Ask the Expert: Dr. Daniel Green, Pediatric Orthopedic Surgeon, Answers Your Questions About Pediatric Sports Injuries

Q1. My 15-year-old son plays football and one of his teammates injured his shoulder. Is it common for adolescents to get shoulder surgery for major injuries?

Shoulder injuries in teenagers are common and can vary greatly. Clavicle or collarbone fractures are especially common. These injuries can be treated conservatively so the patient can get back to the football field within 4-6 weeks. Only severe cases require surgical intervention. Another common shoulder injury involves dislocation or instability. Teens who experience pain in their shoulder after a dislocation typically undergo a focused rehabilitation protocol and a recommended MRI examination to evaluate the severity of their injuries. Hospital for Special Surgery takes care of many adolescents with recurrent shoulder dislocations through an outpatient arthroscopic shoulder stabilization procedure.

Q2. I read that vitamin D can help reduce the risk of a stress fracture in girls. How much vitamin D do girls need to take daily?

For kids and adolescents with stress fractures, HSS conducts a blood test to check for vitamin D levels. For those with low levels, we usually prescribe high doses of vitamin D. For adolescents with adequate levels, we recommend a minimum of 600 units a day. Many physicians recommend 1,000 units a day. Kids and adolescents can also get vitamin D by being in the sun and drinking fortified milk. It is important to consult with your doctor.

Q3. How do you treat an ACL tear in children?

Complete ACL tears in active children can lead to developing other joint injuries such as meniscus tears and articular cartilage injuries as well. ACL reconstructive surgery can be performed safely in children without disruption to the surrounding growth plates. The surgical treatment principles for children are similar to those in adults but with additional steps and inter-operative x-rays to minimize the chance of damage to the growth plates around the knee.

Q4. How long does it take for a muscle sprain to heal in children under 10 and how would you treat it?

Typically mild muscle sprains or contusions can heal within a week. Children experiencing severe pain or prolonged episodes of pain more than a week should be evaluated by physician to rule out other types of injury. Similar to adults, children should rest, apply ice and compression, stretch and consider physical therapy.

Q5. My 9 year-old daughter broke her leg while playing soccer. Will the broken leg affect her growth?

Leg fractures can involve growth plates and also occur outside of growth plates. Lower extremity fractures with growth plates aren’t uncommon and 20-30% of such fractures can lead to growth arrest. If this occurs, physicians typically develop a surgical plan to correct the problem.

Dr. Daniel Green specializes in Pediatric Orthopedic Surgery at Hospital for Special Surgery. He is currently director of the pediatric sports program for the Division of Pediatric Orthopedic Surgery at HSS. Dr. Green’s focus is to provide the finest, most advanced orthopedic care available, with expertise in areas such as pediatric sports injuries, pediatric fractures, and dislocations.

Topics: Featured, Pediatrics
The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.


  1. My 14 year old daughter just fractured her femoral head. Delbit II fracture. Had an open reduction and 3 cannulated screws. Two weeks post op, the doctor has informed us that she will develop AVN and the question is now how much will the femoral head collapse.
    What would be the best approach should the femoral head start collapsing? how soon would you intervene with a possible solution?
    I do know of one patient who received a hip replacement at 24 years of age. Can this be an option for a 14-15 year old.

    Thank you

    1. Hi Caroline, thank you for reaching out. We are sending your concerns to Dr. Charles Cornell for his remarks.

  2. Dear Sir,

    My daughter is 20 months old and she had an broken arm 20 days back. Initially it was treated with close reduction by applying splinter cast for 2 weeks. Later we found out from x-ray that bone healed in wrong position. Please advice us whether it can be treated by surgery now or we have to wait for a year or more to observe and then to operate.

    1. Hi Arun, thank you for reaching out. Dr. Daniel Green, Pediatric Orthopedic Surgeon, says: ?Each fracture location has its own set of rules about whether surgery is required. Typically, the exact location of the fracture, the amount of fracture displacement and the degree of the fracture angulation needs to be analyzed to make the best treatment plan. The good news is that for most fractures in a 20 month old, surgery is not required as the bones of a young child typically remodel with time.?

  3. I had right foot pain and limping on my foot for several weeks. 2 toes were numb. Later I had pain in my butt for 3 days before I went to ER for Siacatia. (Reason Hern Disk) Then the pain was going down my leg. A few months later I was diagnosed with Mortons Neuroma as I still had pain and was limping on my foot. The Siacatia was gone. QUESTION: Those first 3 days of minor pain was all from Siacatia? Going from my butt, skipping my leg, and going into my foot? Or could my foot problem limping and pain been caused by Mortons Neuroma?
    Thank you so much!!!!!!

    1. Hi Jerry, Dr. James Wyss, Physiatrist, says: ?Symptoms of sciatica can include pain that begins at the low back and radiates to the buttocks, thigh, leg and foot. This would be described as classic sciatica, but the pain can also travel to only specific parts of the sciatic nerve distribution (e.g., buttock and calf, thigh and foot, etc.). In addition, the pain from sciatica usually has a nerve-like quality to it (e.g. burning, tingling, and numbness). The most common cause of sciatica is a lumbar disc herniation(s), but physicians should always consider the possibility of additional neurological causes of the patient?s symptoms. Therefore, it is possible to have low back and buttock pain from sciatica and foot pain from a Morton?s neuroma. Only a thorough history and physical examination and the appropriate medical work up by a qualified physician can help to differentiate the two possibilities.? Please consult with your treating physician for the cause of your pain.

If you’d like to consider HSS for treatment, please contact our Patient Referral Service at 888-720-1982. For general questions and comments, reach us on Facebook or Twitter.