Kids on the coast

Moving onto two legs meant changes in our centre of gravity and the structure and function of our lower back and legs. The hips, which are a ball and socket type of joint, bear most of the load. Structurally, the ball sits at the top of the femur and points inwards towards the socket which is part of the pelvis.
 
During the development of the hip in the womb a few things can go wrong, which is why checking every infant that is born for displaced hips is important. Native Americans were the source of the cure when it was discovered that they never suffered from this condition. All their infants were strapped to their mother’s with legs apart which allowed for proper development of the hips.

So now when an infant is discovered to have this condition they are placed in a brace that keeps the legs wide apart ensuring proper repositioning of the hips.
 
After infancy, the most common hip condition is called ‘irritable hip’ or transient synovitis. The child will wake up unable to put much weight on the leg. They will complain of leg pain but careful assessment of the hip, usually by ultrasound, will find some fluid around the joint. The good news is that this is temporary and settles after a few days of rest. The cause is thought to be a post viral inflammation but if the child is unwell with a fever a bacterial infection must be ruled out with urgent treatment.

There are two hip conditions that deserve special mention. One is called Perthe’s disease. It involves a gradual reduction of blood flow to the ‘ball’ of the hip joint, which weakens it considerably. It tends to occur in small, active boys and is detected with x-rays. If picked up early enough it can be fixed with rest, but if not surgery will be required.

The second occurs in adolescents and is sometimes associated with obesity. This is where the ‘ball’ actually starts slipping from the femur and the leg will appear shortened.
 
Knee and ankle joints rarely cause problems during pre-teen years. Parents will often worry about the shape of the legs, and ‘flat feet’ but these are rarely of any significance. They are normal variations.

During teenage years there are a couple of repetitive strain injuries on major tendons. The first involves the tendon that inserts the quadriceps muscle into the tibia just below the knee cap. This area will be sore during and after exercise. This is called Osgood-Schlatters disease and is common during the winter sports.

A similar injury involves the insertion of the achilles tendon into the bottom of the foot. This is called Sever’s disease. Again it is a repetitive strain injury. Both these last 6-10 months then disappear as the tendon’s growth ‘catches up’ with rest of the body. Sever’s sometimes needs some heel raises inserted into sports shoes to lessen discomfort. Limiting the running training during the week will enable weekend participation.
 
Other causes such as juvenile arthritis, bone tumours, rare infections, marrow and metabolic problems also need to be considered, but these are rare.
We have been walking upright for several hundred thousand years now and we seem to be making a good go of it. But if your child wakes up limping, and he did not suffer any obvious injury then he or she will need a proper assessment.

The information contained in this article is not intended nor implied to be a substitute for individual professional medical advice from your physician or qualified health care provider.