They
say it’s all
fun and games until someone gets hurt. But childhood sports-related
injuries are almost unavoidable. Though most children will receive
only minor bumps and bruises, some may experience painful sports-related
injuries that could easily have been prevented.
Broken Bones
Sticks and stones aren’t the only things that will break a child’s
bones. Each year, Children’s Hospital sees its share of sports-related
broken bones.
“In the pediatric
population, the most common injuries are broken bones — wrists,
collarbone and elbow fractures,” says Scott Doyle, orthopaedic
surgeon at UAB and Children’s hospitals and assistant professor
of surgery at UAB.
Doyle said it
is most important for parents and coaches to remember that child
athletes
are vastly different than teenage and adult athletes. He said some
young athletes could receive injuries that interrupt their body’s
growth process.
“Most broken bones
do not leave children with long-term problems. Most heal very well,” he
says. But some do not.
“In children, small
fractures of the growth plates easily can be mistaken as a sprain,” Doyle
says. “If a young athlete experiences a fall in a game and
complains of pain near a joint, such as the wrist, ankle, elbow
or knee, the coach should not assume it is just a sprain and send
that child back in the game to play.
“Anytime a child
has fallen in a game and complains of pain near a joint, you should
assume the worst — that they have a crack in the growth plate.
Restrict him from participating until he feels better. If he doesn’t
feel better, refer him to a doctor,” Doyle explains.
Growth plates
are made of cartilage and are located at the end of long bones
in a growing
child. The growth plate generally is weaker than the ligaments
that surround it, Doyle says. If a child’s growth plate is
cracked and that child is hit or falls again in a game, the growth
plate could become displaced and have to be set or even repaired
surgically.
“Most of the time
fractures of the growth plate will heal. But if it is permanently
damaged, it could cause a slowdown in the growth of that limb or
the limb to grow deformed,” Doyle says. “There are
occasional cases where the damage of the growth plate is permanent.
The smartest thing is for coaches to be aware of that and be wary
of putting children back into play [who are injured].”
Concussions
Oftentimes young athletes “get their bell rung” during sports practices
or games, but sometimes it’s not as simple as getting back up and shrugging
it off. An estimated 300,000 cases of sports-related concussions occur yearly
in the United States.
“A concussion is
a mild brain injury that is caused by external forces — a
blow of some sort to the head — and results, in the vast
majority of cases, in a transient, typically brief disruption of
ongoing neurological functioning,” says Paul Blanton, research
associate professor of psychology at UAB. Blanton performs neuropsychological
evaluations and consulting with athletes and their families following
concussions.
Blanton says many concussions
occur in contact sports, such as football and hockey, but they
also occur in other traditionally non-contact sports, such as soccer
and basketball.
Blanton says most people
believe that a person must sustain a loss of consciousness in order
to have a concussion or a severe concussion, but that simply is
not true.
“Many signs or
symptoms of concussions are fairly subtle and easily missed or
dismissed,” he says. “Obvious signs or symptoms may
include loss of consciousness, confusion, drowsiness, agitation,
irritability, sensitivity to light, persistent headache, argumentativeness,
social withdrawal, difficulties with attention or concentration
and increased sleeping or persistent fatigue. Less obvious signs
or symptoms include subtle personality changes, slowed cognitive
processing, decreased efficiency in completing routine tasks and
decreased appetite.”
Blanton says oftentimes
athletes experiencing the effects of concussions will only report
that they do not feel well.
“My professional
position is that any observed behavioral change or reported symptoms
following a concussion should not be dismissed and should be evaluated.” Blanton
says athletes must be monitored over time to evaluate the severity
of the concussion. “Too many people believe that a concussion
is a static event, when in fact symptoms may linger for hours,
days and, in severe cases, weeks,” he adds.
Blanton says if a coach
suspects his player has a concussion, that player should not be
allowed to return to play or practice until a doctor evaluates
him or her.
“It’s best
if athletes see a sports medicine physician or a neurologist following
a concussion. Never let a player make the decision to return to
play, as most want to return and will deny symptoms in order to
do so. Perhaps the best advice I can offer is, if in doubt, sit
them out,” Blanton says.
If a player returns to
play after receiving a concussion, they could experience Second
Impact Syndrome (SIS).
“Second Impact
Syndrome is a very serious, but fortunately, very rare traumatic
neurological event,” Blanton says. “It has been estimated
that 50 percent of athletes sustaining SIS will die, while the
remaining 50 percent will have significant permanent neurological
symptoms.”
He says SIS occurs when
an athlete who is still experiencing symptoms from a prior concussion,
sustains a second, and often less severe, concussion. It results
in life-threatening brain swelling and increases the intracranial
pressure.
