Sports participation in the pediatric population has grown dramatically over the years. Watching your child participate in competitive sports is one of the great joys of parenthood. There are obvious benefits for children too. Athletics improves physical fitness, coordination, and self-discipline and also teaches valuable lessons about teamwork and goal setting.
However, this huge uptick in activity levels has resulted in an alarming increase in sports injuries. More than 3.5 million children under age 14 receive medical treatment for sports injuries each year and children between ages 5 and 14 account for nearly 40% of all sports related injuries treated in hospitals. In youth baseball, there has been a verifiable epidemic of shoulder and elbow injuries, with a five-fold increase in serious injuries among youth baseball and softball. Fortunately, prevention can be effective, as the CDC estimates that half of these injuries may be preventable with simple approaches.
Acute injuries are due to sudden trauma and include fractures, sprains, and strains as well as lacerations and bruises; it also includes concussions, dehydration, and heat-related issues. The keys to preventing acute injuries include:
•Wear proper protective gear
•Be in proper physical condition, which includes both muscle strengthening as well as emphasizing flexibility
•Warm up before playing
•Use proper technique
•In hot weather, follow strict guidelines for breaks and cool-down periods
•Take concussions seriously and follow recommended guidelines for neurological evaluation and mandatory time off the field.
Chronic injuries are as common as acute injuries among young athletes. These injuries are caused by a number of factors, including improper training or technique, prolonged repetitive motion, inadequate equipment, and intrinsic anatomic factors. It’s important to realize that children are not simply a smaller version of adults and that injury prevention requires an understanding of these differences. The bones, tendons, muscles, and ligaments of a child are still growing and that makes them more prone to injury. In addition, there are significant differences in coordination, strength, and stamina. Plus a child’s growth plates are weaker than the surrounding ligaments and an injury that would result in an ankle sprain in an adult might instead cause a displaced growth plate injury in a child. Depending on the type and severity of a growth plate fracture, future growth of that bone could be affected.
One of the most prevalent factors in the rise of chronic overuse injuries is the trend toward focusing on a single sport year round. The rapid growth of travel teams for children and adolescents has facilitated the trend of hyper focusing on a single sport the entire year. This puts excessive and repetitive stress on immature muscle-bone units. Too often, there is an intense “win at all costs” attitude of parents and coaches, leading to unrealistic expectations. In this environment, early warning signs of injury may be ignored or repressed. The adage of “no pain, no gain” is not appropriate!
Minimizing repetitive-use injuries has been a major priority of the American Academy of Orthopedic Surgeons and they have partnered with STOP Sports Injuries to educate parents, coaches, and athletes about prevention. They recommend that you should limit your child to playing on only one team per season. For example, participating on both a travel and a school soccer team in the same season should be avoided. They also recommend avoiding playing a single sport year-round. Participating in multiple sports throughout the year enhances general fitness and aids in motor development. Taking regular breaks is essential for injury prevention. It is recommended that pediatric athletes take off at least one or two days a week from competitive practice, competition, and sport-specific training. Both preseason and in-season preventative training programs focusing on neuromuscular control, balance, coordination, flexibility, and strengthening are strongly recommended for reducing overall injury risk. Fitness programs should ideally begin at least two months before the start of a sports season.
The major objective of athletic activity should be enjoyable participation. The long-term benefits of fitness, motor skills, and social skills are important. Done in moderation and with attention to the basics of injury prevention, athletic activity in children and adolescents is low risk and rewarding, resulting in great benefits.
Steven Struhl, M.D. is board certified in both Orthopedic Surgery and Sports Medicine/Arthroscopic Surgery and has been in private practice for more than 22 years. He has offices in White Plains and Manhattan. He specializes in shoulder and knee related injuries and conditions. shoul