Beyond Band-Aids: How to Handle Kids’ Sports Injuries

More than 2.6 million kids are treated in the emergency room each year for sports-related injuries.

Samantha Costa, U.S. News & World Report

Exercise helps kids feel well-rested, less stressed and more confident, improves learning in school and helps them maintain healthy weight, bones, muscles and joints. There’s one caveat: They can get hurt.

The Centers for Disease Control and Prevention report that more than 2.6 million children ages 19 and younger are treated in the emergency department each year for sports-related injuries.

“Sprains and strains are easy to treat because kids will heal,” says Dr. Thomas Pommering, division chief of pediatric sports medicine at Nationwide Children’s Hospital in Columbus, Ohio. “The more worrisome injuries are those in the growth plate because it might affect their growth or result in surgery.”

The lines between seasons are blurred now, he says, giving kids more opportunities to play. And with little downtime between sports comes a greater risk for repetitive injuries. The most common sports-related injuries include sprains or strains, growth plate injuries, repetitive motion injuries and heat-related illnesses. Here’s how to handle the scary injuries and keep your young athlete safe:

Strains and Sprains

Strains happen when a muscle is stretched too far and partially tears, says Dr. Chris Koutures, a pediatric and sports medicine specialist with a private practice in Anaheim Hills, California, who also works with the USA Volleyball Men’s and Women’s National Teams and California State Fullerton Intercollegiate Athletics.

Sprains are more serious and can involve the tearing of ligaments that connect two or more bones at a joint, he adds. They can take longer to heal – sometimes weeks – and even make you feel like a bone has been broken.

The American Academy of Pediatrics points out that the signs and symptoms of sprains in young children can mirror those of a fracture, including pain, swelling around the joint and the inability to walk, bear weight or use the joint. If your child is usually very active, red flags include a sudden limp, hesitation to throw a ball as he or she once did and signs of unusually limited activity.

How will you know if your child has one or the other? “A good physical exam will confirm whether it’s a sprain or strain,” Koutures says.

Either way, your doctor will encourage your child to follow the “RICE” rule:

• Rest. Stay off the injured body part for at least 48 hours to prevent further injury.
• Ice. Use a cold or ice pack on the injured area for 20 minutes at a time throughout the day. If kids aren’t getting any relief from the ice, it’s not necessary to use, Koutures says.
• Compression. Ask the primary care physician or orthopedic surgeon if wraps, air casts or special boots are preferred to decrease swelling.
• Elevation. Keep the injured body part elevated above the heart to decrease swelling and promote even circulation.

To bounce back from a sprain or strain, Koutures advises reducing activity below the level of pain, reducing abnormal motions and working on strengthening exercises to support the areas around the injury.

Growth Plate Injuries

Koutures says growth plate injuries usually take place at the end of long bones, such as: the hands and fingers, forearm, upper leg, lower leg and foot. They’re essential for children’s growth, “and they’re in place to let the bone grow longer or wider,” he says. By adolescence, the developing growth plate will be replaced by solid bone.

These types of injuries can occur after a sudden fall or from a repetitive overload of stress to the area. For instance, when a baseball is thrown, stress is put on the growth plate near the elbow. The same is the case for a gymnast’s radius or forearm area.

An orthopedic surgeon might recommend X-rays to determine if a cast or splint is needed. In severe cases where a growth plate injury is fractured or fragments are out of place, surgery may be required. However, the majority of growth plate injuries can be treated with rest, Koutures says.

Repetitive Motion Injuries

Repetitive motion injuries like hairline fractures of bones that have been exposed to repeated stress, or tendinitis – inflammation of a tendon – can be subtle, Koutures says. These types of injuries don’t always show up on X-rays, but they do cause enough discomfort to affect play. Maybe a child won’t run as fast, or his or her fastball isn’t as fast as normal. Kids might even develop a wild serve during tennis, he says.

That’s why it’s important to pay attention to young athletes’ ability to perform. If they haven’t told you they’re in pain, it might be because they want to stay in the game. “Kids aren’t trying to be deceptive, but they’re highly motivated to please their coaches, parents and authority figures, and they will push themselves to do that,” Pommering says.

Treatments for repetitive motion injuries are usually RICE, crutches, cast immobilization and physical therapy. One way to prevent repetitive injuries is by allowing kids to sample various sports from season to season, rather than focus on one sport year-round. Varying sports means using different muscle groups.

Heat-Related Illnesses

The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that heat-related illnesses, including dehydration, heat exhaustion and heat stroke, are among the most common sports injuries.

Where you live may determine how much heat risk you have. If you’re in the South, in a humid environment, your risk for heat illness is much higher, Pommering says. “If you play a sport where you have to wear a lot of external equipment, the risk is even higher.”

That’s why it’s important to find the proper clothing that wicks moisture away and cools athletes through evaporation, he says. Outdoor practices should be held in the morning or evening, when it’s less humid. Don’t restrict a child’s desire to drink water when he or she is thirsty. What’s more, Pommering says kids can sweat up to 1 liter per hour, and under higher heat or humidity conditions, they can sweat up to 2.5 liters each hour.

Although heat-related illnesses are often associated with warmer seasons or climates, Koutures says this sports-related issue is especially problematic with indoor sports. “Gymnasiums that aren’t well ventilated and heated can cause a kid to have a heat illness when it’s 20 degrees outside,” he says.

Signs of heat exhaustion include nausea, dizziness, weakness, headache, pale and moist skin, heavy perspiration, normal or low body temperature, a weak pulse, dilated pupils, disorientation and fainting spells. Heat stroke is more severe and includes headache, dizziness, confusion and hot, dry skin, which has the potential to cause circulation problems, coma and even death.

Kids Just Want to Have Fun

Although these injuries might seem scary, parents should remember that exercise is good for everyone – and shouldn’t hesitate to seek appropriate medical advice. “You’re never wasting my time,” Koutures says.

The rule of thumb is not to allow a child to practice more than their age in a given week. “For example, if you’re a 10-year-old, you shouldn’t be practicing more than 10 hours a week,” Pommering says, adding that free play – not deliberate practice time – should still be part of a child’s daily activity.

The older children are, the more time they’re likely to spend working toward their sport goals. Gymnasts, for example, can easily spend up to 18 to 20 hours in the gym each week, Pommering says. “That’s like a part-time job.”

It’s smart for those teens to take two days off so their bodies can recover both physically and mentally and they don’t get burned out, he adds.

“Research has shown that athletes who specialize in one sport early – or before middle school – have more of a chance to drop out and burn out, and less of a chance to become an elite athlete,” Pommering says.

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