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Safety Blitz: Teens and Sports Injuries

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Rules of Protection

Fortunately, kids can thrive in sports without being sidelined by injuries.

  • Athletes should take off one or two days a week to let muscles rest, says the American Academy of Pediatrics. On no-practice days, don't encourage a baseball player to throw pitches in the backyard or a soccer star to run an extra mile to stay competitive. During the summer, instead of enrolling your kid in an intensive one-sport camp, let her body rebuild. If she worries about getting out of shape, have her cross-train or try other sports that use different muscle groups.
  • Don't let your child increase his training time, number of repetitions or total distance by more than 10% a week. For example, if he currently runs 20 miles a week for track, he shouldn't run more than 22 miles next week. "It's when kids exceed the 10% rule that we see injuries," says Brian Robinson of the National Athletic Trainers' Association.
  • Be on the lookout for signs of burnout, such as complaints about muscles or joints, overall fatigue or reluctance to play. "When kids are physically tired and bored with a sport, skills and technique can get sloppy, which increases injury risk," Robinson says. If you're cajoling your child into participating, it may be time to consider another sport or a less intense team.
  • Support coaches and referees who strictly enforce rules and penalties for illegal play. Ten percent of fractures are due to rule violations—and fractures keep kids on the sidelines more than any other injury.
  • Talk to your teen's trainer about including moves such as lunges, jumps and squats, which strengthen the muscles that reinforce and protect the knees.

Heading Off Concussions

Why young athletes are especially at risk for a devastating brain injury:

A decade ago a kid who was "dinged" or "had his bell rung" might be put back in the game 15 minutes later. "People didn't have the understanding that concussion is a serious brain injury," says Mark Halstead, M.D., of Washington University in St. Louis. Concussions result when a blow to the head causes the brain to rotate or slosh inside the skull, disrupting normal cell function. "Now we know that after just one concussion, it doesn't take as heavy a blow to cause the next," Dr. Halstead says. In fact, a second head injury on the heels of an unhealed earlier concussion can trigger severe swelling inside the skull. "It's rare, but about five kids a year die from this second impact," Dr. Halstead says. "It seems unique to players under 20." Even the kids who survive second-impact brain injuries can be neurologically devastated, says Thomas Pommering, D.O., division chief of Nationwide Children's Hospital Sports Medicine center. "The developing brain is more susceptible to damage," he says. Multiple concussions may also have additional cumulative, long-term effects, including depression and memory loss.

Players who suffer a head impact should seek medical attention immediately if they experience headache, nausea, confusion, dizziness, double vision, sensitivity to light, forgetfulness or trouble with balance. "Concussion isn't as obvious as, say, a knee injury, when the player hobbles off the field," Dr. Halstead says. "The player needs to tell someone he doesn't feel right." Healing requires both physical and mental rest—activities requiring concentration can make symptoms worse. "We recommend taking a few days off school, and avoiding standardized tests, driving and even video games," says Dr. Halstead. In most cases symptoms resolve within about 10 days.

A Dangerous Jolt

Energy drinks score high with young athletes enticed by promises of better performance, increased concentration and improved reaction time. But some of these beverages, containing up to 500mg of caffeine, may also cause dehydration, dizziness, sleeplessness and potentially dangerous heart palpitations. For sustained strength, encourage your child to fuel up naturally on protein and complex carbohydrates by eating a peanut butter sandwich on whole-wheat bread an hour before playing.

Fearless Females

Girls' injuries are different from boys'.

In soccer, basketball and softball—when girls and boys play by the same rules—girls have a higher rate of severe injuries like fractures and ligament sprains, and double the risk of concussion. Experts believe body differences are largely to blame, especially after puberty, when injury rates markedly diverge. Girls use their thigh muscles more than their hamstrings, rely on ligaments more than muscles to control joints and usually favor a dominant leg. "When girls land after a jump, their knees tend to rotate inward more than boys' do, which puts more pressure on the joint and supporting structures," says Dr. Pommering of Nationwide Children's Hospital. Girls also have weaker neck muscles than boys, which may make them less able to withstand a blow to the head.

"Post-puberty, girls start to match boys in height and weight but haven't developed the same burst of muscle to control their new bodies," says Dr. LaBella. They tend not to lift weights like boys do, which is why some coaches have started to add strength training—squats and lunges —to girls' workouts. Plus, females who strive to stay thin may be even more at risk of getting hurt. "Girls are especially likely to sustain stress fractures in sports where performance is partly judged on physical appearance, like gymnastics, diving or figure skating," says Dr. Pommering.

Indoor Threats

You wouldn't start a car engine in a closed garage, but that's essentially what happens when workers at ice rinks fire up diesel-fueled Zambonis and other resurfacing machines. Carbon monoxide is one hazard—even low-level emissions can cause headaches and nausea. Another concern is ultrafine particulate matter from combustion, which is linked to poor airway function in skating athletes," says Loren E. Wold, M.D., principal investigator at the Center for Cardiovascular and Pulmonary Research at Nationwide Children's Hospital. The best solution is to use safer electric resurfacing vehicles, he says.

Indoor pools may also cause breathing issues. Chlorine-related irritants can make inhaling difficult, according to the CDC. "Tight spaces concentrate chlorine, so small pools at schools are problematic," says Steven Teich, M.D., Clinical Associate Professor of Surgery at Ohio State University in Columbus. Ask the coach to open the windows to boost circulation.