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Preventing and Treating Pediatric Sports-Related Injuries

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Roughly 45 million U.S. children play an organized sport. Due to shifts toward involvement in competitive sports at earlier ages, escalated training intensity, frenetic competition schedules and specialization into one sport, acute and chronic pediatric sports-related injuries have increased. The numbers are staggering:

• More than 3.5 million athletes 14 and younger receive medical care for sports-related injuries
• The nation’s youth account for 40% of all sport-related injuries evaluated in the emergency department
• An estimated 2.6 million emergency room visits per year involve athletes between the ages of 5 and 24
• By the age of 16, 42% of boys and 27% of girls will have incurred a fracture

With pediatric injuries in sports accounting for about 25% of all childhood injuries, safety strategies that promote safe play and proper and timely care are essential to minimizing injury severity and avoiding prolonged impacts of injury among young athletes.

Types of Skeletal Muscle Injuries

When it comes to classifying muscle injuries, the most differentiating factor is the trauma mechanism. Muscle injuries are broadly classified as either traumatic (acute) or overuse (chronic) injuries.

Acute injuries are usually the result of a single traumatic event and cause a macro-trauma to the muscle, providing an apparent link between the cause and noticeable symptoms.

Overuse, chronic or exercise-induced injuries are subtler and usually occur over a longer timeframe. Resulting from repetitive micro-trauma to the muscle, these injuries are more challenging to diagnose due to a less obvious link between the cause of the injury and the symptoms.

These injuries are on the rise in pediatric sports, largely due to modern year-round, overloaded schedules. The top five sports that lead to kids’ injuries are soccer, basketball, football, dance and gymnastics, and some common injuries resulting from each are as follows:

Soccer

• Ankle, knee and calf sprains
• Clavicle, foot and wrist fracture
• Kneecap bursitis
• Meniscus tears
• Concussions

Basketball

• Ankle and muscle sprain
• Achilles tendonitis
• Knee tendonitis
• Finger injuries
• Sever’s disease

Football

• ACL tears and MCL sprains
• Meniscus tears
• Concussions
• Finger, ankle and wrist fractures
• Muscle strains
• Shoulder acromioclavicular (AC) joint sprains

Dance and Gymnastics

• Ankle sprains
• Achilles tendonitis
• Trigger toe
• Ankle impingement
• Snapping hip and hip impingement

Why Young Athletes are More Prone to Injuries

Composed of more collagen and cartilage than the ossified bones of adults, a child’s bones are weaker than their associated ligaments and tendons. Thus, stresses placed across these structures produce bone failure and resultant fractures rather than the soft tissue damage seen in adults. If properly managed, however, they can heal without sequelae.

The physis, or growth plate, is the weakest link in the immature skeleton, making it prone to failure with abnormal traumatic or chronic stress. Representing 6 to 30% of all childhood fractures with the potential to exhibit growth arrest, be impaired partially or develop normally, the identification and appropriate management of a physeal injury should be considered high priority. With growth arrest occurring in 15% of growth plate injuries, even seemingly innocuous injuries pose a substantial risk.

Physiological and Other Differences That Influence Adolescent Susceptibility to Sports Injuries

The developing anatomy and physiology of children may make them more prone to unique sports-related injuries. Further, adolescent injuries often manifest differently than adult injuries with severe consequences that can alter growth and development. Additionally, males are more frequently injured during sports participation than females, possibly due to the differences in anatomic and physiologic characteristics (i.e. skeletal structure, muscle mass, ligament laxity, hormone levels) between the sexes and because they have an increased tendency to engage in high-risk activities.

Thus, it is increasingly important that parents, coaches and caregivers have a thorough understanding of the unique physiology of the growing skeleton and the associated intrinsic injury risk factors. Failure to recognize typical acute and chronic injury patterns in young athletes may delay necessary treatment and result in otherwise unneeded surgical intervention, early degenerative change, limb deformity, and disability, as well as increased injury susceptibility and reoccurring pain.

Early Specialization in Sports Versus Diversification

Sports that involve throwing or throwing-like movements, which range from classic ball throwing to throwing-like actions such as a tennis serve, and repetitive overhead motions involve complex biomechanics and great stresses being placed on the musculoskeletal system. Injuries can occur when improper biomechanics are applied, excessive stress beyond the capacity of an individual's musculoskeletal system is incurred or cumulative trauma from throwing too frequently develops.

In fact, medial epicondyle apophysitis (little league elbow) is the most common injury affecting young baseball pitchers whose bones have not yet stopped growing. In a retrospective, observational study of over 740 professional baseball players in the United States, baseball specialization during high school was associated with more upper and lower extremity injuries and fewer games played as a professional compared with players who played multiple sports in high school. Although long-term effects are unclear, these findings imply that early specialization in baseball may increase the risk of injury into adulthood.

There are benefits to adolescents playing a diversification of sports, including the potential to provide stimuli so that a child’s body can adapt and develop multiple motor skills that may crossover between varying sports. Furthermore, the International Olympic Committee put out a consensus statement on youth athletic development, stating, “Children who participate in a variety of sports and specialize only after reaching the age of puberty … tend to be more consistent performers, have fewer injuries and adhere to sports play longer than those who specialize early.”

Sports Injury Prevention Tips

All sports have a risk of injury, and the American Academy of Pediatrics has provided some vital tips that can help parents and coaches promote a safe sports experience.

• Take time off: Take at least one day off per week and at least one month off per year from training to allow the body to recover.
• Wear the right gear: Wear appropriate and properly fitted protective equipment such as pads, helmets, mouthpieces, face guards, protective cups and eyewear.
• Do not play through pain.
• Strengthen muscles through conditioning exercises during practice.
• Increase flexibility: Stretching exercises should be incorporated into a daily fitness plan and after games and practices.

AliMed to the Rescue

With over 50 years of industry experience, AliMed is a leading provider of medical, healthcare and ergonomic products serving all segments of the healthcare market. So, when a pediatric sports injury occurs, AliMed can help. Selling both their own and a wide range of top-quality products from thousands of other leading brands, AliMed boasts a full line of pediatric and adolescent products that can aid in prevention and recovery, including:

AliMed® FREEDOM® Pediatric Elbow Sleeves: Featuring an adjustable hook-and-loop top closure that slips on either the right or left arm and a flexible, double-sided, nylon-covered neoprene construction that provides warmth, comfort and form-fitting compression, these sleeves can be used for lateral ligament sprains, strains, bursitis, tendonitis, arthritis or soft-tissue injuries and for patient protection and postoperative support or long-term injury management.

AliMed® FREEDOM® Pediatric Wraparound Knee Brace: Fitting either the left or right leg, these braces provide child-sized support for knee injuries, including ACL/PCL sprains, patellar pain, medial/lateral ligament instabilities and patellar tendonitis.

AliMed® Pediatric Silicone Heel Cups: Absorbing shock to help relieve heel pain, these cups are ideal for bursitis, Achilles tendonitis, fat pad atrophy and plantar fasciitis.

The Joslin Ultimate Arm Sling: Designed for extraordinary comfort, this easily adjustable shoulder sling is made of soft, breathable cotton spandex fabric that is lightweight and soft to the touch.

Visit AliMed today to learn more about our host of pediatric products that promote safe play and recovery objectives.