Health Topics
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Publication Date: June 2000
Childhood Sports Injuries and Their Prevention
A Guide for Parents with Ideas for Kids
You are sitting in your office and suddenly the phone rings. "Ms. Ramirez?
Your son, Raoul, was injured during football practice. His knee may be badly hurt. He is going to County General. Please go to the emergency room right away." You try to remain composed, but you can feel panic creeping through your body. With your breathing shallow and heart pounding, you drop everything and try to remember how to get to the hospital.
In the past, Raoul has only had scrapes and bruises, like
most kids his age. You recall being hesitant to let him play a rough
sport like football that requires considerable physical contact. But
you decided not to keep him from playing his favorite sport. This is
your child's first major injury.
Preventing Injuries
Childhood sports injuries like Raoul's may be inevitable,
but there are some things you can do to help prevent them:
-
Enroll your child in organized sports through schools,
community clubs, and recreation areas where there may be adults
who are certified athletic trainers (ATC). An ATC is also trained
in the prevention, recognition and immediate care of athletic injuries.1
-
Make sure your child uses the proper protective gear
for a particular sport. This may lessen the chances of being injured.
-
Warmup exercises, such as stretching and light jogging,
can help minimize the chance of muscle strain or other soft tissue
injury during sports. Warmup exercises make the body's tissues warmer
and more flexible. Cooling down exercises loosen the body's muscles
that have tightened during exercise.2
Make warmups and cool downs part of your child's routine before
and after sports participation.
And don't forget to include sunscreen and a hat (where
possible) to reduce the chance of sunburn, which is actually an injury
to the skin. Sun protection may also decrease the chances of malignant
melanoma--a potentially deadly skin cancer--or other skin cancers that
can occur later in life. It is also very important that your child has
access to water or a sports drink to stay properly hydrated while playing.
Treat Injuries With "RICE"
If your child receives a soft tissue injury, commonly
known as a sprain or a strain, or a bone injury, the best immediate
treatment is easy to remember. "RICE" (Rest, Ice, Compression, and Elevation)
the injury. Get professional treatment if any injury is severe. A severe
injury means having an obvious fracture or dislocation of a joint, prolonged
swelling, or prolonged or severe pain.
RICE
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- Rest: Reduce or stop using the injured area for 48
hours. If you have a leg injury, you may need to stay off of
it completely.
- Ice: Put an ice pack on the injured area for 20 minutes
at a time, 4 to 8 times per day. Use a cold pack, ice bag, or
a plastic bag filled with crushed ice that has been wrapped
in a towel.
- Compression: Compression of an injured ankle, knee,
or wrist may help reduce the swelling. These include bandages
such as elastic wraps, special boots, air casts and splints.
Ask your doctor which one is best.
- Elevation: Keep the injured area elevated above the
level of the heart. Use a pillow to help elevate an injured
limb.
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Sprains And Strains
A sprain is an injury to a ligament--a stretching or
a tearing. One or more ligaments can be injured during a sprain. A ligament
is a band of tough, fibrous tissue that connects two or more bones at
a joint and prevents excessive movement of the joint. Ankle sprains
are the most common injury in the United States and often occur during
sports or recreational activities. Approximately 1 million ankle injuries
occur each year and 85 percent of these are sprains.
A strain is an injury to either a muscle or a tendon.
A muscle is a tissue composed of bundles of specialized cells that,
when stimulated by nerve impulses, contract and produce movement. A
tendon is a tough, fibrous cord of tissue that connects muscle to bone.
Growth Plate Injuries
In some sports accidents and injuries, the growth plate
may be injured. The growth plate is the area of developing tissues at
the end of the long bones in growing children and adolescents. When
growth is complete, sometime during adolescence, the growth plate is
replaced by solid bone. The long bones in the body are the long bones
of the fingers, the outer bone of the forearm, the collarbone, the hip,
the bone of the upper leg, the lower leg bones, the ankle, and the foot.
If any of these areas become injured, seek professional help from a
doctor who specializes in bone injuries in children and adolescents
(pediatric orthopaedist).
Repetitive Motion Injuries
Painful injuries such as stress fractures (where the
ligament pulls off small pieces of bone) and tendinitis (inflammation
of a tendon) can occur from overuse of muscles and tendons.3
These injuries don't always show up on x-rays, but they do cause pain
and discomfort. The injured area usually responds to rest. Other treatments
include RICE, crutches, cast immobilization, or physical therapy.
