His advice for keeping young athletes healthy? “Make sure your kids are engaged in multiple activities, and let them figure out what they’re passionate about on their own,” Pandya says. Now in its 18th year, the center has a half-dozen locations around the Bay Area and includes initiatives such as the PlaySafe Sports Medicine Program, which sends athletic trainers into Bay Area schools to help young athletes from diverse socioeconomic backgrounds get the care they need. Pandya, a competitive long- and triple-jumper in college, directs the UCSF Sports Medicine Center for Young Athletes, which offers care exclusively for kids and adolescents. “If you try to use adult principles to treat these young athletes, you’re going to fail.” Not only are their bodies still growing but their emotional needs also differ from those of older athletes. “Children are not little adults,” says Pandya. They have a lifetime of high-impact activity ahead of them, even if they’re not playing sports.” This can spell trouble if injuries aren’t managed by pediatric specialists. “When kids damage their cartilage, it can be really limiting. “The best cartilage is the one that you’re born with,” Pandya says. Of course, avoiding such injuries altogether is better yet. We should be trying to create a culture that allows kids to be healthy and active for their whole lives.” It’s like biological spackle – instead of patching divots in your wall, you’re smoothing living tissue over cratered cartilage. Surgeons can harvest cartilage from cadavers, or from patients themselves, and transplant it into a damaged knee. “There are a lot of new options for placing lab-grown cartilage into the knee or doing cartilage transplants,” says Pandya. Likewise, ACLs can be reconstructed and small cartilage defects repaired. Zhang hopes they’ll also prevent future hip arthritis. The advent of advanced hip arthroscopy technology and surgical techniques – Zhang’s specialty – now allows younger athletes with hip injuries to return to sports. Until a decade ago, kids with hip injuries or labral tears had few treatment options. This can even potentially lead to early arthritis.” “This can lead to additional friction or impingement in the joint, with wear and tear of the hip labrum, which is crucial for maintaining hip stability.
“It can cause the hip to form an abnormal shape, with excess bone,” says Zhang, who directs UCSF’s Hip Preservation Center. “It’s a warning sign for parents out there.”Īlan Zhang, MD, an associate professor of orthopaedic surgery, says overtraining while a child’s skeleton is still maturing can affect the growth plate and hip joint, too. “We’re doing these major reconstructive procedures on very young children,” says Pandya. Instead of playing for fun, kids now train like adults, concentrating on just soccer or just basketball, for example, and getting adult-type injuries. Why the rise in blown ACLs and prematurely pitted cartilage? Pandya attributes this to early single-sport specialization. Damaged cartilage is like a pothole – the joint can’t move easily – and it causes pain, swelling, and stiffness. Pandya, UCSF’s chief of pediatric orthopaedic surgery, has also witnessed an uptick in young athletes with cartilage injuries – damage to the smooth endcaps on bones that allow joints to glide normally. Now, several times a month, he sees 9- or 10-year-olds with ACL (anterior cruciate ligament) tears. When orthopaedic surgeon Nirav Pandya, MD, started his practice a decade ago, he rarely saw 11- or 12-year-olds with torn knee ligaments.
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