Kids’ Sports Injuries: What Parents Need to Know
BY KATHY KATELLA January 29, 2019
Kids can avoid unnecessary sports injuries
Kids have always loved to play games—but today there’s less freeze tag and more T-ball, ice hockey, soccer and gymnastics. This is good news, given all we know about the importance of physical activity for lifelong physical, mental and emotional health. But there’s a downside, too. Each year, more than 2.6 million children up to the age of 19 show up in emergency rooms with a sports- or recreation-related injury.
One-third of childhood injuries occur in sports
Today, close to one out of three childhood injuries happens while a child is playing sports. The most common injuries are sprains and strains, followed by fractures. While injuries can happen in any sport, they are especially common in competitive team sports such as football, basketball, soccer, ice hockey, baseball and softball, as well as in activities involving repetitive movements, such as cheerleading, dance and gymnastics. However, it’s often not the activity that is the problem; rather, it’s how the sport is performed.
Serious athletes at young ages
“Kids’ sports are completely different than they used to be,” says David Frumberg, MD, a Yale Medicine orthopedic surgeon who treats children as well as adults. “When I was growing up, it was about getting fresh air and having fun. Now if a child plays soccer, he might play five days a week and on the weekends—and maybe year-round and on multiple teams. Parents need to be careful, because growing children still have growth plates in their bones that respond uniquely to stresses.”
Kids’ sports injuries: A new focus
Early specialization puts kids at a higher risk for getting hurt, especially for overuse injuries such as stress fractures and acute injuries such as ACL tears. “The problem is that when children do the same thing, like pitch a baseball—over and over again—and don’t play other sports, they continually stress the same body part,” says Dr. Frumberg. “We don’t believe that is natural. Five or 10 years ago, coaches didn’t realize this was such a problem. But now it’s a public health issue. Doctors, coaches and parents need to know about it so they can make better decisions—like establishing pitch limits to protect kids’ shoulders and elbows.”
Practices more dangerous than games
Sixty-two percent of organized sports-related injuries happen during practice, not during a game or competition. Many children spend several hours a day in practice and attend training camps in the off-season. However, one study of more than 1,200 athletes ages 8 to 18 showed that kids who train extensively in just one sport were 70 percent more likely to experience overuse injuries (that sometimes require up to six months of recovery time). Kids did better if they followed this guideline: The number of hours per week spent in training for a single sport should be lower than the child’s age.
Small children get overuse injuries, too
Forty percent of all sports-related injuries happen to children between the ages of 5 and 14. “We see overuse injuries in 6- and 7-year-olds,” Dr. Frumberg says. Gymnastics, dance and baseball are all activities in which children who show early promise are urged to “focus and specialize” at extremely young ages, he adds. “One of my biggest concerns is that when an activity causes pain for very young children, they are going to stop enjoying it. They may lose confidence and the desire to do that activity. Sometimes they think their body is broken—and then that becomes a psychological concern.”
A high-risk time: Starting a new sport
A child’s highest risk of being injured is when he or she is just starting a new sport, says Dr. Frumberg. But the good news is that half of all sports injuries in children are preventable. Some tips: Make sure your child understands the rules of the sport, has appropriate gear and equipment, warms up before playing and takes breaks if he or she is tired or in pain. Your child should be in good physical condition when starting any sport.
Specialization: Not always what’s best
Children and teens reap significant physical, mental and emotional benefits from playing sports. But it’s important to know that specializing in a sport at an early age is not likely to deliver the stellar career parents and kids are led to believe it might. A Belgian study found that boys between ages 10 and 12 who played multiple sports were more physically fit and had better gross motor coordination than boys who specialized in one sport. And research in the United States looking at female Division I NCAA athletes found that only 17 percent had previously competed exclusively in the sport they played in college.
Sport injury spotlight: ACL & meniscus tear
The anterior cruciate ligament (ACL) stabilizes the knee during quick changes in direction, Dr. Frumberg says. Girls are at higher risk for ACL injuries. Though this is partly because of hormones, it is mostly due to biomechanics, including the angle of the knees and how a young woman’s muscles support her joints. “It also has to do with landing mechanics. We know we can prevent ACL tears when women do conditioning exercises to strengthen the hamstrings and land properly,” Dr. Frumberg says.
Sport injury spotlight: Shoulder dislocation
“Another common youth sports injury is a dislocated shoulder, which happens most often in contact sports such as lacrosse, football and rugby,” Dr. Frumberg says. The injury typically occurs as a result of a collision affecting the shoulder. The humerus (ball joint) is forced out of the glenoid (socket), leaving the young athlete at risk for more shoulder dislocations (and potentially, for arthritis) down the road.
Sport injury spotlight: Fracture
Fractures are a common sports injury, Dr. Frumberg says, with different parts of the body at risk depending on the sport. Ankle fractures can happen in any sport that involves running and jumping, including baseball, gymnastics and volleyball. Hand, wrist and arm fractures are also common, especially in sports using sticks, such as hockey and lacrosse.
An acute fracture occurs as a result of a trauma, such as a collision or a fall. A stress fracture is a tiny break in a bone that results from repetitive pounding, such as jumping and landing.
Sports can (and should) be fun
Just having a sports injury puts a child at risk for another injury. “Our job is to prevent injuries from cascading into a never-ending cycle,” says Dr. Frumberg. The goal is to treat young patients well the first time to reduce their risk of later consequences, he adds. “So if young patients have an injury, I’ll take them out of sports until it heals. I’ll also talk to them about how it happened—perhaps they are not in the correct age group, or there is some underlying risk factor, such as a limb length discrepancy.”
But, he says, the most important thing kids can do is have fun.
