I received a call the other day from a fellow Massage Therapist. He was
referring one of his clients, a 15 year old male athlete ( lacrosse
goalie and football linebacker) with severe pain in his right knee. The boy’s coach told his mother he needed an MRI and that he most likely tore
something. My friend did not agree and wanted to see what I
thought and if Integrated Therapeutic Stretching would help. He had tryouts in two days and they were concerned about injury.
According to the client he only felt the pain when he was crouching in goalie position. I had him do it for me. He had all of his wait on the outside of his feet which were not wide enough apart to support his weight properly.
I ran him through some quick range of motion & muscle tests as he lay on the table with no resulting pain but revealed very limited ROM throughout the boy’s lower body. As we started to stretch it was quickly discovered that his left glutes were locked up. Hip rotators on both sides were in as bad a shape. IT Band and hamstrings were at 60% ROM and his quadriceps were down to 45%. This is 15 years old folks!
It is terrifying to see the physical shape of children today. Either they are overweight and under exercised or they are over worked, participating in multiple sports where proper strength and flexibility training is nonexistent.
Sports injuries are on the rise in children and teenagers. Each year more than 3.5 million sports-related injuries requiring medical treatment occur in children under age 15. Today, as more and more children and adolescents participate in the same sport year-round, many young athletes are developing overuse injuries. In fact, overuse is responsible for about half of the sports injuries that happen to middle and high school aged students.
We worked together through each stretch, showing him how his body is supposed to move utilizing body proper form and mechanics. He was very eager to learn as was his mother. I assisted and guided him through the stretches focusing especially the ones which really opened his restrictions. Both he and his mother were surprised at how tight he was in the beginning and at speed with which he loosened up.
Now as we were working I observed a deep scar about 1inch in length on his left knee which he claimed was “no big deal” and said it was over a year old. His mother chimed in “the bad one was on his foot”. Three years prior he flayed his right foot open on a fence. There was a huge c shaped scar on the sole of his foot which upon palpation showed to have spread and attached into the arch.
I asked if he wanted to see something cool and then I proceeded to release the scar on his knee. When I asked him to bend his knee his eyes opened wide and said “That’s Sick!”. His knee flexion had increased by 20% . Next with his mother’s permission I went to work on his foot. When I was done I had him stand up. He laughed out loud and said “No Way! Thats Totally Sick! I can feel the bottom of my foot”. His mother , shocked at his reaction said ” I didn’t know you couldn’t feel your foot?!” “Neither did I” was his reply.
We followed this up with gait re-education and proper mechanics required for his respective sports positions (i.e. crouching and squatting). While he still had some minor pain he could see how adjusting his stance took the pressure off his knee. After having him go through the stretches once more I recommend to the mother that if the pain comes back or increases then she should indeed seek their doctor’s advice.
The mother was shocked at how much the scars were affecting her son. I explained to her that scars and adhesions are generally overlooked by health professionals because the extent of physiological affects they can have on the body have never really been acknowledged. The slightest restriction from falling off his bike at 4 could alter how he grows and have major repercussions from one end of his body to the other.
Four days later the duo returned, the tryouts went great and when asked about his knee he said “it still hurts every now and then but whenever I felt it start I shifted around until I felt right and the pain stopped.” I asked if had been stretching and he say before and after the games. (In the four days since I had seen him he had two lacrosse matches and two days of football tryouts). He was also very excited for more scar therapy “It was so weird but I could feel my foot moving better as I played!” His mother than asked if I had any extra time to look at her two scars that have been driving her crazy for years.
During the course of my career I’ve treated many patients whose problems could be traced back to a scar they had forgotten they even had. While not every scar presents a problem, very often they do. Doctors, along with basically everyone else, tend to ignore scar tissue from surgery and accidents especially in children.
Today children are playing more and more sports driven by the need of scholarships and future fame. It is time we start to pay attention to the adverse affects of training and playing so hard so young. We need to make sure that the fall off the bike or the cut from climbing over the fence does not lead to issues later on.