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Pandemic has affected the bone health of kids around the world; here’s what doctors want parents to know

8-year-old Saksham Gupta complained of persistent knee pain last year when he went back to playing basketball after a gap of one year. When his parents took him to the doctor, they were told that his bones are weak. Something similar was diagnosed for 14-year-old Myra Sinha who complained of wrist pain so acute that she couldn’t do her assignments.

Even before the pandemic hit, we were fighting an epidemic of childhood inactivity leading to health issues in children. And then came the COVID pandemic and took it several notches higher by forcing kids to stay indoors with no option of staying active. It was not only damaging children’s health but their brain development and social skills too.

Dr. (Maj) Harshita Surange, Director, Interventional Pain and Spine Centre (IPSC) India and Dr. Sunil Sherawat, Senior Consultant, IPSC India, Sports Injury, Arthoscopy and Joint Replacement Specialist shares, “Adolescent patients are routinely coming with foot pains and wrist pain according to their routine activities and joints which are used repetitively. This pandemic has impaired the bone health of the young generation who would be likely predisposed to more joint pains and fracture in future. This can be compensated by exercises Vitamin D and calcium supplementation.” During childhood and adolescence, much more bone is deposited than withdrawn, so bone mass in skeleton grows both in size and density which can keep growing until the late 20s. Up to 90 percent of peak bone mass is achieved by age 20 and reaching at its peak at around 30 years. So, a better bone building ability in childhood leads better bone strength in adulthood. Physical activity particularly outdoor sports, vitamin D and healthy diet rich in calcium and proteins plays during this period is vital for good musculoskeletal development. Physical activity is a key factor for maintain adequate bone mass and lack of it can lead to decreased bone strength.

How to keep a check on the child’s bone health

Dr. C. Jayakumar, Professor & Head, General Paediatrics, Amrita Hospital, Kochi explains, “The COVID-19 pandemic has affected the bone health of all children across the world. Almost every kid is now stuck indoors with no way to play outside in parks and open areas as the fear of catching the virus is real. Schools are also not functioning properly due to unforeseen circumstances across the country. And children have no chance to play outdoors or to get any sun exposure. So, now it is very important that parents keep a check on the bone health of their kids and make sure that their children must have 15-20 minutes outdoor exercise in the early morning or during sunny hours, as in few parts of the country, the weather is chilly right now. Outdoor exercises can be at your home balcony, garden, or a rooftop terrace, etc, where there is enough sunlight. In addition to this, maintaining a calcium-rich diet is very important during growing years especially. The most important advice for parents is to encourage their kids to be active and keep them engaged in physical activities at home during these hard times especially to make sure kids don’t suffer any additional health issues later in life.”

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How to limit the effects of juvenile idiopathic arthritis

Dr Shreedhar Archik, Senior Consultant, Orthopaedics and Joint Replacement, Global Hospitals shares a few lifestyle changes that can help them to make their bones stronger again.

Caregivers can help children learn self-care techniques that help limit the effects of juvenile idiopathic arthritis. Techniques include:

Exercise on a regular basis: Exercise plays an important role because it promotes both muscle strength and joint flexibility. Also, swimming is an excellent choice because it places minimal stress on joints.

Applying cold or heat: Stiffness affects many children with juvenile idiopathic arthritis, particularly in the morning. Some children respond well to cold packs, particularly after activity. But, most children prefer warmth, such as a hot pack or a hot bath or shower, especially in the morning.

Eating on time and eating well: Some children with arthritis have poor appetites. Children may gain excess weight due to medications or physical inactivity; a healthy diet can help maintain an appropriate body weight.”

Wrist pain among kids and adults

Talking about wrist pain, Dr Anup Khatri Consultant Orthopaedic Surgeon at Global Hospital, Mumbai shared that it’s prevalent in both kids and adults. “Recently, there has been an increase in people consulting for wrist and hand pain. It can be partly attributed to lockdown and increase in work from home. During these times, due to lack of proper workplace/ tables at home, wrong placement of desktop or laptops leads to incorrect posture and can lead to various musculoskeletal pains. Wrist pains have been one of the major complaints with which young professionals do present.

Also, during lockdown, doing daily household chores like cleaning, washing also increases chances of getting wrist or hand pains. People present commonly with pain in wrist, hands and fingers, stiffness, swelling or burning sensations or tingling in palm or fingers. If left unattended, it may also cause reduced grip strength.”

Adults and kids working on laptops or desktops should avoid the following habits to reduce their chances of hand pain:

• Rapid, sustained, or prolonged keying

• Forceful keystrokes or exertions

• Prolonged mouse use

• Wrists bent back (extended) or forward (flexed) for prolong periods

• Wrists angled to the side when using side keys

• Wrists or palms resting for long periods on hard surface

• Keyboard and mouse not positioned correctly

Due to constant typing, trigger finger may develop, which is inflammation in the tendons or muscles of fingers. Commonly seen in thumb and index fingers. Initially there is only pain, but if continued can cause difficulty in making fingers straight or locking of fingers.

Constant pressure over wrists, due to use of keyboards can lead to pressure over nerves in the wrist and lead to Carpal tunnel syndrome, in which there is tingling, numbness in fingers and may eventually cause weakness if left untreated.

For prevention:

a) Take frequent breaks from any sustained posture every 20-30 minutes

b) Respect pain- positions or stop painful activity

c) Wrists as neutral as possible; safe zone for wrist movement is 15 degrees in all directions

d) Can use soft silicone gel pads for resting the wrist.

If experiencing any of the above, early Consultation can help to arrest progress by simple medicines or braces or exercises, shares Dr Khatri.

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