Heat And Hydration - Playing It Safe Is Cool
Playing rigorous sports in the heat requires close monitoring
of both body and weather conditions. Heat injuries are always dangerous
and can be fatal. Children perspire less than adults and require a higher
core body temperature to trigger sweating. Heat-related illnesses include
dehydration (deficit in body fluids), heat exhaustion (nausea, dizziness,
weakness, headache, pale and moist skin, heavy perspiration, normal
or low body temperature, weak pulse, dilated pupils, disorientation,
fainting spells), and heat stroke (headache, dizziness, confusion, and
hot dry skin, possibly leading to vascular collapse, coma, and death).4,5
These injuries can be prevented.
Playing safe in the heat
is cool
-
Recognize the dangers of playing in the heat.
-
Respond quickly if heat-related injuries occur.
-
Schedule regular fluid breaks during practice
and games.
-
Drinking water is the best choice; others include
fruit juices and sports drinks.
-
Kids need to drink 8 ounces of fluid every 20
minutes, plus more after playing.
-
Make player substitutions more frequently in
the heat.
-
Wear light-colored, "breathable" clothing, and
wide-brimmed hats
-
Use misting water sprays on the body to keep
cool.
*Adapted with permission from Patient Care
Magazine, copyrighted by Medical Economics.
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Exercise Is Beneficial
Even though Raoul got hurt, his involvement in sports
is important. Exercise may reduce his chances of obesity, which is becoming
more common in children. It may also lessen his risk of diabetes, a
disease that is sometimes associated with a lack of exercise and poor
eating habits.
As a parent, it is important for you to match your children
to the sport, and not push him or her too hard into an activity that
he or she may not like or be capable of doing. Sports also helps children
build social skills and provides them with a general sense of well-being.
Sports participation is an important part of learning how to build team
skills.
Sports Injury And Prevention
Raoul's mother may not be able to protect him from all
sports injuries, but she now knows that she may be able to reduce his
risk of injury by using preventive measures. She knows how important
it is to know which sports are more likely to cause injury than others.
In addition, she checks the condition of the athletic area where the
sports are to be played. She makes sure it is properly maintained.
The following "sports scorecard" shows winning ways to
help prevent an injury from occurring (so you are less likely to get
that alarming phone call like Raoul's mom did).
Football
This popular sport "leads the pack" in the number
of injuries, especially in boys, in organized sports.6
-
Common injuries and locations: Bruises,
sprains, strains, pulled muscles, soft tissue tears such as
ligaments, broken bones, internal injuries (bruised or damaged
organs), back injuries, sunburn. Knees and ankles are the
most common injury sites.
-
Safest playing with: Helmet; mouth guard;
shoulder pads; athletic supporters for males; chest/rib pads;
forearm, elbow, and thigh pads; shin guards; proper shoes;
sunscreen; water.
-
Prevention: Proper use of safety equipment,
warm-up exercises, proper coaching and conditioning.
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Basketball
This popular sport has the highest rate of knee
injuries requiring surgery among girls.7
- Common injuries and locations: Sprains, strains, bruises,
fractures, scrapes, dislocation, cuts, dental injuries. Ankles,
knees (injury rates are higher
in girls,8 especially
for the anterior cruciate ligament, the wide ligament that limits
rotation and forward movement of the shin bone), shoulder (rotator
cuff strains and tears, where tendons at the end of muscles
attach to the upper arm and shoulder bones).
- Safest playing with: Eye protection, elbow and knee
pads, mouth guard, athletic supporters for males, proper shoes,
water. If playing outdoors, add a hat and sunscreen.
- Prevention: Strength training (particularly knees and
shoulders), aerobics (exercises that develop the strength and
endurance of heart and lungs), warmup exercises, proper coaching,
and use of safety equipment.
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Soccer
This sport has dramatically increased in popularity
in the past two decades in the U.S.
-
Common injuries: Bruises, cuts and scrapes,
headaches, sunburn.
-
Safest playing with: Shin guards, athletic
supporters for males, cleats, sunscreen, water.
-
Prevention: Aerobic conditioning and
warmups, and proper training in "heading" the ball. ("Heading"
is using the head to strike or make a play with the ball.)
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Baseball and Softball
Sometimes called "America's favorite pastime."
-
Common injuries: Soft tissue strains,
impact injuries that include fractures due to sliding and
being hit by a ball, sunburn.
-
Safest playing with: Batting helmet,
shin guards, elbow guards, athletic supporters for males,
mouth guard, sunscreen, cleats, hat, breakaway bases.
