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Should our kids be exercising when they are in pain?

Should our kids be exercising when they are in pain?

Children and  Young Athletes.

When playing sport we encounter so many differing personalities along our journey, these personalities don’t always share the same opinions on how we treat our younger athletes, it is fascinating.

Kids, parents and coaches all present differing views from each other, this all depends on their relationships with the athletes. Generally kids playing sport, unless they dislike their chosen activity want to get out there and participate.

Parents all differ in their ability to read their kids as to their needs and wants, gauging their ability to push through the discomfort of growing, fatigue and sport, overall I would suggest that parents sympathise really well with their kids. If the child is sore, they can generally determine if it is right for them to go to training or play a game.

Coaches look a little differently at the athlete, they want the best kids on the field, maybe their judgment wavers a little when making decisions on the wellbeing of the child when talking injury and pain, or maybe they are the best judges of this as they see the child in action every week, knowing their strengths and weaknesses.

This begs the questions: Should kids be playing sport with pain?

The best way to start this conversation is to look at why it is important for kids to exercise. Firstly we know for a fact that the years prior to being a teenager and well into this teenage period is crucial for tendon development. During this time a tendon’s capacity to tolerate exercise is born, a capacity which can’t be developed without exercise induced stress ie exercise. Once this window closes the capacity of the tendon to tolerate stress cannot be significantly changed, yes we can increase the strength of a tendon but its ability to adapt to load (exercise) as an adult is limited.

Secondly we know the social, mental health and physical wellbeing of a child are all greatly improved when they are out playing sport. The regulation of hormones, energy consumption, development of friendships and teamwork are all huge benefits of exercise.

So back to the question: Should kids be playing sport with pain?

Pain manifests in many forms, we know that if  a child has a broken leg, they should not be playing sport or running on the injury, it needs time to recover, much the same as having a stress fracture (albeit unlikely in a child).

However, if we are talking about injuries related to growth, such as Calcaneal Apophysitis, arch pain, Achilles pain, or any pain that can be properly managed by a Podiatrist then it is a strong yes to keep them out on the field. Keep young athletes who are sore but can managed within pain limits playing sport.

I will use Calaneal Apophysitis (Severs Heel) as an example, such a common complaint of posterior heel pain. With the use of isometric calf holds, heel raises, exercise modification, topical anti inflammatory medication and ice we can manage these symptoms, leading to not only the child continuing to play sport, but also allowing their tendons to develop and continuing to see their mates.

The level of pain needs to be kept into consideration, we suggest that the maximum level of pain any person in this situation should tolerate is a four out of ten on the pain scale. This means that full function is still a priority, no limping,, no avoiding normal  gait.

We have to continue as parents and coaches to consider the best outcome for the child.  So we can manipulate the training schedule to manage the workload, it may enable the child to continue playing sport, thus continuing to load tendons and developing a level of resilience.

Careful consideration is needed when evaluating pain, especially in kids, they rely on us as parents and coaches to make good decisions, have the right people assess them such as a Podiatrist and the right people making judgments calls on their best step forward to resolve their complaint.

For more information please feel free to call or email the clinic. (03) 9568 3107 or jamesp@sespodiatry.com.au