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Taking part in sport is not just an enjoyable activity for kids, but regular exercise is essential for children’s health and helps to promote a lifelong active lifestyle. Sports participation is also great for developing social and team-working skills. However, it’s important to remember that sporting activities are not without their risks and they are a common cause of childhood injuries. For instance, CDC figures highlight that 2.6 million injuries occur in children each year that require treatment in the ER as a result of sport and recreational activities, not to mention those children who receive treatment in primary care and from sports medicine centers. This is therefore a key issue for parents, schools and sports clubs to address, particularly as many sports related injuries are preventable.
Injuries are more likely in children
As the American Academy of Orthopedic Surgeons points out, there are several reasons why children are more susceptible to sporting injuries than adults. Firstly, as kids’ bones and soft tissues (such as ligaments, muscles and tendons) are still growing, they are more likely to suffer damage. This is also an issue, as damage at this stage can affect growth and long-term health. Secondly, even kids of the same age have varying builds and are at different developmental stages, and any mismatch can increase the risk of injury. However, this is a bigger issue at high school, as adolescents are stronger and faster, with injuries sustained during impact in contact sports more significant. Finally, as the cartilage at the tips of growing bones (known as the growth plate) is weaker than the surrounding ligaments and tendons, injury is more likely, which can impact on growth.
Most common injuries
Before thinking about how to prevent sporting injuries in kids, it’s also essential to consider which ones occur most often and in which sports so that strategies are targeted. According to The Children’s Hospital of Philadelphia, injury is most likely in contact sports or those that involve jumping, sprinting, pivoting or have a repetitive nature, so basketball, football, hockey, rugby, soccer and track sports are among those most likely to result in trauma or overuse injuries. Looking in more detail, figures presented by the University of Michigan show that there are more than one million medical visits due to football, followed by more than 368,000 visits with soccer injuries; perhaps surprisingly cheerleading and gymnastics are also a large source of sporting injuries among the under 18s.
Acute injuries that occur as a result of trauma caused by a fall, twist or collision include fracture, sprains, strains, cuts and bruises. However, the University of Florida advises that overuse injuries are also common and typically affect the ankles, knees, hips and wrists, though the presentation depends on the sport. For example, runners suffer from stress fractures, while too much weight-bearing on the wrists can affect young gymnasts. Some of the typical warning signs of overuse injury to look out for are pain (including referred pain), tiredness, reduced performance and lingering discomfort.
Coaches can reduce risk factors
The University of Michigan also discusses that as in adults, there are some common factors that make damage more likely and controlling for these reduces the risk of childhood sporting injuries. Making sure that fields, courts and tracks are well maintained is the responsibility of schools and sports clubs, and any organization that takes kids safety seriously will ensure that these are always in good condition. It’s also essential that children receive appropriate coaching from someone who understands the needs of kids, as this helps to reduce the strain that training places on their body. Besides providing guidance within training sessions, coaches will also suggest additional exercise that will help young people to strengthen their soft tissues and be in the best possible shape for playing sport. They will additionally emphasize the importance of pre-season training, as being inadequately prepared for the season is a major cause of injury in children just as it is in adults. Coaches can also recognize when children are tiring and will advise when it’s time for them to sit out, as they are more likely to injure themselves when playing tired. Their experience ensures coaches additionally match up players according to their size and ability rather than their age alone, minimizing the risk of trauma should a collision occur during contact sports.
Preventing acute injuries
Protective equipment helps to reduce the impact of trauma and includes a helmet, knee and elbow pads, wrist guards, eye protection and gum shields depending on the sport in question. However, to be effective, all protective items must be in good condition and fit well, so as your child grows you’ll need to replace equipment. However, the CDC advises this isn’t the only measure to reduce injury in children. It’s also important that they are taught the correct sporting techniques and are always encouraged to use these during play. Children should also build up their strength and fitness, as this offers protection against injuries, though it’s best to build this up gradually and from their current fitness level to avoid any harm in the process. Factoring in rest periods, both during and between practice, is also essential and all training sessions should include a warm-up, cool-down and stretching out to protect their soft tissues. Finally, you should also lead by example, wearing protective equipment, following rules and taking the same measures to protect yourself from trauma while participating in sport.
Preventing overuse injuries
To reduce the risk of overuse injuries in children, the University of Florida suggests one of the first steps is to get a physical exam, as this can highlight if your child is more susceptible; if so, an alternative sport may be more suitable. It’s also important that kids vary the physical activities they take part in to avoid repeated stresses and to allow them to develop all-round fitness; they also certainly shouldn’t specialize in one sport before puberty. While it’s essential that children only take part in organized sports a maximum of six days weekly, they also shouldn’t play a given sport more than five times each week and neither should they play in more than one team for the same sport weekly. Equally, young people should take at least two months off each year from their chosen sports, taking part in other activities in the meantime. Finally, when it comes to building up their training, following the 10% increase rule should also allow their body to adapt to increased demands.
Preventing heat injury
Although the focus is usually on preventing physical injuries, it’s important not to forget dehydration, heat exhaustion and heat stroke, which are more likely to affect kids. As the National University of Health Sciences explains, this is partly because children don’t perspire as much as adults and they also need a higher core temperature to start sweating. It’s therefore essential for parents, teachers and coaches to look out for symptoms suggestive of heat exhaustion, which includes dizziness, headache, weakness, nausea, skin that is pale and moist, high perspiration, reduced body temperature, dilated pupils, appearing disorientated and fainting. Reacting quickly to these symptoms by taking a child somewhere cool, giving them water and removing excess clothing helps to prevent any lasting problems. Heat stroke is more serious and in addition to developing a headache, dizziness and confusion, if it progresses, vascular collapse and coma are likely. While it’s essential to get urgent medical help for heat stroke, taking quick action to cool the child down helps to protect their organs from damage.
However, heat exhaustion and heat stroke are both easily preventable. Firstly, kids need regular stops for fluid, ideally taking 8oz of fluid per 20 minutes of play, as well as extra fluid after exercise. It’s also important that coaches substitute more frequently when it’s hot to prevent kids overheating. Wearing light colored clothing made from breathable materials and a hat with a brim is additionally helpful, as is encouraging children to use a mist spray over their body to keep cool.
On a similar note, it’s also important not to forget about preventing sunburn during outdoor activities, as burning badly as a child increases the risk of skin cancer as an adult. Encouraging kids to apply waterproof sunscreen and to reapply during longer sessions or if they notice they are sweating heavily, as well as wearing a hat, are helpful measure to prevent them burning.
Despite taking measures to prevent injuries, some will still occur, so prompt management is vital. The University of Utah advises that you should teach kids to stop if they are in pain, as continuing to play when they are hurt will usually only make matters worse. If they have a probable sprain or strain, remember the acronym RICE. They should Rest the affected limb for at least two days, apply Ice or a cold pack every 20 minutes between four and eight times daily, use an elastic wrap to provide Compression to reduce swelling and keep the limb Elevated as a further measure to minimize swelling. However, you should ideally seek medical attention for other injuries.
Before your child returns to sport it’s best for them to receive medical clearance and this is essential if they sustained a head injury. Thinking about the factors that contributed to their injury is also recommended before they resume play so that extra precautions can be taken to reduce the risk of it happening again.
By Amy Linton