“Most commonly this
has occurred in high school football,” Blanton says. “As
you might imagine, the possibility of SIS, although rare, raises
the importance of making certain that concussed athletes are symptom-free
prior to being permitted to return to play.”
In addition,
Blanton points out that coaches should limit players’ exposure to
hard contact during practices. “Less contact will decrease
the likelihood that concussions will occur. This isn’t always
possible, however, so coaches should certainly teach proper tackling
techniques in football and proper heading and proper challenge
techniques in soccer. Coaches and parents also should discourage
dirty and overly aggressive play, such as elbowing in soccer, as
this often can increase the likelihood of concussions.
“Proper-fitting
equipment is also important,” Blanton says. “In collision
sports, players always should wear proper-fitting helmets that
are securely held with chin straps.” Blanton says there also
is some evidence that proper-fitting mouthpieces can help reduce
concussions, as can some specially designed football helmets.
Rehabilitating Growing
Athletes
Steve Milliron,
physical therapist, certified athletic trainer and administrator
of the
HealthSouth Sports Medicine & Rehabilitation Center in Hoover,
says most of the younger patients treated at the clinic have experienced
sports-related injuries.
“The therapists
in the clinic see patients who have been injured from every sport.
It depends mainly on the season. In the fall, we see a lot more
football and volleyball injuries. In the winter, we see more basketball
and wrestling injuries. And in the spring, we see more soccer,
softball and baseball injuries,” he says.
“The majority of
what we see is non-operative, overuse cases,” he explains. “A
lot of injuries have to deal with the adolescent athlete maturing
and pushing the limits while dealing with the changes that come
with puberty and the natural maturing process of the body.”
He said males
typically experience a growth spurt between junior and senior high
school. “The
bones in the skeletal system grow quicker than the muscles, ligaments
and tendons can adapt. Therefore, what you’ll see is people
getting tendonitis,” Milliron says. To help them combat the
pain and discomfort, “we show them specific range-of-motion,
stretching and strengthening exercises for their specific complaints
and diagnosis.”
Milliron says
it is important that children receive regular check-ups — at least once a
year — with their pediatrician when they begin to play organized
sports. In addition, he says young athletes should warm up and
stretch for at least five to 10 minutes before engaging in sports
activities in order to avoid injury. And he adds that parents and
coaches should practice common sense when it comes to overexposing
children to sports activities.
“Parents and coaches
should know when a child has had enough and needs to come out of
a game,” he explains. “The coach should try to keep
everyone fresh and rotate them in and out as much as possible.”
Milliron says most young
children are honest and will let their coach know when they are
hurting and need to come out of the game.
“You’ve just
got to listen to them,” he says. “This is all designed
for the child to have fun and be involved in team sports. When
a child is hurting, it’s not going to do the athlete or the
team any good to play while they are hurting. The harder parents
push their children, the more we’ll see them in rehab or
needing surgery.”
STEPHANIE HASBROUCK IS
A BIRMINGHAM FREELANCE WRITER AND MOTHER.
TIPS TO PREVENT SPORTS-RELATED
INJURIES:
According to the National
Institutes of Health, parents can take important steps to help
prevent their child from receiving sports-related injuries.
• Enroll
your child in organized sports with a certified athletic trainer.
• Make
sure your child uses the proper protective gear.
• Make
sure your child does warm-up exercises, such as stretching and
light jogging,
before play or practice to minimize the chance of muscle strain.
• Make sure your
child does cooling down exercises after sports play to loosen the
body’s muscles.
• Make
sure your child wears sunscreen and a hat to reduce the chance
of sunburn.
• Make
sure your child drinks plenty of fluids, preferably water, during
sports
play. Children need to drink 8 ounces of fluid every 20 minutes
and more after playing.
Treating injuries with
RICE
According to the National Institutes of Health, soft-tissue injuries,
such as sprains or strains, or a bone injuries immediately can
be treated with RICE — rest,
ice, compression and elevation. Parents should seek professional treatment
if the injury is severe.
• Rest:
Restrict or stop use of the injured area for 48 hours.
• Ice:
Put an ice pack on the injured area for 20 minutes at a time four
to eight
times per day.
• Compression:
Compressing an injured ankle, knee or wrist may help reduce swelling.
The area
can be compressed using bandages, such as elastic wraps, special
boots, air casts and splints. Parents should ask their pediatrician
which technique is best.
• Elevation:
Keep the injured area elevated above the level of the heart.
For more information on
sports injuries and prevention, visit the National Institute of
Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Web site,
www.niams.nih.gov/
Source: Childhood Sports
Injuries and Their Prevention: A Guide for Parents with Ideas for
Kids
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