Play it safe: Your guide to kids' sports injuries

Washington PostAugust 12, 2013 

More than 38 million children and teens play sports in the United States each year, according to Safe Kids Worldwide, and it’s taking a toll.

About 1 in 3 kids playing team sports is injured seriously enough to miss practice or a game. Those who play multiple sports that put pressure on the same body part are at an increased risk for injury.

Here’s what experts say about some common sports risks for children and how to recognize, prevent and treat them.

Concussion

Causes: A blow to the head or a hit to the body that causes the head to jerk back quickly can result in a concussion. Gerard Gioia, chief of neuropsychology at Children’s National Medical Center in Washington, said it’s like an injury to the brain’s software system.

Signs and symptoms: If a child appears confused or stunned, she might have a concussion, Gioia said. Symptoms also include headache, a feeling of pressure in the head, dizziness, blurred vision or feeling like your head is foggy.

“When they raise those questions or symptoms, then we invoke the rule: ‘When in doubt, sit them out,’ ” Gioia said. “Remove the youngster from playing, let the parent know, and seek medical attention immediately.”

Gioia and his colleagues have developed a smartphone app called Concussion Recognition and Response to help coaches and parents evaluate athletes after a blow to the head.

Treatment: If the child’s headache gets worse or she is not responding to questions, has trouble recognizing people, has slurred speech or loses consciousness, go to the emergency room immediately, Gioia said. If the child is coherent but having some symptoms, call your pediatrician.

There is no set treatment for concussions that will fit all children, Gioia said, but parents and coaches should manage the child’s activity level to give the brain time to heal. After a concussion, a child needs rest from physical and mental activities, and a gradual return to normal, as long as it doesn’t aggravate symptoms. If something does make symptoms worse, stop that activity.

“You have to figure out that sweet spot of how much activity you can tolerate without worsening your symptoms,” Gioia said. “That’s where careful management comes in.”

Prevention: Gioia said parents should advocate with coaches and youth sports organizations to follow safe procedures. Many youth sports have altered their policies to increase safety, Gioia said. Teach your child that it is not a matter of winning at all costs and that safety should be the top priority.

Heat illness

Causes: Extreme temperatures, particularly when combined with high humidity or intense sunlight, can interfere with the body’s normal ways of regulating temperature, said pediatrician Stephen Rice, an expert on the subject.

Signs and symptoms: Children who are getting overheated might look flushed or feel lightheaded. Heat illness can also cause dry mouth, fatigue, a decrease in performance or attention span and excessive sweatiness, Rice said. When humidity is high, sweat can’t evaporate, which keeps the body from cooling.

Treatment: Get the child to the shade, Rice said. Coaches should be prepared to cool someone down rapidly if necessary, including having cold, wet towels and washcloths and ice packs to apply to the child’s neck, armpits and groin. Start the cooling process immediately, Rice said, even if you are calling 911. Don’t wait for medical help to arrive.

Prevention: Drink plenty of water before and stay hydrated during physical activity. Children ages 9 to 12 should drink 3 to 8 ounces of water every 20 minutes. Adolescents should drink 34 to 50 ounces of water an hour while they are exercising in the heat.

Orthopedic injury

Causes: Sprains, strains, growth-plate fractures (damage to areas of cartilage near the ends of developing bones), tendinitis and other injuries to bones, ligaments and joints can be caused by falls, but also by overtraining in one sport, not stretching properly and not giving the body time to rest between workouts.

“Kids are getting more over-specialized at an earlier age,” said Laurel Blakemore, head of orthopedics at Children’s National Medical Center. “Specializing in one sport at too young an age can lead to injuries, along with burnout.”

Jon Almquist, who recently retired as the athletic training program coordinator for Fairfax County Public Schools in Virginia, agreed.

“Let the kid play sports to have fun playing sports instead of to boost the parent’s ego,” Almquist said. “Let them play different sports.”

Signs and symptoms: Swelling, limping, bruising and pain that is aggravated by activity are all signs of possible injury.

Treatment: Most orthopedic injuries are treated successfully with rest, ice, compression, elevation, anti-inflammatory medication or physical therapy, Blakemore said. The child might have to wear a brace, boot or cast while the injury heals. Occasionally, with a fracture or torn ligament, surgery is necessary.

Prevention: Proper training – including stretching, varying workouts and starting slow at the beginning of the season – is key to preventing many orthopedic injuries, Blakemore said.

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