17 Jan Youth Athletes and Sports Injury Concerns
The following is an article posted in the American Association of Orthopedic Surgeons website www.aaos.org
Youth Sports Injuries Background:
Physical activity is a great way for kids to build bone strength, prevent obesity and stay healthy, when paired with safety and prevention practices. With youth sports injuries rising at alarming rates, overuse injuries – such as sore bones and muscles, and swollen or injured joints – need prompt attention in child athletes to prevent chronic musculoskeletal problems later in life. Statistics: •According to the U.S. Consumer Product Safety Commission More than 3.5 million sport-related injuries in children under 15 were reported in the U.S. in 2003. •30 percent of boys and 25 percent of girls between the ages of eight and 16 compete in an organized sports program sometime during the year. •girls, for a variety of reasons, including neuromuscular, biomechanical, and hormonal, are at least several times more likely to have knee injuries – especially involving the ACL – than boys playing the same sport. Talking Points: •kids are vulnerable to sports injuries that can become chronic later in life. Repetitive overuse can cause stress fractures, tendon and muscle tears or even bone deformity. •studies have shown that chronic overuse injuries – particularly those in the shoulder and elbow caused by repetitive overhead motion – occur more frequently than acute traumatic injuries in children. •American Academy of Orthopaedic Surgeons and the National Athletic Trainers’ Association recently launched a public service campaign to remind coaches, parents and players that young athletes are prone to overuse injuries and to do what they can to prevent them, using the slogan: “What will they have longer, their trophies or their injuries?” This campaign was not to discourage children participating in sports and physical activity, which is essential for healthy growth and development, but rather to focus on safety and preventive issues. Recommendations for youth: •Warm up before beginning any activity, including light jogging and stretching •Take rest breaks •Replenish fluids •Cool down and stretch after play •Do not play through pain •Avoid seasonal overuse •Do year round conditioning including cardio, strength and flexibility For parents and coaches: •Have an emergency plan in place •Use proper equipment and wear appropriate gear for the sport •Youth athletes should have pre-participation physical exams to ensure they’re physically fit for play •Group youngsters according to skill level and size not age •Practice proper techniques •Coaches should educate players on the importance of and techniques for stretching and strengthening the extremities •Be alert to injuries •For an acute injury, employ the RICE method: Rest, Ice, Compression, Elevation •Ensure the child sees a doctor if there is severe pain, joint swelling, limp, loss of motion or other significant loss of function. Remember children are not just small adults. Their bodies are different with different vulnerabilities. •Hold practices and games with rest days built into the schedule •Encourage schools to employ ATC’s (certified athletic trainers) when feasible. They are experts at developing preventive programs and also evaluating injuries should they occur. They also work closely with both the athlete and physician to help athletes recover from injuries and get back to play in a more rapid and safe manner. Potential Media Questions: Q: Why are youth sports injuries on the rise? A: These types of injuries are dramatically increasing for a variety of reasons, but most notably, “overuse syndrome” – children are specializing in one sport year-round instead of participating in a variety of activities. Many young athletes are either being pushed too hard or are being thrown into intense athletic activity without the proper conditioning and supervision. Additionally, kids are now playing coached sports at a much earlier age than a generation ago, often play on several organized teams at the same time and extended practice hours and the level of intensity may exceed what some young bodies can handle. Also, many children are under unhealthy levels of pressure to “win at all costs” which can easily overload them both physically and psychologically. These pressures can come from both parents and coaches. Q: Why are children more prone to these injuries than adults? A: Young athletes are not merely small adults. Children’s bones, muscles, tendons and ligaments are still growing, which makes them more susceptible to injury. Growth plates – the areas of developing cartilage where bone growth occurs in youngsters – are weaker than the nearby ligaments and tendons. What is often a bruise or sprain in an adult can be a potentially serious growth plate injury