Sports Injury Prevention: It’s Not Whether You Win or Lose Dr Jagannatha D Consultant orthopedic surgeon Trauma & sports medicine specialist

Background Millions of children participate daily in sports activities Children learn to improve: Physical fitness Coordination Team play There is a risk of injury just by participating This slide is the standard background that will be on all slides unless otherwise noted

Problems with Surveillance Difficult to track injuries All injuries don’t get reported Best data from team physicians and trainers No standard method of reporting May report by Body part injured Amount of time a player missed practice or a game Type of injury sustained

Magnitude of the Problem 3.5 million sports injuries for children < 15 years of age treated in medical settings ¼ of all Emergency Department visits For children involved in organized sports 770,000 physician visits 90,000 hospitalizations / year 70-80% injuries are minor (< 1 wk of practice missed) 60% occur during practice

Injury Mechanisms < 10 years of age Pubertal child Often injured during individual recreational activities Usually within the first week of the activity Examples = bike riding, roller skating, sledding Pubertal child Greater weights, greater force = more severe collision Usually occur during organized sporting events Examples = Football, Wrestling, Basketball

Sports Causing Significant Injuries at High School & Intercollegiate Level Football Wrestling Gymnastics Basket ball Hockey

Types of Injuries Acute vs. Chronic Both types usually involve muscle & bone Acute Result from a collision or sudden twist Examples = Sprains/Strains, Contusions, Fractures Chronic / Overuse Repetitive, small injuries due to repeat motions Increased today as children strive for excellence at younger ages Examples = Pitching a baseball, Running cross country

Body Parts Injured May Vary By Sport Played Some sports emphasize different body parts Lower extremity = soccer, basketball Upper extremity = tennis, baseball Equipment Used Projectiles may cause ocular injury Examples = baseball, tennis

Body Parts Injured May Vary By (Continued) Age Younger children often injure upper extremity Older children usually injure lower extremity Sex Some sports injure one sex differently than an another Females tend to have more knee injuries in basketball than males In general, shoulder more male, knee/ankle more female

Catastrophic Injuries Injuries that result in permanent, severe neurologic disability Direct Catastrophic Injury Trauma from active participation in sport Example = Football, Ice Hockey Indirect Result from overexertion while playing a sport Causes – Dehydration or sudden cardiac death

Preventing Sports Injuries Field / Equipment Changes Rule Changes / Coaching Individual Preparation

Field/Equipment Changes Add equipment as injuries become evident Examples Helmets & Face Masks in youth hockey Chin protector in Little League Baseball Field modifications to prevent injuries Avoid potholes, grates, rocks near field Change field as injuries seen Example = Anchoring soccer goals

Proper equipments

Rule Changes/Coaching Rule changes to adjust for injury patterns Example = “spearing” in football Officials must enforce the established rules Coaches Teach the appropriate techniques Encourage discipline in preparation (stretching, etc)

Individual Preparation Prior to Participation Learn about the game prior to signing up Is this sport appropriate for your child? Does your child wish to participate? Who will be supervising practices/games? Purchase the recommended equipment Pre-participation physical exam Preseason conditioning

Individual Preparation At Participation Practice within your limits Stay well-hydrated Know and follow the rules of the game If injured Seek medical attention prior to returning to play Adequate rehabilitation is essential

FRACTURES A fracture is a break or crack in the continuity of the bone. SYMPTOMS: Pain at or near fractured site Tenderness on gentle pressure Swelling over the fracture site Deformity e.g. irregularity of bone, angulation or rotation of limb, depression of bone etc. Loss of power Signs and symptoms of shock

DISLOCATIONS SYMPTOMS: Pain at the site of injury A dislocation is the displacement of one or more bones at a joint. It usually occurs in the shoulders, elbow, thumb, fingers and the lower jaw. SYMPTOMS: Pain at the site of injury Limited movement at joint Deformity Swelling Tenderness

FRACTURES AND DISLOCATIONS TREATMENT: Support and immobilize the injured limb Use a splint (if possible) in order to prevent movement of the injured part Arrange for casualty to be removed to hospital In doubtful cases, always treat as for a fracture Do not attempt to replace the bones

STRAINS SYMPTOMS: Localised pain Stiffness Inflammation Bruising A strain is an injury to a muscle in which the Muscle fibres tear as a result of overstretching. (Sprain – to a ligament) SYMPTOMS: Localised pain Stiffness Inflammation Bruising

SPRAINS SYMPTOMS: Pain at site of of injury A sprain occurs at a joint where there is tearing or over-stretching of the ligaments and tissues. SYMPTOMS: Pain at site of of injury Swelling and later bruising Pain on movement Loss of function

SPRAINS TREATMENT: Support the joint in most comfortable position P.R.I.C.E. (Protect, Rest, Ice, Compression, Elevation) treatment When a sprained ankle occurs outdoors, do not remove the shoe If unsure whether there is a fracture, always assume it is one

Summary All sports pose a risk of injury Research the interested sport prior to participation Know the rules, equipment needed, and who will supervise / coach your child Seek a pre-participation physical exam Have fun and play hard