Youth sports leagues offer a space for children to stay fit and active while also gaining important life skills such as working with a team and building relationships with others. Here in the South Bay, many children play in youth sports leagues and participate in athletics at school. Often times these children play multiple sports throughout the year. While these experiences play critical roles in a child’s development, injuries do sometimes occur as a result of participation. Injuries—like life skills—can have lasting effects. The key to playing it safe for children is proper form and technique, keeping an eye out for any strange behaviors, and proper care for an injury when it does occur in order to minimize effects.
According to the National Center for Sports Safety, more than 3.5 million children ages 14 and under receive medical treatment for sports injuries each year. Sports injuries can be caused as a result of play—for example dehydration, a sprained ankle, a concussion from a collision, or a scraped knee, while others are caused by overuse of specific parts of the body. Overuse injury is responsible for nearly half of all sports injuries to middle and high school students.
While parents and coaches do their best to prevent injuries through proper training and equipment for their children, injuries do occur and it is important to treat them properly to avoid long-term damage.
Injuries vary by sport, of course. For example, football, a contact sport where people hit each other, poses a greater risk for injury versus baseball, which may see fewer injuries but those can be very severe (e.g., if hit with a ball). Swimming has minimal contact injuries but quite a few shoulder injuries.
Brad Thomas, MD, is an orthopedic sports medicine specialist and co-owner of Beach Cities Orthopedics & Sports Medicine with two locations in the South Bay. He is an expert on orthopedic injuries and works with athletes ranging from the Olympic and professional levels to youth sports and high school athletics.
“Sprains and strains and breaks and bruises and rips and tears are our thing,” explains Dr. Thomas, who cares for many of the South Bay high schools and all local junior colleges. “We consider any muscular, tendon or bony injury or illness an orthopedic problem. Additionally, injury prevention and muscluloskeletal wellness is part of an orthopedic practice.”
“Overuse injuries, fractures around growth plates, and ligament problems are seen on a daily basis in youth athletes in my office,” says Dr. Thomas. “Young women athletes, especially soccer players, have a much higher rate of Anterior Cruciate Ligament (ACL) tears than do the boys. We have developed an ACL injury prevention program to address the muscle imbalance and pivoting and jump-landing issues young women have that lead to these injuries.”
One of the most ‘acute’ common injuries in weight bearing sports is an ankle sprain, says Helaine Lopes, PhD, ATC, CSCS. Although not usually career ending, an ankle sprain can cause the athlete to lose important playing time. If not treated correctly, it can also cause the ankle not to heal the best it can and continue to cause problems later on (even if they are not playing competitively).
Dr. Lopes is the coordinator for Kids N’ Fitness and Healthy Ever After programs at Torrance Memorial Medical Center. She is also the assistant athletic trainer at Palos Verdes High School and a lecturer in the kinesiology department at the University of Southern California.
How can parents and coaches help kids avoid ankle sprains? It is highly recommended that athletes use braces that provide stability (not just compression) in weight bearing sports that require agility and quick movements. Different braces are made for different sports so that the athlete’s performance is not hindered. Although strengthening is important too, it is very important to include balance exercises so that the athlete can react quicker to an unforeseen incident (e.g. stepping in a hole or on another athlete’s foot).
The most common chronic injuries usually involve some form of tendonitis (for example shoulder in any sport that involves repetitive throwing like pitching or rotation like swimming). Patellar tendinitis (below the knee cap) is more common in running and jumping sports (sometimes aggravated by a growth spurt). “Shin splints,” which is many times due to periostitis (inflammation of the bone lining on the tibia), is also common in any sports that involve running.
Over the last few years, the media has increased its attention on concussion—a traumatic brain injury to the head that alters the way the brain functions. Concussion is usually the result of a blow to the head and can cause headache and problems with balance, coordination, and concentration.
“I’m not sure if there are actually more concussions occurring recently or if we are simply more aware of concussions, but it appears that an increase may be due to increases in forces produced by athletes in certain sports as well as the amount of time athletes are devoting to contact in those sports (increasing chance for injury),” says Dr. Lopes. “Of crucial importance is the appropriate evaluation of the athlete when a concussion happens as well as thorough understanding of post-concussion symptoms in an effort to return the athlete to activity when they are ready. The focus now is on getting that evaluation done by qualified personnel in a timely manner as well as making sports safer.”
Everyone—parents, coaches, administrators and athletes need to be well educated about concussions.
