When kids hop on a bike or grab a football, they have little else on their mind besides having fun or winning against the other kids. That's probably as it should be. But it also means it's up to parents, coaches, and doctors to help kids avoid sports-related injuries that can range from simple fractures to total paralysis -- or worse.
For kids 5-14, biking, basketball, football, roller sports, soccer, baseball and softball, and playing on playgrounds and trampolines are among the favorite sports and recreational activities. But these also top the list when it comes to causing injuries.
According to a study published in the November/December 2001 issue of the Journal of the American Academy of Orthopaedic Surgeons, U.S. hospital emergency rooms, doctors' offices, and clinics treated an estimated 2.2 million children's bone fractures, dislocations, and muscle injuries related to these recreational activities in the year 2000.
John M. Purvis, MD, a clinical assistant professor of orthopaedic surgery and rehabilitation at the University of Mississippi Medical School in Jackson and co-author of the study, is a pediatric orthopaedic specialist who sees all kinds of sprains, strains, and contusions. Because their muscles, bones, ligaments, and tendons are still growing, he says, young athletes are more likely to be injured than others.
And, he adds, other activities may sometimes be even riskier. The number of injuries caused by activities such as cheerleading, gymnastics, and winter sports may be smaller, but the risk of really serious injury may be higher, according to Purvis. "There's a high risk of catastrophic injuries, such as paralysis, in these sports."
'Play it Safe!'
Recreational activities are important for kids' healthy development, says Purvis, but "with the [increasing] number of children and adolescents participating in sports and play activities, the number of injuries continues to increase."
Purvis doesn't suggest reducing your kids' involvement in these activities, but he does stress the importance of following safety guidelines and using protective equipment.
To that end, the American Academy of Orthopaedic Surgeons (AAOS), the Pediatric Orthopaedic Society of North America, the Canadian Orthopaedic Association, and the American Orthopaedic Society for Sports Medicine have started a "Play It Safe!" campaign to reduce sports injuries.
This campaign recommends encouraging children to:
- Be in proper physical condition before they play a sport. (A preparticipation physical, especially for older children, is important, says Purvis, to screen for undiagnosed heart ailments).
- Know and follow the rules of the sport.
- Wear appropriate protective gear -- such as shin guards for soccer, a hard-shell helmet when facing a baseball pitcher, a helmet and body padding for ice hockey, and properly fitting shoes whatever the sport.
- Know how to use athletic equipment -- for instance, how to adjust the bindings on snow skis.
- Always warm up before playing.
- Avoid playing when tired or in pain.
High School Sports
Younger kids are more likely to get hurt in falls (off bikes, playground equipment, and scooters, for example), while older kids are more apt to get hurt in collisions as they move into high-contact sports. Those high school athletic injuries should get more attention, said Joseph A. Bosco III, MD, at the 69th Annual Meeting of the AAOS. Professional and college sports offer athletes sophisticated medical care, he says, but high school athletes don't get the same attention.
"More than 1 million American children participate in high school sports annually," says Bosco, who practices in New York City and works with a number of high school teams.
The bone structure of many teenagers has not fully matured, Bosco explains. This makes them more vulnerable to certain types of injuries and conditions than older athletes are. Areas of growing tissue near the end of children's long bones -- known as growth plates -- for example, get injured more easily than tendons and ligaments. These growth plates mature by the end of adolescence, but until then, what might be a sprain in an adult could be a serious injury in a high school player, says Bosco. Contact sports such as football and basketball, and overdoing it in sports such as gymnastics and baseball, can result in growth plate injuries.
High school athletes may also suffer from osteochondritis -- an inflammation of the cartilage and underlying bone -- and spondylolisthesis -- a condition in which a vertebra slips forward on one beneath it.
Don't Tough It Out
Even when injuries appear slight, Bosco says, young athletes need prompt medical attention. "Parents and coaches should not pressure the athlete to work through the pain because untreated injuries can lead to permanent damage and later disease, such as osteoarthritis," he says. "Young athletes are resilient, but parents and coaches should never assume kids will 'bounce back' from an injury because of their youth."
Mary Lloyd Ireland, MD, team physician for Eastern Kentucky University in Lexington, agrees: "Toughing it out" is not the way to go for young athletes, she says. Coaches and players can't always tell how severe an injury really is. A minor injury such as a dislocated finger, for example, can be painful, while serious injuries such as concussions or neck injuries may not be.
Ireland says physicians should always "overtreat" head injuries especially and keep athletes out of the game if they appear to have memory loss or a headache, or if they become nauseated while running.
"The more experience I get, the more conservative I get," she says.