Gesellschaft für Orthopädisch-Traumatologische Sportmedizin

Experten warnen vor Überlastungsschäden an kindlichen Gelenken und Knochen

Berlin – Akute Verletzungen wie Brüche, Prellungen und Zerrungen aber auch Überbelastungsschäden an Gelenken und Knochen, nehmen im Kindes- und Jugendalter zu, beobachten Sportorthopäden. Die Ursache sehen sie vor allem in zu wenig Verletzungsprävention, etwa passendem Schuhwerk, Einlagen, einem altersgerechten abwechslungsreichen Trainingsplan oder ausreichenden Regenerationszeiten. In vielen Fällen würden sich auch bereits durch ein adäquates Präventionstraining oder maßvollere Sporteinheiten Verletzungen und deren Spätfolgen vermeiden lassen. Im Vorfeld des Deutschen Kongresses für Orthopädie und Unfallchirurgie 2019 (DKOU) warnen die Experten vor zu intensivem Sport ohne Regenerationszeiten im Kindesalter. Sie weisen darauf hin, dass Folge- und Überlastungsschäden – auch durch zu einseitige Bewegungsabläufe – junge Menschen lebenslang körperlich beeinträchtigen können. 

„Wir beobachten in der Praxis zunehmend Verletzungsmuster, die auf zu intensive Sporteinheiten ohne ausreichende Erholung für Knochen, Gelenke und Muskulatur zurückzuführen sind“, betont Professor Dr. med. Romain Seil, Präsident der Gesellschaft für Orthopädisch-Traumatologische Sportmedizin (GOTS). Der orthopädische Chirurg aus Luxemburg warnt vor zu langanhaltendem und einseitigen Übertraining, das den kindlichen Halte- und Bewegungsapparat dauerhaft schädigen kann.

Eine Schwachstelle im Knochenbau von Kindern und Jugendlichen ist die Wachstumsfuge (Epiphysenfuge). Sie schließt sich bei Mädchen meist zum 14. oder 15. und bei Jungen etwa zum 16. Lebensjahr, nachdem das Knochenwachstum abgeschlossen ist. Akute Verletzungen, aber auch chronische Überbelastungen, die zu mikrotraumatischen – für das Auge nicht sichtbaren – Verletzungen führen, können Schäden an den Wachstumsfugen verursachen. „Insbesondere eine gelenknahe oder auch das Gelenk direkt betreffenden Verletzung, bei der die Wachstumsfuge beteiligt ist, kann dann eine Fehlstellung nach sich ziehen.“ Als Beispiel nennt er O-Beine von Fußballern, die in ihrer Jugend zu intensiv trainiert haben1. Je nach Ausprägung könne dies auch Spätschäden wie Arthrose zur Folge haben, so Seil.

Insbesondere bei Sportarten mit erhöhten Überlastungsrisiko an Knochen und Gelenken wie dem Kunstturnen oder Tennis aber auch Kontaktsportarten wie Judo sind Überlastungsschäden häufiger als akute Verletzungen. Kinder im Leistungssport sind öfter betroffen, doch auch im Breitensport ist es ratsam, Sport in Maßen zu betrieben. „Kinder sollten wöchentlich mindestens zwei Ruhetage einhalten und höchstens drei bis vier Stunden am Tag trainieren, so Tischer, Leiter Sektion Sportorthopädie an der Orthopädischen Klinik, Universitätsmedizin Rostock. „Dabei ist es wichtig das Training altersgerecht, abwechslungsreich und mit ausreichend Aufwärm- und Ruhezeiten zu gestalten.“

Die Experten weisen im Vorfeld des DKOU 2019 darauf hin, dass die Prävention, Behandlung und Rehabilitation von verletzten Sportlern im Leistungs- aber auch im Breitensport zu sehr vernachlässigt wird. Sie sollte konsequenter in das Sportprogramm aufgenommen werden, um eine gesunde sportliche Entwicklung zu fördern und den jungen Sportlern ein gesundes und schmerzfreies Leben mit und nach dem Sport zu ermöglichen. Hat das Kind Beschwerden, sollten Eltern sich umgehend an einen Sportorthopäden wenden, sagt auch Dr. med. Thomas Möller, Kongresspräsident des DKOU aus Speyer.

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