While many believe that loss of consciousness is the main sign of concussion, 90% of sports related concussions occur without a loss of consciousness. Therefore if loss of consciousness is the symptom coaches and parents look for, many concussions could go unnoticed.
Any athlete exhibiting symptoms of concussion syndrome for a prolonged amount of time should be evaluated and obtain a head CT Scan or MRI, according to the American Academy of Neurology.
“There is some new evidence that the use of fish oil (DHA and omega-3 fatty acids) may be beneficial after a concussion,” explains Dr. Thomas. “The thinking behind this is that Omega-3 fatty acids make up about 30% of the brain and are added to 100% of infant formulas for healthy brain development. This is not currently proven, but there is no harm in taking Omega-3 fatty acids and they are recognized as safe by the FDA up to 3 grams daily.”
Second impact syndrome occurs when an athlete is hit a second time in the head before they have fully recovered from a concussion. The second impact has become a major concern and is avoidable if the athlete is not returned to play before he/she is ready. Those who know the athlete best may be the best source for noticing a change in their behavior that is possibly due to a concussion. This also happens when an athlete gets hit and does not want to tell anyone in fear of being taken out of competition or practice because of it. Additionally, an athlete might not be aware that it happened.
Underage But Overworked
“The most common injuries to young athletes include sprains and strains of ligaments and tendons, as a consequence of an acute event or injury, or what we call ‘overuse’ injuries from repeated activities. These injuries tend to be reasonably equal in frequency amongst males and females,” explains Nicholas Silvino, MD, Board Certified Orthopedic Surgeon, partner of South Bay Orthopaedic Specialists, based in Torrance. Dr. Silvino is also co-team physician for Peninsula High School.
“Overuse injuries are very common. They occur because an activity is repeated so frequently in a sport that a body part (eg a tendon) can’t keep up and begins to fail. Common examples include stress fractures in runners and elbow tendonitis in tennis players, etc.,” says Dr. Silvino.
“Competitive youth athletes are dedicated to their sport and often overdue the training by participating on multiple teams at the same time and playing a single sport year-round. This is unhealthy in many regards. A single sport will often produce muscle imbalance leading to spine and joint problems. A single sport will also produce repetitive stress to certain body parts leading to tendinitis and stress fractures,” says Dr. Thomas.
According to Dr. Silvino, the best protection from overuse injuries is proper rest, stretching, and most importantly allowing an appropriate amount of time to build up force, intensity, and frequency of the activity to allow the body to acclimate to the sport.
“Parents, do not risk an injury just so that your child can play or practice in fear that they won’t be put in a competition later on,” cautions Dr. Lopes. “To prevent burnout, talk to your children and find out if this is really what they want to do and if they are having fun.”
According to “Coaching Our Kids to Fewer Injuries,” a report published by Safe Kids Worldwide®, parents should encourage athletes to have one to two days off per week from competitive athletics, sport-specific training, and competitive practice, in order to allow them to recover both physically and mentally.
All athletes, young or old, need a break. “Year round sports should be limited to nine months per year with short rest periods every three months,” says Dr. Thomas.
“Performing varied sports at a young age, rather than focusing all time and attention on one sport only can help with injury prevention,” says Dr. Silvino. “If you are a one sport athlete, then spend some time, especially during off season, on dynamic exercise programs that value core strength and balance, quickness, movement, ballistic exercise, in addition to muscle strength development and endurance. “
Coaches and parents should listen to their kids. The athletes are oft en the first to recognize their injuries, and early diagnosis and treatment is by far the best way to avoid an overuse injury. Early recognition can oft en identify muscle imbalances, equipment issues, and technique problems that would ultimately lead to bigger problems.
“I think that the most important things for parents to know is how to take care of their child’s injuries because they are not always predictable,” says Dr. Lopes. “When injuries do occur, even if they are minor they can easily develop into a more serious situation if they are not addressed correctly. Parents should treat the child’s injury as if it is the worst possible scenario until they know what it is. In other words, err on the conservative side.”
For example if it’s a twisted ankle and it is unclear if it is a sprain or a fracture, but visiting a doctor or ER is not immediately an option, do what you can to protect the area and keep the inflammation down. The best way to protect the ankle is to stay off of it (use crutches), until a trained professional can further evaluate.
To prevent the initial surge of inflammation use the “RICE” method – Rest, Ice, Compression (bandage) and Elevation.
“Parents should make sure their children are well-rested, hydrated and fed when they go to practice or competitions,” says Dr. Lopes. “Make sure they are mentally rested as well, alert and ready to go. Parents should know their kids better than anyone, so they should be able to see if something is not right.”