Participation in sports definitely develops strong bodies, but it also builds strong minds, discipline, character and sportsmanship. Parents love to watch and coach their kids, but they can also experience a great deal of anxiety about potential injuries as they cheer from the sidelines. Understanding the risks of athletic engagement as well as some prevention tips can help alleviate those worries. Knowing what to do to help kids if they have sports injuries is an important part of being a sports mom or dad as well.
Ages and stages: Children, especially those under 8 years old, have slower reaction times than adults, simply due to development. They also may be faced with team members and opponents who vary greatly in size although they are the same age. As kids grow and mature and are physically larger, the risk for injury increases. The amount of force applied by a 75 pound pre-teen tackle is not nearly as much as a 200 pound high school senior tackle. Kids also do not have the same judgment that an adult would when faced with physical risk, and they tend to overestimate their abilities and ignore injuries in favor of continued play. In short, kids need adult input in sports to stay safe.
Coaches: In activities involving younger children, parents often serve as coaches and may have far less experience in establishing safe practices than a certified athletics teacher would have. Find out if the coach is CPR certified and ask meaningful questions about how they approach safety and readiness for participation as well as coaching experience. Ask how the coach identifies an injured player and how he/she approaches return to play.
Equipment: Coaches should communicate to parents the appropriate equipment required for a sport. Though it may be tempting to use an older sibling’s retired cleats or helmet, it truly is better to start fresh to ensure good fit and that there is not so much wear and tear with equipment that it fails to protect the child. Before purchasing a piece of equipment, look closely to ensure it is certified by a safety organization, which means it meets national standards for safety prevention. Also consider things such as shatterproof glasses for kids who don’t wear contacts.
Preparation: Though coaches review rules and expectations of a game, parents can help reinforce those concepts so that kids thoroughly understand the flow of play. This understanding can help reduce anxiety of “not knowing what to do” during play, which means a more confident player who makes appropriate decisions while engaged in play. Monitor practices for organized warming up and cooling down, including stretching and mental preparation for play. Ensure kids have access to hydration before and throughout practice and games.
Acute injuries: These are injuries that occur at an easily identified moment during play such as a sprained ankle, broken finger, or concussion. When adults recognize signs that a child may be injured, it is important that the adults stop play and evaluate the child, even if the child is resistant to being evaluated. Such signs include limping, compensating for a hurt upper extremity by trying to use the opposite one instead when it isn’t natural to do so, or appearing to have difficulty concentrating in the game or practice after impact involving the head and neck. Eyes are commonly injured during sports, though they are not thought of as typical sports injuries, so watch for kids keeping an eye closed or rubbing the eye as clues.
For most acute injuries of extremities, the thing to remember is RICE: rest, ice, compression and elevation. Immediately remove the child from play to rest. Apply ice for 10 to 15 minutes, possibly using a towel between ice and skin to prevent the area from becoming too cold. Use a compressive bandage to keep swelling at bay, but evaluate fingers and toes to make sure the bandage isn’t too tight—digits should not be red or purple while a bandage is in place. Elevating the affected limb to the level of the heart or higher can help swelling resolve by using gravity to return the fluid back to the heart.
Concussion requires special mention. At any point in practice or play that a concussion is suspected, play must stop and evaluation of the player must occur. Parents should advocate for players to be evaluated if concussion is suspected and play does not stop. The player should immediately be removed from activity and no return should be allowed until appropriately evaluated and cleared. This may involve a very detailed plan created by a medical professional including approaching schoolwork and homework differently while the brain heals. Just as an injured arm or leg needs rest to heal, so does the brain. Healing from concussion takes a great deal of effort from parents, educators, and coaches. Being patient and restricting activity will reduce the chance of any permanent brain damage, which can occur if a player continues to play and continues to sustain further concussive injuries.
As long as there is an effect on the function of a body part due to injury, the child should not participate in sports. That means a child who is limping should not rejoin teammates until the limp is resolved. A child who cannot fully extend or flex fingers should not play. When a prior injury is made worse by a re-injury sustained when a player engages in activity earlier than recommended, the recovery is often much longer than two separate single injuries. It may be heartbreaking to “miss the big game,” but the short term investment in healing pays off in the long run. Playing with an injury also increases the likelihood of injuring a different body part because the athlete is compensating for the original injury.
Overuse injuries: These are injuries that don’t have an identifiable event that causes them, but rather are noticed slowly over time. They are caused by a limited motion that is repeated over and over again, such as pitching or swinging a tennis racquet or golf club. Because kids are still growing, these are particularly problematic as they can affect bone growth if not addressed. No child should play sports with chronic pain, and the child’s pediatrician may recommend an orthopedic physician or sports medicine specialist for complete evaluation. Many high school teams have athletic trainers who can assist in physical therapy exercises to return painless function to the athlete, but a trip to a specialist may be necessary as well. Knees, shoulders, elbows, and shin splints are common sites of overuse injuries, and so is chronic low back pain. No chronic pain should be ignored as being normal for an athlete. Once healing is complete for an athlete with an overuse injury, special care may need to be taken to retrain technique to prevent repeating the same injury.
The benefits of athleticism in youth are quite rewarding, and for most players, injuries are few and far between. Observing safety guidelines and ensuring proper healing when injuries occur can mean the difference between being sidelined and having a satisfying experience as an athlete. Carrying athletic participation into adulthood is a fantastic way to ensure a healthy child blossoms into a healthy adult.
Meet the Author:
Dr. Kristi Whitenton is a graduate of the University of North Texas Health Science Center in Fort Worth, followed by general pediatrics residency at the University of Texas Health Science Center at San Antonio. After two years of additional training in pediatric critical care, she became a medical director for Little Spurs Pediatric Urgent Care in San Antonio. In August 2014, she joined Urgent Care for Kids as the medical director for the Austin area. She is a fellow of the American Academy of Pediatrics and has a son attending Southern Methodist University in Dallas. In her spare time, she enjoys running, baking, and supporting the visual and performing arts.