The paperback version with the complete text and all illustrations is available at all good medical book stores. Children are not merely small adults . There are marked differences in coordination, strength and stamina. Children have lower anaerobic capabilities, are less metabolically efficient and have less efficient thermoregulatory mechanisms. The growth cartilage is susceptible to stress.
Children are therefore more susceptible to overuse injuries.
Mismatch between bone and soft tissue growth during the adolescent growth spurt causes muscle-tendon tightness, loss of flexibility and increase risk of overuse injuries. Bone injuries occur more readily than ligamentous injuries. X-rays are always indicated in sprains and strains to exclude bone, epiphyseal or apophyseal injuries. Of Special Note in Children Valgus and varus stress injuries to the knee may present as joint laxity. Anterior instability may result.