Sports Injury Prevention: It’s Not Whether You Win or Lose Michael A. Gittelman, MD Assistant Professor, Division of Emergency Medicine Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio

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

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

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

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

Resources/Links Widome MD, ed. American Academy of Pediatric’s Committee on Injury and Poison Prevention. Sports safety. In: Injury Prevention and Control for Children and Youth, 3rded. 1997. American Academy of Pediatrics Rice SG. Risks of injury during sports participation. In: Sullivan JA, Anderson SJ, ed. Care of The Young Athlete. 2000. American Academy of Orthopedic Surgeons & American Academy of Pediatrics www.hooah4health.com www.aaos.org