Just as the leg bone’s connected to the knee bone, the way kids care for bones now is connected to their skeletal and joint health throughout their lives. According to the U.S. Bone and Joint Initiative, musculoskeletal disorders like arthritis, osteoporosis, and sports-related trauma rank among the most common reasons people visit healthcare professionals.

Keeping bones and joints functioning properly at a young age may be essential for lifelong mobility health, says Dr. Matthew Dobbs, president elect of the U.S. Bone and Joint Initiative and professor at Washington University in Saint Louis. Here are his five best tricks to keep little skeletons happy and healthy.

1. Maintain a Healthy Weight

“Obesity causes so many orthopedic problems in the growing bones,” Dobbs says. When extra pounds are added to limbs, it puts undue stress on bones and joints, especially weight-bearing joints like hips and knees.

According to an article by Harvard Medical School’s Harvard Health Publishing, on flat ground, the force on a person’s knees is equivalent to one-and-a-half times their body weight, and on an incline, the force can be two to three times their body weight. Thus, the more one weighs, the more force is exerted on one’s joints.

Over time, the pressure can break down cartilage, which can lead to pain and serious growth deformities or chronic illnesses like arthritis.

“Obesity can cause hip problems and [can even lead to] bowed legs, [both of] which can require surgery,” Dobbs says, adding that keeping a healthy weight might play the most important role in keeping joints healthy.

2. Get Enough Vitamin D

Vitamin D deficiencies can also put kids at increased risk for broken bones, says Dobbs. As the National Osteoporosis Foundation has reported, Vitamin D helps the body absorb calcium, a mineral vital for bone health and strength, and supports stabilizing muscles. Getting enough Vitamin D can help reduce the likelihood of breaking bones later on in life, too.

Dobbs recommends that kids eat a well-rounded diet including foods that provide quality sources of Vitamin D, such as milk, fish, many orange juices, soy milk, different cereals, egg yolks, and some cheeses.

3. Diversify Sports and Sports Training

“Most of the injuries we see today are [kids] trying to do elite, high-pressure year-round sports,” says Dobbs. “Kids need to be varied in their sports, not do the same sport year round.”

When kids specialize in sports, they can overwork certain muscle groups and neglect others, which can cause imbalances throughout all joints in the body. By diversifying sports, kids also diversify the muscles they use. Placing limitations on repetitive motions in children’s sports, like pitching baseballs or kicking footballs, can also alleviate joint and muscular pain kids may report after overuse.

Looking at adolescent girls, ACL injuries—a tear or partial tear in one of the knee’s key ligaments—are increasingly common, Dobbs says. An ACL injury, or any other ligament injury, can be prevented with well-rounded training programs that target the supporting muscles of the area. “It’s important to work the quads and hamstrings, to know when to protect the knee, when to feel [something’s off] and how to respond,” Dobbs says. This can help girls involved particularly “in any of those twisting sports like soccer and basketball” maintain preventative care of their knees.

“Stretching is a good thing for kids to be doing in addition to sports,” Dobbs says. “As you get older [losing flexibility] can cause more problems with aging.”

4. Wear Sports Safety Equipment

No matter the sport, activity, or hobby, Dobbs emphasizes safety gear. Wearing appropriate guards or pads on shins, knees, and elbows can prevent unnecessary stress on the joints. Dobbs adds it’s worth repeating the value of wearing a helmet in all activities on wheels, and potentially in sports like lacrosse or soccer, in addition to football.

Adding other protective layers to joints can help prevent sprains or aches. “Taping and bracing [ankles] can prevent recurring injuries in athletes that have [pre-existing] problems,” says Dobbs. Taping and bracing can help other areas in need of extra support, too, like knees or shoulders, depending on the sport.

5. Develop Healthy Lifestyle Routines

“A common parent concern when you talk about school is heavy backpacks,” Dobbs says, noting that kids in high school these days are lugging around 40 to 50 pounds.

Remind kids to carry a backpack over both shoulders, not just one. “Kids who like to carry their backpack over one shoulder rather than two put an isometric load on their back, which can increase back pain,” Dobbs explains. “Some schools don’t allow rolling backpacks, but you could also look at that as a solution.”

Dobbs also encourages parents to prioritize sleep. “It’s just hugely important for growth and school participation and being your best,” he says. “Sleep has been shown to be absolutely important. There’s not necessarily something to point to in the orthopedic world,” he admits, but, as a study done on behalf of the Endocrine Society has shown, insufficient sleep might be connected to bone loss.

In other cases, when dealing with bone strength, “one of the things that’s often brought up is all the soda that kids drink now,” Dobbs says, citing information that associates kids who drink more soda have a higher likelihood of fracturing a bone. “Now, whether that’s the soda or the fact that they’re drinking less milk…” he trails off with a shrug. There has not been definitive research evaluating this matter, but Dobbs advises that drinking less soda is always a good idea.

Overall, learning how to prioritize and maintain healthy bones and joints at a young age is integral to developing lifelong comfort in the body. “Bone health in kids is something everyone should be aware of,” Dobbs says. Little skeletons are the foundation for big skeletons, after all.

This article was originally published in October 2018.
Emma Athena

Emma Athena is an award-winning journalist based in Boulder.