Prevention of sports injuries in children

sports injuries in childrenIt is estimated that about half of sports injuries in children are preventable. Because sports account for about one-third of all childhood injuries, the potential impact on childhood is enormous. Environmental and personal factors are both important.

Environmental Factors

Thermal regulation is of critical importance in children. Select a cool environment when possible. Avoid excessive clothing and prolonged exposure to sunlight. Insist on adequate fluid intake. Check weight before and after participation to monitor hydration status.

Playing surface should be as shock absorbing as possible. Avoid running on hard surfaces. Insist on padded surfaces for playgrounds and for field events where falls are common.

Motor vehicles are dangerous in areas of play, especially for sledding and biking.

Encourage adults to focus more on safety than winning. Emphasize the importance of learning sport skills, the value of team participation, and having an enjoyable experience. Point out that participation sometimes involves losing. Learning to accept and handle losing teaches an important lesson that will be valuable throughout life.

Maintain equipment in good working condition and be certain the equipment is size appropriate.

Provide medical care for preparticipation evaluation and ongoing management.

Individual Factors

Wear protective devices Be sure the children wear protection, such as helmets, face, mouth guards, and body protection in vulnerable sites. Also, they should remove helmets when not involved in a risk of collision.

Proper conditioning improves strength, flexibility, and endurance.

Limit rate of increase in loading or repetitions to about 10% per week (10% rule).

Proper footwear provides good shock absorption and traction.

Psychological factors Early excessive grooming of elite athletes exposes children to external pressure to perform inappropriate training regimes.

Sporting Environment Control

Preseason medical evaluation should identify which conditions could be worsened by sports participation and identify musculoskeletal problems that could be improved by rehabilitation before returning to sports.

Provide medical coverage at high-risk events to provide prompt professional diagnoses and management.

Improved coaching skill is an important factor. Encourage coaches to avoid coaching by the approach used in their own childhood experience. Help them understand that the primary source of overuse injuries is too much, too soon–—not just too much. Coaches should advance progression in sports participation appropriately to avoid placing the young athlete at risk. Too rapid advancement increases risk of injury.

Children with Orthopedic Disabilities

Children with hip dysplasia, clubfeet, and other orthopedic deformities may become outstanding athletes. This is important information to give parents while treating these children.

Elite Athletes

Elite or outstanding athletes can have musculoskeletal problems. It is commonly believed that to become elite athletes, children must start training during their first decade; however, this has not been documented.

Studies have demonstrated that the injury rate in elite juvenile athletes is lower than that of average-ability athletes. Elite athletes are stronger and more flexible than their peers. Because many will progress to participate in impact sports in late adolescence and adulthood, they risk long-term disability from osteoarthritis later in life. The risk of osteoarthritis is sport specific, and greater for those participating in collision sports.

Focused juvenile athletes are preoccupied with their sports. This is beneficial in enhancing self-esteem; promotes a healthy lifestyle by discouraging the use of drugs, smoking, and obesity; and possibly provides scholarships or other sport-generated income. On the downside, academic achievement, socialization, interpersonal skills, and other broadening experiences may be limited. The cost to girls may be greater. Menstrual irregularities, possibly shortened stature, and eating disorders may occur. The preoccupation with thinness in gymnasts and dancers creates special problems for girls.

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