Dynamic Chiropractic – August 26, 2009, Vol. 27, Issue 18

Sports-Related Injuries in Children: What Parents Need to Know

By Claudia Anrig, DC

Almost 75 percent of families with children between the ages of 5 and 18 have at least one child who plays organized sports, either at school or on a community team. This may seem like a good thing; after all, there's the benefits of learning to work together as a team, building camaraderie and consistent physical activity.

However, parents need to pay special attention to the potential injuries that can occur at any time and proactively involve you, their chiropractor, as a part of their child's health care team. You may need to become more actively involved by teaching preventative techniques to young athletes and incorporating extremity adjusting, stretching and rehab and nutrition to maximize their performance and recovery if an injury occurs.

Inside the Numbers

It is estimated that 3.5 million children under the age of 14 receive medical treatment for sports injuries each year and that almost one-third of all injuries incurred during childhood are related to sports activities, with the most common injuries being strains and sprains. Here are the estimated number of children injured each year by sport:

  • Football: 350,000+
  • Basketball: 300,000+
  • Soccer: 140,000+
  • Baseball: 120,000+
  • Swimming: 43,000+
  • Wrestling: 33,500+
  • Gymnastics: 26,500+
  • Hockey: 21,000+
  • Track and Field: 17,000+

In addition to the health consequences, the financial costs for treating injuries are estimated to be between $3 billion and $4 billion a year. In addition, the impact of childhood sports injuries on the number of school days missed can be significant. The Institute for Preventative Sports Medicine estimates that each year, there are almost 212 million school days missed by students due to musculoskeletal injuries, the vast majority of which are sports-related injuries.

Concussions: The Silent Injury

The U.S. Centers for Disease Control and Prevention estimates that 300,000 children and adolescents suffer from sports-related concussions each year. Many of these children will recover within just a few weeks, but research is proving that this "silent injury" can have long-lasting effects that are easy to miss at the time of the injury. Symptoms such as memory problems, chronic headaches, difficulty concentrating and even depression can manifest for months and even years after a serious concussion. Many doctors and parents have also noticed abrupt personality changes following a serious sports-related head injury.

Worse yet are the young athletes who get up, "shake it off" and continue playing after an impact on the field. Warning signs are silenced by adrenaline or endorphins, and since only about 5 percent of injuries that cause a concussion will actually "knock out" the athlete, they don't realize that they've been seriously injured. Failing to get proper medical attention following a head injury can have disastrous consequences; while rare, a concussion can even result in death. And don't think football is the only sport that results in concussions: Any child involved in basketball, soccer, hockey or any sport that puts them in close proximity with their opponent(s) and/or teammates is susceptible to this dangerous brain injury.

Repetitive Stress Syndrome

Sports that require children to move one arm or leg repetitively over long periods of time (baseball and tennis are good examples) can actually cause repetitive stress syndrome (RSS) to their still-developing spine and extremities. The body was designed to move symmetrically. When we walk, we tend to swing both arms rhythmically as our legs move in counter-motion to our arms. This develops muscle tone evenly and keeps the spine in proper alignment. However, many sports require participants to use their dominant arm or leg repeatedly, discouraging symmetry in their body movements.

Preventing RSS may be as simple as encouraging parents and their child athletes to ensure they are using both arms and both legs equally while playing their chosen sport. If their sport is inclined to have asymmetry, children should be encouraged to perform warm-up and warm-down symmetrical activities to provide as much balance to the body as possible.

Teach Children to Listen to Pain Signals

Athletes, whether professional or in grade school, place a tremendous amount of stress on their bodies. The running, jumping, tackling and falling that is a fairly frequent part of many competitive sports tend to result in sprains, strains and chronic injuries. These injuries can sideline an athlete and cause considerable pain, typically for only days, but sometimes for months.

The concept of pain should be taught to children as an important warning signal from the body that something is wrong and should be checked out. Taking prescription or over-the-counter pain relievers effectively masks the warning signal, which means children will tend to overextend themselves, resulting in a worsening of the underlying problem. This is why forward-thinking coaches, athletes and doctors (and parents) have come to realize that painkillers are not the answer. We need to teach parents and their children that painkillers merely cover up the pain and deceive the athlete into believing they can do more than they actually should.

Our Role as Chiropractors

Whether providing prevention education, structural adjustments or ancillary care, we have a role to play with young athletes. We typically take more time to assess the injury site than other health care providers, provide appropriate care, and most importantly, recommend or teach how to prevent future injuries. We can also provide extremity adjusting, stretching and rehabilitation, and even recommend nutritional protocols to assist in performance and injury recovery.

The larger role we can play involves developing a schedule of care for children that's not pain- or relief-based only. Children will definitely benefit from regular spinal and extremity examinations and screenings. Rather than waiting for an injury to be in a state of pain and instability, you can help the young athlete practice the ideal prevention model by introducing them to early intervention strategies.


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