Preventing sports related injuries in children

More than 30 million children participate in organized sports in the United States, with millions more participating in recreational activities such as skateboarding, in-line skating and bicycling. Each year, approximately 775,000 children are treated in hospital emergency departments for sports-related injuries and about 25 percent of these injuries are considered serious.
Children suffer from three common types of sports injuries: acute, overuse and re-injuries.
Acute injuries
Acute injuries typically include bruises, sprains, and strains: however older children commonly sustain more severe injuries, such as broken bones and torn ligaments. If an acute injury is affecting a child’ s function, first aid should be administered immediately. The child should then visit a physician for further assistance or, if the injury appears severe, they should be taken to the nearest hospital emergency department.
Overuse
Overuse injuries occur from repetitive actions that puts too much stress on the musculoskeletal system. Child athletes often suffer from this type of injury because of the constant strain that is applied to developing bones and muscles. Overuse injuries range from “Little League elbow” and “swimmer’ s shoulder” to shin splints.
Prompt diagnosis and treatment of overuse injuries are crucial to preventing the development of a chronic problem.
Re-injuries
Re-injuries occur when an athlete returns to a sport before a previous injury has sufficiently healed.
The anterior cruciate ligament, or ACL, is one of the major ligaments in the middle of the knee. It connects the back part of the thigh bone (femur) with the shin bone (tibia). The ACL prevents the tibia from shifting forward in relation to the femur. An intact ACL prevents the knee from giving out or buckling especially during cutting, pivoting or twisting activities. It is commonly torn or injured during sports that require jumping or direction changes.
According to the Journal of Bone & Joint Surgery, as female athletes approach adolescence, muscular changes cause them to have less control of their knee joints, placing them at greater risk for injuries related to the ACL. A study of sports injuries over three decades showed that women sustain anywhere between four and eight times as many ACL tears or ruptures as men. The study also maintained that girls involved in jumping and cutting sports such as basketball and soccer are at the highest risk for ACL injuries. The study sought to determine what role growth and development play in the difference between the genders. And the primary finding in the studies showed that growth in height and bone length without increased strength and power in girls appeared to be related to decreased control of the knee and potentially, increased injury risk.
There are three theories about why there are variations between the genders when it comes to ACL injury; 1) anatomical differences (Anatomically, the female pelvis is typically wider than a male pelvis, creating a slightly different angle from the femur to the tibia, making their meeting at the knee sharper and more “knock-kneed” than men); 2) female hormones and their effects (female hormones may also play a role, naturally relaxing the muscles, ligaments and joints during the ovulation phase of the menstrual cycle.); and 3) neuromuscular development. (Neuromuscularly, there are developmental differences in boys and girls. And for undefined reasons, women do not seem to have neuromuscular precision developed to the extent that men do).
An ACL tear will not heal on its own. Although many of the body’ s ligaments will heal after injury if the patient rests and keeps the area immobilized. Once the ACL is torn, stability becomes an issue and the knee is compromised and more prone to cartilage tears and can lead to subsequent arthritis.
Advances in arthroscopic surgical technology allow for minimally invasive surgery, resulting in smaller incisions, less post-operative pain and quicker recovery. Some patients who experience ACL tears are able to resume normal daily activities without surgical repair of this ligament. But, if a patient intends to resume participation in sports that stress the knee, surgery is generally required, and there is a postoperative rehabilitation period that is critical to the patient resuming activity, both for exercise and in sport.
In general, experts estimate that about half of the injuries children suffer during sports activities are preventable by following a few simple guidelines. These guidelines will help children stay safe, without taking all the fun out of the activities:
— Supply children with proper equipment, such as helmets, pads, protective eyewear and mouth guards.
— Make sure playing surfaces are properly maintained and are appropriate for the activities being conducted on them.
— Adults should supervise activities at all times and be committed to safety.
Involvement in sports can be very important for children as exercise can reduce their chances of developing health problems related to inactivity, including obesity. Sports also help children build social skills, learn team skills, and develop a general sense of well-eing.
Encouraging safe sports participation with your children is great way to help them stay healthy and happy for years to come.

“To Your Health” is brought to you by the physicians and staff at Scripps Memorial Hospital Encinitas. For more information or for physician referral call 1-800-SCRIPPS.

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