Big injuries troubling more little athletes

A14-year-old gymnast with a stress fracture in her lower back. A 12-year-old who tore knee ligaments in a soccer game. A 16-year-old runner with a leg stress fracture. A 15-year-old who tore his meniscus playing basketball.

A single morning's patients for Harvard's Dr. Mininder Kocher provides a window into a troubling trend: Injuries once seen mostly in adult athletes are occurring in youth athletes down to Little League and Pee Wee Football.

These aren't simple injuries. In the past decade, "Tommy John" surgeries to repair elbows blown out playing baseball -- an operation named for a Major League Baseball Hall of Famer Tommy John -- have almost tripled among adolescents at a high-profile Alabama clinic.
Worse, some injuries don't have good treatments for young patients. The surgery that fixed the torn ligament in Tiger Woods' knee, for instance, can thwart the growth of a young child's leg.
Kocher, an orthopedic surgeon at Children's Hospital Boston, is beginning a government-funded study to figure out the best treatment for children who tear that anterior cruciate ligament while growth plates around the knee still are active.

But no matter how well certain injuries heal for now, Kocher worries about the long-term consequences.

Why the sudden influx? Orthopedic surgeons say that today's youth sports are more intense, with players often picking just one to specialize in as young as 8. And they can play and train in some sports year-round.

Pitching offers a prime example. The Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala. counts a fiveto six-fold increase in serious shoulder and elbow injuries in youth baseball and softball since 2000.

Prompted by such research, Little League Baseball last year limited how many pitches youngsters of different ages can throw before mandatory rest periods.

Then there's the notoriously painful torn ACL -- not an overuse injury but one that can happen to anyone who lands wrong while pivoting on a knee.

It was long thought a rarity in childhood. But among males, one in five torn ACLs occurs before age 18; the figure is 30 percent among females, Kocher says.

In 2006, McCall Maddox of Jacksboro, Texas, tore his ACL during Pee Wee Football at age 12. Three doctors refused to do surgery until he was 16 and had quit growing, ordering no running until then.

Why? Standard ACL repair involves drilling through the leg's growth plates, risking a stunting of any still-to-come growth.

McCall's mother, Roxanna, sought out Kocher in Boston, who repairs children's ACLs in a different way: Winding the new ligament around the shinbone instead of drilling.
McCall took a chance with the operation and, after six months of sometimes grueling physical therapy, he was back playing football and basketball and running track in seventh grade.
But, until doctors come up with the best solution, Kocher has some easy advice: Try old-fashioned play, like jumping rope, playing hopscotch, climbing trees. High school teams now are trained to avoid ACL tears with core-body conditioning and tips on bending knees for jumping -- things younger kids can learn on their own just by having fun.

"A lot of the stuff kids used to do in free play was ACL prevention," he says. "Now they don't get that, and they jump into high-level soccer."