lynchburgpediatrics

Sprain, Strain or Something More

Fri, 04 Sep 2026 15:51:36 GMT

What I Tell Parents About Sports Injuries

With Dr. Luke McKenna

Your child limps off the field, or grabs a wrist after a bad landing. Most of the time you're right to call it a sprain, ice it, and move on. I've spent years working with young athletes in Florida and Virginia, from weekend rec to MLB/NFL/NHL players, and the sprains aren't what worry me. What worries me is the six-week ache nobody mentioned because it "wasn't that bad."

A child's skeleton isn't a small adult skeleton. There are growth plates near the ends of the bones, and mechanically they're the weakest point in the system, weaker than the ligaments and tendons around them. So an injury that would strain an adult's muscle can instead land on a child's growth plate, and it often doesn't swell or bruise. It just aches a little more each week.

Routine Injuries

Sprains and strains still make up most of the injuries I see. Rest it, ice it fifteen to twenty minutes a few times a day, wrap it, elevate it, ibuprofen if appropriate. Most improve over a week or two. The mistake I see isn't the first few days, it's the comeback: sending a child from the couch straight back into a scrimmage instead of easing in.

Get it looked at sooner if they can't bear weight, if there was a pop at the moment of injury, if the joint feels unstable, if there's real swelling or numbness, or if two weeks pass with no improvement.

The ones that don't announce themselves

These build quietly and the first sign is often performance, not pain. A pitcher losing velocity. A gymnast avoiding one specific move. By the time it hurts enough to complain about, it's usually been going on a while.

Low back pain: In a gymnast, diver, football player, weightlifter, dancer, or volleyball player, don't wave this off. Spondylolysis, a stress fracture in a small bony bridge in the spine, is the single most common cause of low back pain in teenage athletes who show up in a sports clinic. It aches, gets worse with activity and with arching backward, eases with rest, and lingers for weeks. Caught early, it heals well and children go back to their sport. Ignored, it can occasionally progress to a vertebra slipping and that isn't a toughing-it-out injury, but a season ender.

The throwing arm: Little League shoulder (usually ages 11-16) and Little League elbow (usually 9-13) come from the same overuse mechanism on a growth plate that isn't ready for it. Watch for shoulder or inner-elbow pain, and for a drop in velocity or accuracy before pain even shows up. Pitch count limits and several real months off throwing each year are the best prevention I know of.

Gymnast's wrist: Handsprings and vaults load a bent-back wrist over and over, and it can injure the growth plate of the forearm bone. This causes a nagging ache on the thumb side of the wrist. This must be allowed to heal fully, otherwise it will persist for as long as the athlete is active.

Apophysitis : This is the real name behind most "growing pains" in active 8-15 year olds, where a tendon keeps pulling on a growth center. Osgood-Schlatter (tender bump below the kneecap), Sinding-Larsen-Johansson (pain at the bottom of the kneecap), Sever disease (heel pain, extremely common in runners, soccer, basketball, gymnastics, dance). These are able to be diagnosed with a good physical exam, rarely need imaging, and are treated with relative rest, stretching, ice after activity, sometimes a heel cup. They resolve as children finish growing.

Bone stress injuries: These are the so-called overtraining injuries. Too much impact, not enough recovery, and bone weakens before it can rebuild. Pain builds at one specific spot, worse with activity, better with rest, mostly the lower leg and foot in runners and endurance athletes . Shin, foot, and hip locations are higher risk and need prompt attention. Recovery runs weeks to months, with a gradual, genuinely pain-free return.

Why this keeps happening

These injuries result from too much of one motion, too often, without enough recovery. Growing bone just doesn't handle repetitive stress the way adult bone does.

What can actually help prevent these are one or two days off organized sport each week, two to three months off any single sport per year, gradual increases in training load, taking early back/elbow/shoulder pain seriously, and playing more than one sport when you can instead of specializing young.

When to call

Back pain lasting more than a week or two, or worse with arching. Elbow or shoulder pain, or a throwing arm that's underperforming. Pain over one specific bony spot that worsens with activity. Anything not improving with rest, ice, and time. A limp, night pain, or pain interfering with daily life.

We don’t want to keep children off the field. We want them on it for years, not sidelined for a season because something small got ignored too long.