-
Prevention: Proper conditioning and warmups.
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Gymnastics
The performance of systematic exercises.9
-
Common injuries: Sprains and strains
of soft tissues.
-
Safest playing with: Athletic supporters
for males, safety harness, joint supports (such as neoprene
wraps), water.
-
Prevention: Proper conditioning and warmups.
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Track and Field
Competing at running, walking, jumping, throwing,
or pushing events.10
-
Common injuries: Strains, sprains, scrapes
from falls.
-
Safest playing with: Proper shoes, athletic
supporters for males, sunscreen, water.
-
Prevention: Proper conditioning and coaching.
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How your child can prevent
sports injuries
-
Be in proper physical condition to play the
sport.
-
Know and abide by the rules of the sport.
-
Wear appropriate protective gear (for example,
shin guards for soccer, a hard-shell helmet when facing a
baseball or softball pitcher, a helmet and body padding for
ice hockey).
-
Know how to use athletic equipment.
-
Always warm up before playing.
-
Avoid playing when very tired or in pain.
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Get a preseason physical examination.
-
Make sure there is adequate water or other liquids
to maintain proper hydration.
*Adapted from Play It Safe, a Guide to Safety
for Young Athletes, with permission of the American Academy
of Orthopaedic Surgeons.
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Play Safe To Stay Safe
Luckily for Raoul and his mom, his injury wasn't serious.
In a few weeks, he will be fully recovered and be able to play football
again before the end of the season. Raoul now also knows how important
it is to do everything possible to keep from being hurt so he won't
have to sit on the team bench as much next season.
For More Information
For more information on sports injuries and prevention,
contact:
National Institute of Arthritis and Musculoskeletal and
Skin Diseases
NIAMS/National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484; 1-877-22NIAMS (free of charge)
TTY: 301-565-2966
Fax: 301-718-6366
E-mail: NIAMSinfo@mail.nih.gov
Access: www.niams.nih.gov/
Useful NIAMS Links
Other Useful Links
- American Academy of Orthopaedic Surgeons (AAOS ): www.aaos.org
- American Academy of Pediatrics (AAP): www.aap.org
- American College of Rheumatology: www.rheumatology.org
- American Medical Society for Sports Medicine (AMSSM): www.amssm.org
- American Orthopaedic Society for Sports Medicine (AOSSM): www.sportsmed.org
- American Physical Therapy Association (APTA): www.apta.org
- Arthritis Foundation (AF): www.arthritis.org
- National Athletic Trainers Association (NATA): www.nata.org
References
1. National Athletic Trainers Association.
What happens if your child is injured on the sports field? Press
release. 9/23/99.
2. O'Connor, Deborah. Preventing sports
injuries in kids. Patient Care, 6/15/98, pp.60-83.
3. Powell, John W, Barber-Foss, Kim D. Injury
Patterns in Selected High School Sports: A Review of the 1995-1997 Seasons.
Journal of Athletic Training 1999;34:(3):277-284.
4. O'Connor, Deborah. Preventing sports
injuries in kids. Patient Care, 6/15/98, pp.60-83.
5. American Academy of Family Physicians.
Heat-Related Illness: What You Can Do to Prevent It. Brochure.
1994.
6. Requa, Ralph. The scope of the problem:
the impact of sports-related injuries. In Proceedings of Sports Injuries
in Youth: Surveillance Strategies, Bethesda, MD, 8-9 April 1991. National
Institute of Arthritis and Musculoskeletal and Skin Diseases, National
Institutes of Health, Bethesda, MD. 11/92, p.19.
7. Messina, DF; Farney, WC; DeLee, JC. The
incidence of injury in Texas high school basketball. The American
Journal of Sports Medicine. Vol. 27; No.3; 294-299; 1999.
8. Messina, DF; Farney, WC; DeLee, JC. The
incidence of injury in Texas high school basketball. The American
Journal of Sports Medicine. Vol. 27; No.3; 294-299; 1999.
9. Encyclopedia Britannica Online; http://members.eb.com
10. Encyclopedia Britannica Online; http://members.eb.com
National Institute of Arthritis and Musculoskeletal
and Skin Diseases
NIAMS/National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Phone: 301-495-4484; 1-877-22NIAMS (free call)
TTY: 301-565-2966
Fax: 301-718-6366
E-mail: NIAMSinfo@mail.nih.gov
Access: www.niams.nih.gov/