Sports Injury Prevention: Sports Injury Prevention: It’s Not Whether You Win It’s Not Whether You Win

or Loseor Lose

Michael A. Gittelman, MDAssistant Professor, Division of Emergency Medicine

Cincinnati Children’s Hospital Medical CenterCincinnati, 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

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– 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