Measles Cases Reported in Neighboring Counties: Updated Vaccine Recommendations for Our Patients

Tue, 19 May 2026 18:31:54 GMT

WHAT THIS MEANS FOR OUR LYNCHBURG PEDIATRICS FAMILIES

We want to make our families aware that there is currently a measles outbreak in neighboring Buckingham and Cumberland Counties. While both counties are rural areas, many residents regularly travel to Lynchburg for shopping, work, and activities, which increases the likelihood of local exposure in our community.

Because measles is highly contagious and can spread rapidly among unvaccinated individuals, we are updating our vaccine recommendations for patients at our practice.

Updated MMR Vaccine Recommendations

At this time, we are recommending:

Infants ages 6–11 months:
Receive an early MMR vaccine dose now for added protection during the outbreak.
Children ages 1–5 years who have only received 1 MMR vaccine:
Receive their second MMR dose now, as long as it has been at least 1 month since the first dose .

Please note:
An early MMR dose given between 6–11 months does not replace the routine 12–15 month dose or the routine second dose later in childhood. Your child will still need the standard vaccine series.

What Are the Symptoms of Measles?

Measles often begins like a common viral illness before the rash appears. Symptoms may include:

High fever
Cough
Runny nose
Red or watery eyes
Fatigue
Rash that typically starts on the face and spreads downward to the body

Some children may also develop small white spots inside the mouth (called Koplik spots).

Measles can lead to serious complications, especially in infants and young children.

If You Suspect Measles

If your child has symptoms concerning for measles or has been exposed to someone with measles, please call our office before arriving.

Letting us know ahead of time allows us to:

Prepare a safe evaluation plan for your child
Minimize exposure to other patients and families
Continue providing excellent care while protecting vulnerable children in our office

If you would like to schedule an MMR vaccine appointment or have questions about whether your child should receive an early or accelerated dose, please contact our office.

Hand, Foot, and Mouth Disease: What Parents Need to Know Amid a Summer Surge

Mon, 09 Feb 2026 12:10:56 GMT

Hand, Foot, and Mouth Disease: What Parents Need to Know Amid a Summer Surge

This summer, our community has seen a noticeable increase in cases of Hand, Foot, and Mouth Disease (HFMD) —a common viral illness that mostly affects infants and young children. At our pediatric office, we want to help you recognize the symptoms, understand how it spreads, and know how to care for your child if they become sick.

What Is Hand, Foot, and Mouth Disease?

HFMD is usually caused by coxsackievirus and is most common in children under 5, though older kids and even adults can occasionally be affected. It is highly contagious and spreads through coughs, sneezes, saliva, fluid from blisters, and stool.

Common Symptoms Include:

Fever
Sore throat
Painful mouth sores
A rash or small blisters on the hands, feet, and sometimes the buttocks or legs
Decreased appetite or fussiness in young children

Symptoms typically appear 3–6 days after exposure and can last up to a week.

Why Are Cases Increasing Now?

Summer often brings more group activities like camps, daycare programs, and family gatherings—ideal environments for viruses like HFMD to spread quickly. This year, we’re seeing an especially active season.

How Can I Help Prevent It?

While there’s no vaccine for HFMD, good hygiene is your best defense:

Encourage frequent handwashing with soap and water
Disinfect commonly touched surfaces and shared toys
Keep children home when they're sick, especially if they have a fever or rash

When to Call the Doctor

Most cases of HFMD are mild and resolve on their own. However, you should contact your pediatrician if your child:

Has a high fever lasting more than 3 days
Refuses to drink fluids or shows signs of dehydration
Appears unusually sleepy or irritable
Has symptoms that worsen or don’t improve after a few days

Rise In Norovirus Cases: What To Watch For

Mon, 09 Feb 2026 12:05:20 GMT

We are seeing a lot of cases of Norovirus and other stomach bugs in our community.

Norovirus is a highly contagious virus that causes gastroenteritis, leading to symptoms like nausea, vomiting, diarrhea, stomach cramps, and sometimes fever or headache. These symptoms typically appear suddenly and can last anywhere from one to three days. In young children, the impact of norovirus can be more severe, as they are more prone to dehydration due to their smaller body size and higher fluid turnover. Dehydration in young children can lead to dry mouth, sunken eyes, reduced urine output, and lethargy, all of which require urgent medical attention.

