By: Kevin Neal, M.D.
Summertime means long days and plenty of time to play outdoors. Many coaches also take advantage of this time to get their teams ready for the fall season. With some 30 million school-aged children taking part in organized sports, injuries are inevitable. In fact, according to the American Academy of Pediatrics (AAP), roughly 3 million children ages 14 and under are injured annually while playing sports or participating in a recreational activity. Also, in
kids ages 5 – 17, one in five trips to the emergency room are due to sports-related injuries.

Kids are more at risk for injury than adults for a variety of reasons. They are less coordinated, have a slower reaction time, their bones and muscles are still growing, and they are more likely to take risks. Overuse is another big problem. When kids play sports all year long, with little or no rest in between seasons, this causes more strain on their growing bodies. Less recovery time leads to a variety of injuries of varying severity.

With proper preparation by kids, coaches, and parents, a large number of sports-related injuries can be avoided. Here are some of the most common types of injuries and ways to prevent them.

Heatstroke and dehydration are big risks to kids involved in sports during the summer and early
fall months. Working out in heavy gear, running long distances, or having long practices require frequent breaks and the drinking of fluids. For most practices under an hour, water is the drink of choice. In the heat, and for practices that last more than one hour, sports drinks should be offered as well. Drinking fluids before, during, and after playing sports will help to keep kids hydrated. Also, on very hot and humid days, practices should be held either early morning or early evening to avoid the hottest parts of the day.

Acute injuries happen suddenly and are usually associated with some form of trauma. They can range in severity from scrapes, bruises, sprains and strains to broken bones, torn ligaments, eye injuries, and brain injuries. Acute injuries often occur due to a lack of proper equipment or improper use of equipment. For example, helmets should always be worn in sports like football, lacrosse, baseball and softball. They should be in good shape and fit well. Protective eyewear can prevent injuries in basketball or racquet sports. Knee and elbow pads can prevent joint injury due to falls that happen often among children.

Overuse injuries occur from repetitive motion that puts too much stress on the bones and muscles. These types of injuries are especially problematic for kids because they can affect bone growth. Common overuse injuries include damage to the knees, elbows, shoulders, shins, ankles, back, and hips, and can be diagnosed as tendonitis, stress fractures, or even growth plate issues depending on the severity of the injury.

A focus on prevention, sometimes referred to as “prehab,” can help prevent injuries. Proper warm-up, stretching, strength training, good mechanics, as well as knowing how and when to rest are all vital to overuse injury prevention.

Reinjuries take place when an athlete returns to the sport before an injury has time to heal. This
can lead to further, or permanent, damage. For example, one concussion, an injury to the brain, can be dangerous. But if a child, or adult for that matter, returns to play before being medically cleared by a doctor and has another concussion, the result can be permanent brain damage or even death.

Other things to consider:

• Pre-Screening All kids should have a physical before beginning any sport. Pre-screenings can clear kids to play and can identify any condition that could put a child at risk for injury.
• No playing through pain Kids may think they’re helping the team, but they are only hurting themselves. If a child complains of a chronic ache or pain, see a doctor right away. Additionally, if your child suffers any type of head injury, look for signs of a concussion—headache, confusion, dizziness, forgetfulness, nausea, or change in
  behavior—and seek medical attention immediately.
• Returning to play means taking proper precautions to ensure reinjury does not occur. Depending on the injury this could mean taping the affected area, new protective gear, wearing a brace, or involve a formal physical therapy/rehab plan.
• Know the rules and encourage safe play. Get to know your child’s coaches to see what their philosophy is on safety and injury prevention. Make sure your child’s coaches include proper warm-up and cool down exercises with every practice.
• Don’t push Sports should be fun and teach kids life lessons about teamwork, problem solving, and good sportsmanship. Pushing your child to excel and win-at-all-costs can cause emotional stress, overuse injuries, and burnout.

For more tips and detailed information about getting back in the game, visit KidsHealth.org.

Kevin Neal is an orthopedic surgeon in the Department of Orthopedics at Nemours.