in a young athlete. Q: What are some different types of youth sports injuries and how frequently do they occur? A: It’s always important to study the types and patterns of injuries that occur. This allows us to develop preventive strategies. We have found that many of the injuries that children get are indeed preventable. About 95 percent of sports injuries are classified as “soft tissue injuries” due to minor trauma involving soft tissues-bruises, muscle pulls, sprains (ligaments), strains (muscles and tendons), and cuts or abrasions. Little sports time is lost from these injuries. Sprains: A partial or complete tear of a ligament. Almost one-third of all sports injuries are classified as sprains. Symptoms include the feeling that a joint is “loose” or unstable; an inability to bear weight because of pain; loss of motion; the sound or feeling of a “pop” or “snap” when the injury occurred, and swelling. Not all sprains produce pain, however. Sprains can be minor or severe in nature. Most can be treated conservatively (i.e. ankle sprains) and others require surgery (i.e. ACL tear). With children, one must always be suspicious of a possible growth plate injury or fracture when evaluating a “sprain.” Strains: a partial or complete tear of a muscle or tendon. These are usually treated conservatively. Contusions: These common injuries (bruises) rarely cause a young athlete to be sidelined, and can commonly be treated with the RICE method. Spinal cord injuries: while these injuries are rare, 10 percent of all spinal injuries occur during sports, primarily diving, surfing and football. They can range from a sprain to paralysis in the arms and legs (quadriplegia) to death. Participants in contact sports can minimize the risk of minor neck spinal injuries-sprains and pinched nerves-by doing exercises to strengthen their neck muscles. Fractures: these skeletal injuries constitute a low five to six percent of all sports injuries, with most breaks occurring in the arms and legs. Rarely are the spine and skull fractured. Stress fractures and ligament-bone disruptions: these are more common, and occur because of continuing overuse of a joint. The main symptom of a stress fracture is pain. Frequently, initial x-rays do not show any signs of a stress fracture so the athlete is wrongly permitted to return to the same activity. Unfortunately the pain often returns or continues and a more serious issue can develop. Stress fractures, which usually involve a minor crack or micro-disruption in the bone can progress to a true fracture. The most frequent places stress fractures occur are the tibia (the larger leg bone below the knee), fibula (the outer and thinner leg bone below the knee) and foot. The location of stress fractures will vary depending on the sport or activity. Q: What are some recommendations to help minimize injuries among child baseball players? A: Baseball is a culprit of many overuse injuries. Kids can get “Little League elbow” from sidearm throwing and repetitive strain. While there is no concrete guideline for the number of pitches allowed, reasonable limits are 80 to 100 pitches in a game and 30 to 40 pitches in a single practice session, depending on the child’s skeletal maturity, muscle strength and pitching techniques. For example, coaches should limit the pitch count to about 60 to 80 a week for younger kids. Q: How can parents and coaches prevent injuries in children involved in sports? A: In addition to the above mentioned bullet points on prevention, parents and coaches must realize that every child is different in terms of their body’s ability to adapt to the demands of sport and physical activity, especially at the higher levels of training and competition. They should always monitor the young athletes for signs of psychological burnout, physical overuse or the development of injuries, which should always be taken seriously and be properly evaluated. A good philosophy to follow with young athletes is: “When in doubt, keep the athlete out.” Relevant Material: •AAOS (and NATA) Public Service Campaign – Poster on Youth Sports Injury Prevention: http://www6.aaos.org/pemr/psa/2005/2005kids.jpg •Play it Safe Sports: A Guide to Safety for Young Athletes: http://orthoinfo.aaos.org/brochure/thr_report.cfm?Thread_ID=34&topcategory=Sports%20%2F%20Exercise •Exercises for Young Athletes: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=2&topcategory=Sports%20%2F%20Exercise •Keep injured high school athletes out of game: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=399&topcategory=Sports%20%2F%20Exercise •Pay Attention to High School Sports Injuries: http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=401&topcategory=Sports%20%2F%20Exercise •The Young Athlete: http://orthoinfo.aaos.org/brochure/thr_report.cfm?Thread_ID=19&topcategory=Sports%20%2F%20Exercise