Sports Injury Risks

All sports have a risk of injury. In general, the more contact in a sport, the greater the risk of injury.

Most injuries occur to ligaments (connect bones together), tendons (connect muscles to bones) and muscles. Only about 5 percent of sports injuries involve broken bones. However, the areas where bones grow in children (aka growth plates) are at more risk of injury during the rapid phases of growth. In a growing child, point tenderness over a bone should be evaluated further by a medical provider even if there is minimal swelling or limitation in motion.

Most frequent sports injuries are sprains (injuries to ligaments), strains (injuries to muscles), or contusions (muscle bruises from direct trauma).  These injuries are usually caused when an abnormal stress is placed on tendons, joints, bones and/or muscle.

Most injuries in young athletes overuse injuries –injuries to bones, muscles, tendons or ligaments caused by repetitive stress without allowing sufficient time to heal.  Therefore, injury prevention focuses on overuse avoiding overuse.

Injury Risk Reduction

Time off. Plan to have at least 1 day off per week from a particular sport to allow the body to recover. Plan to have at least 2-3 months off per year from a specific sport (time off does not need to be consecutive).

Stop the activity if there is pain & take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.

Avoid specializing in one sport before puberty.  “Cross-training” helps with flexibility and strength.

Strengthen muscles. Conditioning exercises before games and during practice strengthens muscles used in play.

Increase flexibility. Stretching exercises before and after games or practice can increase flexibility.

Use the proper technique. This should be reinforced during the playing season.

Wear the right gear. Players should wear appropriate and properly fit protective equipment such as pads (neck, shoulder, elbow, chest, knee, shin), helmets, mouthpieces, face guards, protective cups, and/or eyewear. Young athletes should not assume that protective gear will protect them from performing more dangerous or risky activities.

Play safe. Strict rules against headfirst sliding (baseball and softball), spearing (football), and body checking (ice hockey) should be enforced.

Avoid heat injury by drinking plenty of fluids before, during and after exercise or play; decrease or stop practices or competitions during high heat/humidity periods; wear light clothing.

Minimize full contact practices in collision sports.  Recent concussion data indicate that minimizing total cumulative number of collisions in a sports season may lower the chances of incurring brain injury.

Sports-Related Emotional Stress

The pressure to win can cause significant emotional stress for a child. Many coaches and parents consider winning the most important aspect of sports. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticized for losing a game or competition. The main goal should be to have fun and learn lifelong physical activity skills.

Sports Injury Diagnosis

With major injuries or illnesses, there is little doubt about the need to seek medical attention. However, it is much more difficult to know when to seek help if there is no obvious trauma or if the symptoms don’t get in the way of playing.

Many overuse injuries, such as tendonitis or stress fractures, happen over time and often have subtle symptoms. The result can be a delay in diagnosis and treatment, and delays can lead to a more serious or disabling injury.

Athletes should see a doctor for:

  • Symptoms that do not go away after rest and home treatment
  • Any condition that affects training or performance that has not been evaluated or treated
  • Any condition that may be a risk to other teammates or competitors

Types of conditions

There are 3 types of conditions in which an athlete may need to see a doctor:

  1. Overuse injuries: any injuries to bones, muscles, tendons or ligaments caused by repetitive stress without allowing sufficient time to heal.
  2. Acute injuries.
  3. Medical illnesses or conditions.

Sports Injury Treatment

Fractures: A fracture is a break or crack in the bone and needs to be treated by a doctor. If you think your child has a broken bone, follow the first aid instructions below.

  • Shoulder or arm: Use a sling made of a triangular piece of cloth. A cold pack may help. Drive your child to the doctor.
  • Leg: Use padded boards, pillows, newspapers, etc. to splint the fracture. At a minimum, carry your child and don’t permit your child to put any weight on the leg. A cold pack may help. Drive your child to the doctor.
  • Neck: Protect the neck from any turning or bending. Do not move your child until a neck brace or spine board has been applied. Call 911 for help.

Sprains: Sprains are stretches or tears of ligaments (bands of tissue that connect one bone to another). They are caused by sudden twisting injuries and require medical attention (unless they are very mild). Knees and ankles are often sprained.

  • Immediately wrap the injured area with an elastic bandage and put ice on the injury to reduce bleeding, swelling, and pain.
  • While some mild sprains can be cared for at home, most injuries to ligaments need to be checked by your healthcare provider.

Treat most sports injuries with P. R.I.C.E. (protect, rest, ice, compression, and elevation) for the first 24 to 48 hours.

  • Apply compression with a snug, elastic bandage for 48 hours. Numbness, tingling, or increased pain means the bandage is too tight.
  • Apply crushed ice in a plastic bag for 20 minutes. Repeat every hour for 4 hours.
  • Give acetaminophen or ibuprofen for pain. Continue for at least 48 hours.
  • Keep injured ankle or knee elevated and at rest for 24 hours. After 24 hours, allow any activity that doesn’t cause pain.

Strains: Strains are stretches, pulls, or tears of muscles. They are usually caused by overexertion (for example, when several muscles hurt after a strenuous practice, athletic game, or long hike). Most muscle injuries can be cared for safely at home.

  • Put an ice bag or cold pack on the area for 20 minutes. Repeat this 3-4 times the first day.
  • Give your child acetaminophen or ibuprofen for at least 48 hours.
  • If stiffness continues after 48 hours, have your child soak in a hot bath or if the pain is in one particular area, use a heating pad or hot compresses. Apply heat for 10 minutes 3 times a day until it improves.

Your child should learn about stretching exercises and return to exercise gradually. Next time, your child should be in better condition before going full throttle. Getting back in condition takes at least 7 days.

Contusions: Bruises of muscles (called a “charley horse”) are the most common injury in contact sports and can also be treated at home. Bone bruises usually follow direct blows to the bone in exposed areas (for example, the elbow, hip, or knee) and are usually minor injuries.

  • Put an ice bag or cold pack on the area for 20 minutes. Repeat this 3 to 4 times the first day. After 48 hours apply heat with a heating pad or hot compresses for 10 minutes 3 times a day.
  • Give your child acetaminophen or ibuprofen for severe pain. Don’t give aspirin to anyone with an injury that has bleeding or bruising. Because aspirin is an anticoagulant, one aspirin can increase the tendency to bleed easily for up to a week.
  • Rest the injured part as much as possible. The pain usually starts to ease after 48 hours, but there may be some discomfort for 2 weeks.

Call your doctor IMMEDIATELY if:

  • The bone is deformed or crooked.
  • Your child won’t use an arm normally (especially if the injury occurred after someone pulled on the arm). Young children who won’t straighten the elbow or turn the palm up usually have a partial dislocation of the elbow.
  • Your child won’t stand on the injured leg.
  • The pain is severe.
  • Your child can’t walk without pain and a limp.

Call during office hours if:

  • The pain is not improving by 3 days.
  • The pain is not gone by 2 weeks.
  • You have other concerns or questions.
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