Sports Injuries Can Affect Children And Teenagers

And preventing sports injuries

By Linda L. Esterson

Richard Manski’s sons have always participated in sports as long as they can remember. Between them, they’ve played baseball, soccer, lacrosse, golf, hockey and basketball.

When they were younger, participation was partly for physical activity and partly for enjoyment. They learned sportsmanship, worked together and shared common experiences with other children.

As Manski’s sons aged, they steered themselves to fewer sports. Today, Scott, now 18, focuses on golf, and Eric, 15, is primarily a baseball player.

Eric has a year-round commitment to baseball. He’s played travel ball and is trying out for the high school team at Beth Tfiloh Dahan Community School.

Two years ago, he broke his wrist sliding into home plate. He took off the amount of time prescribed by his physician and then returned to the field.

“I wasn’t happy about it, but I would never change his activities or influence his desire to play because he’s had an injury,” says his father. “You can be injured running down the street.”

According to Safe Kids USA, more than 3.5 million children ages 14 and under receive medical treatment for sports injuries each year, and more than 775,000 children ages 5 to 14 are treated in hospital emergency rooms for sports-related injuries. This accounts for 40 percent of the sports-related injuries cared for in the ER.

Andrew Lincoln, Sc.D., director of MedStar Research Institute’s Sports Health Research Center, says the risk of injury for children is based on exposure. The greater the frequency of practice or games, the higher the risk, due to overuse and overexposure, he says. The level of play also is a factor.

“There is not as much concern about overuse at the lower end (less frequency and less competitive sports),” he says. “But four-five-six days a week is a primary concern as kids go through developmental phases. The biggest concern is that we don’t interfere with their maturation or development.

“We have to recognize that they are not smaller versions of adults. There are a lot of physiological changes going on that shouldn’t be interfered with.”

With increasing amounts of practices and games as children advance in level and age, the more important it is for open communication between parents, coaches and athletes, Lincoln says. “They have to be honest with us about how they are feeling,” he explains. “They have to listen to their bodies and let us know, and let coaches know, and not play through pain.”

Manski watches Eric closely to make sure he doesn’t “overdo it.” They talk often about the need for rest, and haven’t worried about his game-load since he’s not in the lineup for every one of the five or six games his team plays per week.

In conjunction with Ripken Baseball, MedStar Research Institute has evaluated the incidence of injury among baseball players at weeklong baseball summer camps. Most often, the players endured hand contusions, blisters and sprains. Younger players experienced head and facial contusions, as their reaction time to “hot grounders” is longer.

Jacob Troy Lincoln anticipates inflammatory arm injuries — sprains, strains, tendonitis and major ligament damage — occurring in players who play on multiple teams, pitching every other day, for instance. Baseball leagues are instituting safeguards to lessen the likelihood of overuse injuries. Some leagues impose limits on the number of innings pitched per game, week or tournament, in an effort to protect players from overuse injuries, and some coaches limit pitch counts per pitcher.

However, according to Richard Hinton, M.D., director of the sport medicine fellowship program and an attending physician at Union Memorial Hospital, when a player plays for multiple teams, it is up to him and his parents to impose overall limits.

Hinton expresses concern over the growing incidence of anterior cruciate ligament (ACL) tears in children. Constant running, jumping, turning and twisting result in the collapse of the knee, particularly for female athletes.

In addition, concussions are a particular worry to the medical community, most notably from contact during football or lacrosse play. Lincoln currently is leading several studies of the mechanisms for injury for male and female lacrosse players: checking, stick to head contact and head to ground contact.

Joseph Troy is used to bruises and welts he sustains as a lacrosse goalie, now for the boy’s varsity team at Beth Tfiloh. He’s also been kicked with cleats and run over. Following one lacrosse game two years ago, the school nurse insisted his hand was broken, but an x-ray revealed just a severe bruise. His swollen finger was taped and he was able to play in the game the following day. Because he needed to grip the stick only while defending the goal, he was permitted to play.

Joesph Troy “When he stands, he holds the stick more loosely,” says his father, Steven Troy. “It was important for him to play. He didn’t want to let down his teammates. He was the only goalie at the time.”

Steven gave his blessing when he knew the hand was not fractured. “Despite that it hurt a little, he was loyal to his team and wanted to be there for his teammates,” he says.

Not only is his father impressed by his loyalty, but he’s also impressed with his common sense. During the season, Joseph eats well and makes sure to get a good night’s rest; and instead of playing basketball, Joseph took the winter off to rest. It was his idea, says his father. He remains active, practicing in the backyard or working out in their home gym.

Time off is essential for young athletes, Hinton says, especially because they are playing at a higher level at a young age.

“Kids should have sports holidays throughout the year for a month or two, two or three times a year, that they are not playing competitive sports,” says Hinton. This is when they should work on conditioning and strengthening programs which help maintain stability and lessen the chance for injury over the course of a sports season.

Steven admits Joseph and his two younger sons, Isaac, 6, and Jacob, 9, have been blessed with good health, but he knows that at some point they will face an injury. They’ll deal with it when it happens.

“Of course we’re concerned,” he says. “I try not to project because I’m very supportive of my kids doing these things. If an injury happens, we’ll address it.”

For now, he does what he can to equip them with the best protective gear and makes sure they get enough sleep, eat right and stretch properly.

Injuries by Sport

Statistics released by the Safe Kids Campaign for children ages 5 to 14 injured in 2002.

Fifteen percent of basketball players, 28 percent of football players, 22 percent of soccer players, 25 percent of baseball players and 12 percent of softball players have been injured while playing their respective sports.
More than 207,400 children were treated in hospital emergency rooms for basketball-related injuries.
Nearly 187,800 children were treated in hospital emergency rooms for football-related injuries.
Nearly 76,200 children were treated in hospital emergency rooms for soccer-related injuries.
Baseball has the highest fatality rate among all sports for children. Each year, three to four children die from injuries sustained while playing baseball. Nearly 116,900 children ages 5 to 14 were treated in hospital emergency rooms for baseball- or softball-related injuries.
Nearly 21,200 children were treated in hospital emergency rooms for gymnastics-related injuries.
Almost 14,000 children were treated in hospital emergency rooms for ice skating-related injuries.

February 13, 2009