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Musculoskeletal injury in children and skeletally immature adolescents: Overview of treatment principles for nonoperative injuries

Gabriel P Brooks, PT, DPT, SCS, MTC
Dana M Fitzgerald, MD
Albert C Hergenroeder, MD
Section Editor
Joseph Chorley, MD
Deputy Editor
James F Wiley, II, MD, MPH


This topic provides an overview of the basic principles of and modalities used in the treatment of nonoperative musculoskeletal injuries in young athletes. Rehabilitation of musculoskeletal injuries, with an emphasis on the physical therapy program, is discussed separately. (See "Musculoskeletal injury in children and skeletally immature adolescents: Overview of rehabilitation for nonoperative injuries".)

The discussion that follows assumes that fractures and joint instability have been excluded. The evaluation of musculoskeletal trauma and the management of fractures and unstable joints are discussed separately.


Formal physical activity in the form of high school sports participation has grown from an estimated 4 million participants during the 1971-72 school year to an estimated 7.5 million in 2008-09 [1]. For the first time in 2007, the number of girls competing in high school sports exceeded 3 million. The health benefits of increased physical activity (eg, bone health, weight management, improved self-esteem, increased strength, endurance, and flexibility) are well documented. However, those who participate in athletics are at risk for sports-related injuries [2].

High school athletes account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually [2]. Most injuries among high school athletes are lower-extremity sprains and strains. (See "Ankle sprain".)

Among younger children (aged 3 to 15 years) who present to their primary care provider with complaints of musculoskeletal pain, more than 80 percent of cases are caused by trauma, overuse, or osteochondroses (eg, Osgood-Schlatter, Sever disease, Kienböck disease, Freiberg infraction) [3,4].


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Literature review current through: Jul 2017. | This topic last updated: Apr 11, 2016.
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