Obesity is increasing at an alarming rate, particularly in the last 20 years. Now, what was once an adult problem – marked by health concerns like Type 2 diabetes, high blood pressure and more – has become a childhood epidemic. Consider that:
- Over the past three decades, the prevalence of children in the U.S. who are obese has doubled, while the number of adolescents who are obese has tripled
- Approximately 32% of American children and adolescents, ages 2 to 19, are considered overweight or obese
- About one in eight preschoolers (ages 2 to 5) in the U.S. are obese
There are many serious health and social problems associated with excess weight, including a variety of issues impacting musculoskeletal health. Why? Increased stress and tension can result in deformity, pain and, potentially, a lifetime of limited mobility and diminished life quality. Read on for specifics on how obesity can impact a child’s bone and joint health.
Growth Plate Damage
Bones grow in size and strength during childhood. Excess weight can damage the growth plate, which is the area of developing cartilage tissue at the end of the body’s arm, leg and other long bones. Growth plates regulate and help determine the length and shape of a bone at full growth or maturity. Too much weight places excess stress on the growth plate, which can lead to early arthritis, a greater risk for broken bones and other serious conditions.
Slipped Capital Femoral Epiphysis
This is an orthopaedic disorder of the adolescent hip that occurs when the ball at the upper end of the femur slips off in a backward direction due to weakness of the growth plate. It can cause weeks or months of hip or knee pain, and an intermittent limp. In severe cases, the adolescent may be unable to bear any weight on the affected leg.
The condition often develops during periods of accelerated growth or shortly after the onset of puberty. Hormonal dysfunction associated with obesity may predispose a child’s hip to slip. In addition, extra weight may also increase the sheer forces across the growth plate, contributing to the slip.
Blount’s disease, or severe bowing of the legs, is another condition in which hormonal changes and increased stress on a growth plate – caused by excess weight – can lead to irregular growth and deformity. Progressive deformity, rather than knee discomfort, is the most common complaint. In younger children and less-severe cases, a leg brace or orthotic may correct the problem. However, surgery consisting of a tibial osteotomy, may be needed.
Fractures and Related Complications
Children diagnosed as obese or overweight may have a higher risk for broken bones due to stress on the bones, or due to bones weakened by inactivity. In addition, these children may have more complications that can delay or alter treatment outcomes. For example:
- Traditional metal implants may not be sufficiently strong to repair broken or misaligned bones
- Overweight or obese children may find crutches difficult to use
- Cast immobilization may not sufficiently stabilize broken bones, meaning surgery (in addition to casting) might be required
Children who are overweight or obese often have painful, flat feet that tire easily and prevent them from walking long distances. Many children with flat feet are treated with orthotics and stretching exercises focused on the Achilles tendon (heel cord). Because weight loss is often enough to ease the pain of flat feet, low-impact weight reduction exercises, such as swimming, may be recommended.
Children diagnosed with obesity often have difficulties with their coordination, called developmental coordination disorder. The symptoms of DCD may include:
- Problems with gross motor coordination such as jumping, hopping or standing on one foot
- Problems with visual or fine motor coordination, such as writing, using scissors, tying shoelaces or tapping one finger to another
Developmental coordination disorder may impair or limit a child’s ability to exercise, potentially resulting in more weight gain. Physical and occupational therapy may improve DCD.
Preventing and Treating Childhood Obesity
For most children, a diet rich in calcium and other nutrients plus regular physical activity — at least 35 to 60 minutes a day – can help minimize weight gain, promote healthy weight and build strong bones for life. Talk to your child’s pediatrician for information and answers on healthy weight and development.
Information revised from OrthoInfo, courtesy of the American Academy of Orthopaedic Surgeons.