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This article discusses the importance of preventing sports injuries in children and provides information on the magnitude of the problem, common injury mechanisms, types of injuries, and ways to prevent them.
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Sports Injury Prevention: It’s Not Whether You Win or Lose Michael A. Gittelman, MD Assistant Professor, Division of Emergency Medicine Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio
Background • Millions of children participate daily in sports activities • Children learn to improve: • Physical fitness • Coordination • Team play • There is a risk of injury just by participating
Problems with Surveillance • Difficult to track injuries • All injuries don’t get reported • Best data from team physicians and trainers • No standard method of reporting • May report by • Body part injured • Amount of time a player missed practice or a game • Type of injury sustained
Magnitude of the Problem • 3.5 million sports injuries for children < 15 years of age treated in medical settings • ¼ of all Emergency Department visits • For children involved in organized sports • 770,000 physician visits • 90,000 hospitalizations / year • 70-80% injuries are minor (< 1 wk of practice missed) • 60% occur during practice
Injury Mechanisms • < 10 years of age • Often injured during individual recreational activities • Usually within the first week of the activity • Examples = bike riding, roller skating, sledding • Pubertal child • Greater weights, greater force = more severe collision • Usually occur during organized sporting events • Examples = Football, Wrestling, Basketball
Sports Causing Significant Injuries at High School & Intercollegiate Level • Football • Wrestling • Gymnastics
Types of Injuries Acute vs. Chronic • Both types usually involve muscle & bone • Acute • Result from a collision or sudden twist • Examples = Sprains/Strains, Contusions, Fractures • Chronic / Overuse • Repetitive, small injuries due to repeat motions • Increased today as children strive for excellence at younger ages • Examples = Pitching a baseball, Running cross country
Body Parts Injured May Vary By • Sport Played • Some sports emphasize different body parts • Lower extremity = soccer, basketball • Upper extremity = tennis, baseball • Equipment Used • Projectiles may cause ocular injury • Examples = baseball, tennis
Body Parts Injured May Vary By (Continued) • Age • Younger children often injure upper extremity • Older children usually injure lower extremity • Sex • Some sports injure one sex differently than an another • Females tend to have more knee injuries in basketball than males • In general, shoulder more male, knee/ankle more female
Catastrophic Injuries • Injuries that result in permanent, severe neurologic disability • Direct Catastrophic Injury • Trauma from active participation in sport • Example = Football, Ice Hockey • Indirect • Result from overexertion while playing a sport • Causes – Dehydration or sudden cardiac death
Preventing Sports Injuries • Field / Equipment Changes • Rule Changes / Coaching • Individual Preparation
Field/Equipment Changes • Add equipment as injuries become evident • Examples • Helmets & Face Masks in youth hockey • Chin protector in Little League Baseball • Field modifications to prevent injuries • Avoid potholes, grates, rocks near field • Change field as injuries seen • Example = Anchoring soccer goals
Rule Changes/Coaching • Rule changes to adjust for injury patterns • Example = “spearing” in football • Officials must enforce the established rules • Coaches • Teach the appropriate techniques • Encourage discipline in preparation (stretching, etc)
Individual Preparation Prior to Participation • Learn about the game prior to signing up • Is this sport appropriate for your child? • Does your child wish to participate? • Who will be supervising practices/games? • Purchase the recommended equipment • Pre-participation physical exam • Preseason conditioning
Individual Preparation At Participation • Practice within your limits • Stay well-hydrated • Know and follow the rules of the game • If injured • Seek medical attention prior to returning to play • Adequate rehabilitation is essential
Summary • All sports pose a risk of injury • Research the interested sport prior to participation • Know the rules, equipment needed, and who will supervise / coach your child • Seek a pre-participation physical exam • Have fun and play hard
Resources/Links • Widome MD, ed. American Academy of Pediatric’s Committee on Injury and Poison Prevention. Sports safety. In: Injury Prevention and Control for Children and Youth, 3rded. 1997. American Academy of Pediatrics • Rice SG. Risks of injury during sports participation. In: Sullivan JA, Anderson SJ, ed. Care of The Young Athlete. 2000. American Academy of Orthopedic Surgeons & American Academy of Pediatrics • www.hooah4health.com • www.aaos.org