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Children Are Still Growing

The young athlete is not a smaller version of an adult. Children's bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. In addition, there are significant differences in coordination, strength, and stamina between children and adults.

Children Vary in Size and Maturity

Young athletes of the same age can differ greatly in size and physical maturity.

• Grade school students are less likely to experience severe injuries during athletic activities because they are smaller and slower than older athletes.
• High school athletes, however, are bigger, faster, stronger, and capable of delivering tremendous forces in contact sports.

Children Can Injure Growth Plates

Growth plates are the areas of developing cartilage at the ends of long bones where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete. Growth plate injuries have the potential to disrupt the normal growth of bone.

Acute Injuries

Acute sports injuries are caused by a sudden trauma, such as a twist, fall, or collision. Common acute injuries include:

• Broken bones
• Sprains (ligament injuries)
• Strains (muscle and tendon injuries)
• Cuts or bruises

Most acute injuries should be evaluated by a doctor. Prompt first aid treatment should be provided by coaches and parents when the injury occurs. This usually consists of the RICE method:

• Rest. Avoid activities that involve the affected body part for the first few days after the injury.
• Ice. Apply ice immediately after the injury to keep the swelling down. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly on the skin; use an ice pack or place a cloth between the ice and bare skin.
• Compression. To prevent additional swelling, lightly wrap the area in a soft bandage.
• Elevation. As often as possible, rest with the injured arm, hand, leg, or foot raised up higher than the heart.

This usually limits discomfort and reduces healing time. Proper first aid will minimize swelling and help the doctor establish an accurate diagnosis.

Overuse Injuries

Overuse injuries occur gradually over time, when an athletic activity is repeated so often that parts of the body do not have enough time to heal between playing. Examples of overuse injuries include:

• Achilles tendinitis
• Osgood-Schlatter disease (knee pain)
• Jumper's knee
• Sever's disease
• Shin splints
• Stress fractures
• Throwing injuries in the elbow

Coaches may have more difficulty spotting less severe problems, however, because the pain is mild and the athlete often ignores it. Repeat injuries may turn into overuse conditions, which can put the athlete on the sidelines for the rest of the season.

To keep athletes in the game long-term, overuse injuries need to be diagnosed and treated by a physician as soon as possible. Parents and coaches should be aware of the more common signs of overuse injury. These include:

• Pain that increases with activity
• Swelling
• Changes in form or technique
• Decreased interest in practice

In the growing athlete's musculoskeletal system, pain from repetitive motion may appear somewhere besides the actual site of the injury. For instance, a knee ache in a child or adolescent may actually be pain caused by an injury to the hip.

Whether an injury is acute or due to overuse, a child who develops a symptom that persists or that affects their athletic performance should be examined by a doctor. A child should never be instructed or allowed to "work through the pain."

Concussion

Concussions can occur in contact and non-contact sports with:

•  A direct force to the head (e.g., helmet-to-helmet contact during football, or "heading" a soccer ball)
• A sudden, forced deceleration or direction change

Many concussions are not associated with a loss of consciousness. Common symptoms include headache, difficulty focusing, light sensitivity, fatigue, balance difficulty, and nausea.

After a concussion, the child should not practice or play until they are cleared to return to play by a health professional. A second head impact during the recovery phase from a prior concussion can put athletes at risk for serious neurological consequences.

Most people will be fully recovered by 10 days after a concussion, but some may recover sooner. Once symptoms resolve, the athlete can begin a gradual, guided progression of sports activity as long as they don’t experience symptoms with the progression. Helpful tips to resolve a concussion — aside from time alone — are to avoid bright screens, get plenty of sleep, and avoid activities that require significant mental focus or physical exertion.

Historically, concussions were not thought to be serious injuries (e.g., “they had their bell rung.”)  But, in fact, concussions are significant injuries to the brain and require careful attention to prevent serious consequences. Any youth athlete with significant impact to the head and neck should be evaluated for concussion by an orthopaedic specialist.

Learn more: Sports Concussion

Proper Training

Young athletes need proper training for sports. They should be encouraged to train for the sport rather than expecting the sport itself to get them in shape.

Young athletes also should follow a regular conditioning program (in conjunction with their coach) with incorporated exercises designed specifically for their chosen sport. In addition, a well-structured, closely supervised weight-training regimen may help youngsters prepare for athletic activities.

STOP Sports Injuries

Many sports injuries in young athletes — particularly elbow and knee injuries — are caused by excessive, repetitive stress on immature muscle-tendon-bone units. Doctors are seeing an increase in overuse injuries because many young athletes are focusing on just one sport and are training year-round. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:

• Limit the number of teams on which your child plays in one season. Kids who play on more than one team are especially at risk for overuse injuries.
• Do not allow your child to play one sport year-round — taking regular breaks and playing other sports is essential to skill development and injury prevention.

Atmosphere of Healthy Competition

Coaches and parents are also responsible for creating an atmosphere that promotes teamwork and sportsmanship.

Youth sports should always be fun. The "win at all costs" attitude of many parents, coaches, professional athletes, and peers can lead to injuries. A young athlete striving to meet the unrealistic expectations of others may ignore warning signs of injury and continue to play with pain.

Young athletes must learn to deal with success and defeat to place events in a proper perspective. The promotion of the "win at all costs" ethic can have both short-term and long-term harmful effects on impressionable young athletes.

Female Athletes

Sports and exercise are healthy activities for girls and women of all ages. The participation of girls and young women in sports has increased significantly since the passage of Title IX. Occasionally, a female athlete who focuses on being thin or lightweight may eat too little or exercise too much. Doing this can cause long-term health damage.

Three interrelated illnesses may develop when a girl or young woman goes to extremes in dieting or exercise. Together, these conditions are known as the "female athlete triad."

The three conditions are:

• Disordered eating
• Menstrual dysfunction
• Premature osteoporosis (low bone density for age)

Treatment for female athlete triad often requires help from a team of medical professionals, including your doctor, your athletic trainer, a nutritionist, and a psychological counselor.

More recently, concern for energy deficiency leading to poor training and risk for stress fractures has been expanding beyond the female sex to include REDS (relative energy deficiency syndrome). REDS can be experienced athletes of all genders — especially endurance athletes with high energy demands due to high energy expenditure during sport.

Steroid Use

Many young athletes — boys and girls — use illegal anabolic steroids to improve their athletic performance. Steroids have been shown to increase muscle mass, but they can cause serious and potentially life-threatening complications and should be avoided. Most steroids are illegal and are banned by sports organizations.

Learn more: The Risks of Using Performance-Enhancing Drugs in Sports

Sports Supplements

Many athletes of all ages take sports supplements, such as creatine, because they think it will increase strength and improve sports performance.

The U.S. Food and Drug Administration does not regulate nutritional supplements. This means that the supplement products available in stores may vary in amount and quality, and there is no guarantee of safety or purity.

There is also not enough research on the long-term health effects of taking sports supplements, especially in adolescents and children who are still growing.

No matter what your age or health condition, always see your doctor for advice before taking nutritional supplements.