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
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