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The return to school in the fall also heralds the return to sports and to other intense physical activities for many school-aged kids. As a pediatric emergency room physician, I can attest to the increase in sports-related injuries we see as the school sports schedule resumes. Correct use of safety equipment and other preventive measures will help keep these injuries to a minimum. While there will always be some injuries, I would like to use this opportunity to help parents recognize those that are worthy of a doctor’s visit.
Mostly we see a range of musculoskeletal injuries. Strains, sprains, and contusions (bruises) are common. Children, as opposed to adults, are susceptible to injuries of their growth plates (areas close to the ends of the long bones where growing tissue is found), joint surfaces, and apophyses (bony projections where tendons or ligaments start out or insert into bones).
Injury Prevention
Simple steps can
be taken to prevent sports-related injuries. An important first step is having
your child’s pediatrician complete a preseason physical. Parents should also
consider the age, developmental status, and realistic skill level of their child
prior to enrolling them or allowing them to participate in certain sports.
Adult supervision, particularly by trained coaches, must be a requisite. Ideally, coaches should be certified in CPR and have experience in their respective sport and also in identifying and providing first aid for common injuries.
Proper equipment and knowing how to use it is essential. Make sure all helmets, shoes, supportive padding, athletic cups, and mouth guards fit properly and are used at all times.
Helmets must always be worn for skating, horseback riding, skateboarding, baseball, softball, biking, skiing, and hockey. Shatterproof goggles are important for basketball and racquetball. And don’t forget sun protection and plenty of drinking water.
Young athletes need to learn proper techniques and exercises for warm-up and cool-down to avoid injuries. Proper training in safety equipment and skills development, prior to engaging in competition, is perhaps the best preventative step.
Despite the Best Prevention, Injuries Can
Happen
Surprisingly, some broken bones can go unrecognized by
parents and the injured child. Not recognizing and appropriately treating a
fracture can distort a child’s overall growth. Furthermore, the signs and
symptoms of strains, sprains, and fractures may overlap and mimic each other,
making it difficult for a parent to tell them apart.
Examples of such signs and symptoms include pain, tenderness to touch, decreased range of motion, swelling, bruising and discoloration, numbness and tingling, and deformity.
If you suspect that your child has a strain, sprain, or fracture, inspect the area of injury, provide elevation and support such as with a homemade sling, ace wrap, or pillow, apply ice, prevent the child from using the injured extremity, and contact your doctor or seek medical attention immediately. Remember the mnemonic — RICE: rest, ice, compression, and elevation.
For pain relief, you may give acetaminophen (Tylenol®) or ibuprofen following the over-the-counter dispensing directions and precautions. Many times, children will need an X-ray of the injured area. Depending on the results, a splint and further evaluation and treatment by an orthopaedic surgeon may be necessary. The orthopaedic surgeon may then determine that casting or further surgical intervention is warranted. Physical therapy and rehabilitation may also be indicated.
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| Stretching before exercise as well as proper techniques for warm-up and cool-down will help children avoid injuries. |
Common Injuries and the Sports That Often Cause
Them
The following are examples of common sports injuries in
children and adolescents.
Contusions (bruises): Contusions frequently occur in hockey, football, and soccer.
Strained Muscles: The most commonly strained muscle in the lower extremity is the hamstring, and susceptible athletes include those who participate in track and field, martial arts, gymnastics, and dance.
Sprains: Ankle and knee sprains are common in athletes who partake in soccer, volleyball, football, and basketball. The range of severity and recovery time varies for the different types and grades of ankle and knee injuries.
Fractures: Stress fractures are often seen in runners; basketball, soccer, and volleyball players; dancers; and gymnasts. Common spots for lower extremity fractures in young athletes include the fifth metatarsal of the foot and the calf bones — distal fibula and the tibial eminence. Common fracture locations in the upper extremity include the clavicle (shoulder), humerus (upper arm), elbow, radial and ulnar (forearm) bones, and the carpal bones of the wrist.
Dislocations: Shoulder dislocations may occur in a football player during a fall or in a wrestler who has his arm pinned down.
Overuse and Repetitive Use: Overuse injuries are a result of chronic repetitive trauma and strain.
A few examples include:
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Tendonitis of the ankle may occur in dancers, skaters, or gymnasts.
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Tendonitis of the rotator cuff may occur in swimmers and baseball players.
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Runners may be prone to shin pain caused by medial tibial stress syndrome.
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“Little League elbow” includes several injuries to the elbow and is a result of repetitive strain of throwing.
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Osgood-Schlatter disease is common in the adolescent athlete and involves pain and swelling in the front lower part of the knee. It is seen in sports that involve running and jumping.
Spinal Injuries: The spine of a young athlete may suffer from injuries such as spondyloysis (a defect in the vertebrae) and spondylolysthesis (a forward slip of the vertebrae). These may occur in divers or gymnasts as a result of repetitive bending exercises.
Other Injuries: Other nonmusculoskeletal injuries to keep in mind that may occur as a result of sport participation include concussions, eye injuries, dental trauma, and heat-related illnesses.
Preparation helps avoid injuries that can leave your child sitting on the sidelines. When an injury does happen, though, have your child evaluated by a medical professional.
Whatever the outcome may be, make sure your child has time to recover and receives proper training prior to returning to activities. Take time to heal or the injured area can be prone to reinjury, further delaying playing time.
The return to school and organized sports does not have to mean a return to injuries or a visit to the emergency room. Have fun; be safe!