Parents should seek evaluation by a pediatrician if their child exhibits signs of severe dehydration, such as excessive thirst, inability to keep fluids down, a decrease in wet diapers, or a dry mouth. Additionally, if the child appears excessively sleepy, has a high fever, or shows blood in the stool or vomit, it's essential to contact a healthcare provider. Young children, particularly those under the age of 5, are at higher risk for complications from norovirus, making prompt medical attention important to prevent further health issues.

It's Flu and RSV Season

Mon, 09 Feb 2026 12:01:25 GMT

We are offering influenza and RSV shot clinics every Saturday in October.
Children younger than 5 years old–especially those younger than 2–are at higher risk of developing serious flu-related complications .

While not at higher risk, children 5 years and older can spread flu to their higher risk family members, like infants younger than 6 months old and adults who are 65 years and older or people of any age who have certain chronic health conditions. It’s important to vaccinate everyone 6 months and older in your family against flu each year to help protect those most at risk. A flu vaccine offers the best defense against flu and its potentially serious complications and also can reduce the spread of flu to others.

There is also an RSV immunization available for children under 8 months old. Infants in this age group are at the highest risk for severe respiratory illness caused by this common virus. The RSV immunization helps to protect vulnerable infants by significantly reducing the likeliuhood of hospitalization and serious compications, including pneumonia and bronchiolitis.

It's Time for Kindergarten Registration

Mon, 09 Feb 2026 11:59:55 GMT

Spring is the time when most schools start registration for Preschool and Kindergarten. This is the perfect time for your child's annual wellness visit. At this visit, we assess for school rediness, help discuss services that schools can provide for children who need them, evaluate growth, and discuss healthy habits. We can discuss stratigies for successful school entrance. It is also the time when kids get their booster shot series (typically recommended at 4 years old). Most schools also require a Virginia school entrance form to be filled out by your child's health care provider. We have these forms in our office and can get this filled out for you during your child's visit. We can also fill out other forms such as allergy or asthma plans that schools will need for children who need them. Call our office today to schedule an appointment!

COVID-19 Vaccine Available at Lynchburg Pediatrics

Mon, 09 Feb 2026 11:59:10 GMT

We are now offering the 2-dose, Pfizer vaccine for COVID-19 to our patients ages 12 years old and up. If you would like to sign your child up to receive the COVID-19 vaccine at Lynchburg Pediatrics, please call our office at 434-385-7776 to be scheduled for one of our COVID vaccine clinic days.

COVID-19 Vaccine Approved for Children 12 and Up

Mon, 09 Feb 2026 11:56:59 GMT

As of May 12, 2021, the Virginia Department of Health has approved the COVID-19 vaccine for children down to the age of 12! Lynchburg Pediatrics is not currently administering COVID vaccines at our offices, and we do not know when we will receive COVID vaccines from the state, though we are hoping to have them available here soon.

Because we do not know when we will be receiving vaccines to administer to our patients, the doctors at Lynchburg Pediatrics highly encourage you to schedule your child’s vaccine appointment through the health department so that they can get it as soon as possible. To schedule an appointment, adolescents and their parents or guardians can:

Go to Virginia.gov , and search for locations offering Pfizer-BioNTech
Call 877-VAX-IN-VA (877-829-4682)

Please remember that teens and tweens ages 12-17yo can only receive the Pfizer BioNTech COVID vaccine.

The doctors at Lynchburg Pediatrics strongly recommend that all of our patients and their families get vaccinated against COVID-19 as soon as possible. While adolescents in general have not been as severely affected by COVID, protecting them from this virus is the only way to make sure we don't see more illness and hospitalization among kids, and will help stop the spread of COVID-19. Adolescents who are vaccinated will not have to quarantine after an exposure and will avoid missing school, sports, and other activities. We're all looking forward to getting back to 'normal' and we want your kids to be able to safely hang out with friends, go to summer camp, travel and attend school next fall. Please don't wait - there are very few reasons for someone to skip this vaccine. If you have questions, please feel free to call and speak with one of our advice nurses or your child's pediatrician.