[Referral pattern, diagnoses and occurrence of short muscles in children and adolescents in an orthopedic specialist practice].

The patterns of referral for 600 consecutive children and adolescents under the age of 17 years were analysed and the symptoms were compared with the diagnoses. 40% were referred because of foot problems, 20% had mobility problems and 20% had pain in the back or extremities. Out of the 240 patients with foot problems, these could be confirmed in 44%. 30% had merely short muscles and 7% had, in addition, spasticity. 70% out of the 110 patients referred on account of flat foot had too short achilles tendons. 50% out of the 600 patients referred had short achilles tendons and/or hamstring muscles. In 20%, the short muscles alone could explain the symptoms experienced by the patients. Short heel tendons are found with broad fore-feet, cavus and valgus feet, loose subtaloid joints, heel exostoses, pain in the heel and in the calf. Short hamstrings result in a shuffling gait, high-riding patellae with periodic pain, pain on the posterior aspect of the thigh and a straight transition in the thoraco-lumbar region with subsequent Scheuermann's disease. The length of the muscles should, therefore, be investigated. If they are too short, they should be stretched for one minute every twelfth hour to obtain optimal elasticity and length.