury risks. We as parents and caregivers need to be aware of potential kids’ running injuries.

Overuse injuries are the most common. Researchers estimate that more than 25% of all runners will have to seek medical attention for injuries suffered during their careers. The American Academy of Pediatrics warns against intense training at a young age. And there is still a hot debate in sports medicine on whether children should participate in long-distance running. However, no matter the distance or age, all runners should be injury-free and self-motivated.

Nutrition & Hydration

All runners, young and old, should begin their training with proper nutrition and hydration. Caloric intake should at least be the recommended daily requirement and should include both carbohydrates and protein. Children should never eat right before exercise and should also maintain a minimum amount of calcium and iron in their daily diet. Many runners and especially children do not maintain adequate hydration for exercise. This leads to increased risks of exhaustion, strains, heat cramps, passing out (syncope) or even heat stroke. Children are even more susceptible to these risks due to their higher production of heat per body surface area and decreased sweating ability. They should work on being hydrated prior to exercise and replace lost fluids with a sports drink with electrolytes. We also recommend proper clothing, such as light breathable fabrics, and frequent breaks, especially on hot humid days.

Muscle Strains

The most common injury to all runners and especially adolescents are muscle strains. Strains are generally graded between 1 and 3.  Even grade 3 strains can heal in 12 weeks or less with proper care. You can lower the risk of strains with good stretching techniques before and after all exercise. You should treat all strains initially with ice and complete rest from activity. After the first few days, you can use heat. NSAIDs, such as ibuprofen, are helpful with pain but may delay healing. So, use them sparingly. Cross-training with swimming, biking or elliptical machines to maintain cardiovascular fitness and maintain surrounding muscle tone may also speed recovery. As with any injury, the return to running should be gradual and pain-free.

Other Kids’ Running Injuries

Iliotibial band syndrome (ITBS) and patella-femoral pain syndrome (PFPS) are both common causes of non-traumatic knee pain in runners. ITBS usually causes pain over the outer knee that occurs especially with longer runs and descending stairs. Treat it with proper stretching, rest and strengthening of the gluteal muscles. A visit to the physical therapist is sometimes necessary for massage and proper stretching and running technique.

PFPS causes a dull, achy pain above or below the knee and can be worse with climbing stairs or prolonged sitting. Poor kneecap tracking or general overuse usually causes PFPS. You can also treat it with rest and stretching, along with strengthening of the lower quadriceps muscles.

A physical therapist can recommend treatment exercises for both syndromes, or you can find them on the internet. Many times bracing or taping is helpful for prevention and care.

We see other acute ligament and bony injuries quite often with runners as they increase their distances. For instance, we see ankle sprains or fractures, avulsion fractures, or stress fractures in runners, and more commonly in children and adolescents than in adults. A physician should always evaluate injuries initially, especially with point tenderness and swelling over the lower leg, ankle, or foot. These running injuries will also heal in time but a physician needs to monitor them before exercise is resumed.

At what age a child may begin running for exercise is still under debate. But no matter the age, proper technique, precautions and stretching along with good nutrition and hydration guidelines should be followed for a more enjoyable and injury-free running career for all.