We like to think of kids playing sports as tiny juggernauts who can bounce back from anything that’s thrown their way, but the truth is that sports injuries in children are more common than you might think. We spoke to PA Scot Rheinecker with OrthoCarolina in Concord about how to keep kids healthy from the court, to the field, to the track and beyond. Here’s what he had to say:
SCOOP: What are the most common sports injuries you see in children?
Scot: Sports injuries in children may run the gamut from mild (cuts, scrapes, bruises) to severe (fractures and dislocations). Luckily, most fall somewhere in between.
- Sprains are stretch injuries to ligaments — the tough bands of connective tissue that attach two bones together at a joint.
- Strains are a stretch of a muscle that results in pain and spasm. In children, the ligaments are very tough and not as easily stretched as in an older adolescent or adult.
- The growth plate (the area at the ends of the bones where cartilage is converted into bone) is the “weak link” in the system and stresses often get transferred through this region during an injury. Small fractures are prone to occur at these sites and can often be more common than sprains. In most cases these fractures are not displaced and heal without permanent limitations, but any injury to a growth plate may cause changes in the growth and development of the bone. The ones that we generally watch closely are ones that require the bones to be “set” or put in place, or injuries that involve the joint. Also, if there is a disruption to the normal shape of the joint, there is a chance of developing arthritis at a later age.
SCOOP: Is age a factor?
Scot: Sports for children and adolescents have become big business. More and more individuals start competitive sports at an early age and may play on multiple teams of a single sport.
Repetitive use injuries are very common at any age. This is due in large part to the excessive practice/game schedules that many children keep. Some children may practice one-to-two hours three-to-four times a week and then play two games on a weekend. This leaves little time for recreational play which allows for cross-training of muscles that balance out their musculoskeletal systems. It’s important to build adequate rest time into kids’ schedules to allow their muscles to “calm down” from repetitive overuse and to avoid subsequent injuries.
SCOOP: What are some good general tips to help avoid injury in children who play sports?
Scot: There are many recommendations but here are my top five:
- Start with a pre-season physical
Have your child checked to ensure he or she is healthy enough to participate in the chosen sport. Be honest with your healthcare provider about any significant medical history in your family or child including diabetes, heart disease, irregular heart rhythm, asthma, or heart attack. - Encourage participation in a variety of sports and communicate with your children
Find out why he or she wants to play a certain sport. Is the sport fun? Are friends playing? Did Mom or Dad play in the past? Children’s interests shift from year to year. Don’t get too caught up if he or she wants to try something different. Make good informed decisions together about the sport based on interest, time commitment, expense and overall safety. - Make sure to warm up properly
This can be as simple as light jogging or jumping jacks. Any type of cardiovascular activity for 10-to-15 minutes elevates the heart rate and gets blood moving to all the muscles. Warm muscles are less prone to spasm — allowing for quicker reaction speed and reducing chances of injury. - Hydrate, hydrate, hydrate
Participating in sports in the south during the warmer months can be brutal. With hot, humid weather and exercise comes profuse sweating. Many children may lose one or two pounds in sweat during vigorous activity. Dehydration places children at risk for more serious heat-related illness.
Drinking plain water is typically fine. Sports drinks contain significant amounts of sugar that add unnecessary calories. In addition, the acid in the drinks may soften the enamel of kids’ teeth.
The simple rule is that the child’s urine should be clear or very light yellow. If it is dark yellow or brown, this is a sign that the child may be dehydrated. Athletes should drink before they get thirsty: thirst is a late-alarm mechanism and not reliable to tell when a child needs fluid. Keeping the tank topped off ahead of time will help keep kids out of heat illness trouble. - Eat a balanced diet
Hectic schedules and running straight from school to practice often make it difficult to make scheduled mealtimes. Don’t skip breakfast — it’s the one meal you have control over and it sets the pace for the rest of the day. Parents should encourage filling foods such as oatmeal with whole fruits.
If time is an issue, smoothies are an excellent go-to. Keep frozen fruits on hand to throw in with other foods such as carrots, peanut butter, yogurt, and wheat bran or flax meal. There are a number of recipes on the internet for athletes of all types. Stay away from supplements such as amino acids and protein builders. They often contain excessive amounts of substances not proven to be beneficial and may often be harmful if taken in large quantities.
SCOOP: Which sport is the number one offender for injuries?
Scot: Based on reported trips to the emergency room and frequency of injuries, basketball is one of the top offenders.
Ankle sprains are the typical injury. While most are mild to moderate and do not require surgery, they can be painful and make walking difficult for several weeks.
Other contact sports such as soccer, football, wrestling, and gymnastics see their share of injuries too. They may range from sprains of the knee and ankle to torn ligaments such as the anterior cruciate ligament (ACL) of the knee.
Finger fractures often occur in sports such as football, soccer, baseball, and basketball where the ball strikes the finger.
SCOOP: Which sport would you consider the “safest” (fewest injuries)
Scot: Swimming is probably one of the safest sports when it comes to traumatic injuries. Very few fractures occur during swimming, with most occurring through accidents during dry land training. Additionally, finger injuries may occur by striking the timing pad on wall too forcefully. However, swimming does see its share of overuse injuries of the knees and shoulders due the amount of yardage and frequency of workouts. If a parent wants to keep his or her child away from the emergency room, though, this is the sport.
SCOOP: What types of injuries are fine to treat with just rest/ice/heat, and at what point should I call a doctor for my child?
Scot: The bottom line is you know your child (and how he or she reacts to pain) best. Not all fractures swell and bruise, and many simple sprains can look quite swollen and bruised.
As a rule, applying ice immediately after an injury cools the area and helps decrease pain and swelling.
Elevation of the extremity helps keep any swelling from pooling in the area.
I think a simple rule is if the pain is significant enough to keep him or her from sleeping, or he or she is hesitant to move the body part, then it should be examined. I often tell parents that if it hurt bad enough that the child wanted to take time out to come to my office and sit through an examination, then it is worth a look.
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Scot Rheinecker is a physician’s assistant based out of OrthoCarolina Concord. He specializes in sports medicine — especially shoulder, elbow and general orthopedics.
