Athletic activity in youth offers many benefits, including the development of fitness, motor skills and social skills, as well as learning structure and teamwork, and fostering a lifelong appreciation for physical activity. With all sports, there is some inherent risk involved, but by understanding factors which are known to increase injury and by following certain guidelines, the injury risk can be minimized and enjoyment maximized. As a sports medicine specialist who happens to be an athlete and a parent of an athlete, my goal in this article is to help educate parents, grandparents, coaches and athletes about making sports a bit safer while encouraging healthy participation and maximum performance.

The scope of the problem

Statistics from 2018 showed that in youth ages 5 to 18 there were 1.35 million ER visits for sports-related injuries per year. Too often today’s youth sports often involve relentless scheduling and intense pressure including year-round scheduling, early single sports specialization and private coaching. Seventy percent of kids drop out of youth sports by age 13, often related to burnout.

Types of injuries

Acute sports injuries are caused by a sudden trauma, such as a fall, collision or twisting event. Common acute injuries include sprains (ligament injuries), strains (muscle and tendon injuries), fractures (broken bones) and cuts or bruises. Most acute injuries should be evaluated by a doctor, but immediate first aid at the scene may include the RICE method: Rest, Ice, Compression and Elevation. Prompt early treatment will limit discomfort and prevent further injury.

Overuse injuries occur gradually over time, such as when an athletic activity is repeated so often that parts of the body do not have enough time to heal or recover. Examples of overuse injuries include throwing injuries in the elbow, tendinitis, shin splints and even stress fractures. Many sports overuse injuries in young athletes – particularly elbow and knee injuries – are caused by excessive, repetitive stress on immature muscle-bone units. Repetitive injury may turn into overuse conditions, which can sideline an athlete for extended periods of time.

An unfortunate development in recent years is that we sports medicine doctors are now seeing an increase in overuse injuries because many young athletes are focusing on just one sport at early ages and are training year-round.

The American Academy of Orthopaedic Surgeons has partnered with the American Orthopaedic Society for Sports Medicine and the National Athletic Trainers Association in a campaign called STOP Sports Injuries. This program aims to educate parents, coaches and athletes about how to prevent overuse injuries.

To reduce the risk of injury:

• Take time off.

Do not allow your child to play one sport year round. Plan to have at least one day off per week and at least three or four weeks off per year from training for a particular sport, to allow the body to recover. Taking regular breaks and playing other sports allows use of various muscle groups, thus limiting injury risk and aiding skill development.

• Limit the number of teams.

Kids who play on more than one team per season are at especially high risk of injury. One sport per one season should be the rule.

• Wear the right gear.

Players should wear proper and appropriately fit protective equipment such as helmets, mouth and face guards, pads, protective cups and eyewear, depending on their sport.

• Strengthen muscles.

Conditioning exercises and cross-training provides ideal muscle development and joint support and has been shown especially to prevent knee injuries. Although there is no minimum age for youth participation in a strength-training program, children should have the emotional maturity to follow directions and to appreciate safety concerns.

• Incorporate proper warmup and flexibility.

Dynamic warmup before and stretching exercises after games and practice can decrease strain injuries and improve flexibility.

• Use the proper technique and follow safety rules.

Proper form should always be reinforced, and if fatigue compromises technique then the activity should be stopped.

By following an injury prevention “game plan” we can avoid an array of largely preventable overuse and sports injuries. Remember that the benefits of sports participation far outweigh the risks when basic rules are respected. The major goal should be enjoyable participation and fun.

Diane Hillard-Sembell, M.D., of Springfield Clinic Orthopedic Group and Springfield Clinic Sports Medicine, is a board-certified orthopaedic surgeon, with additional board certification in sports medicine, and specializes in knee surgery and sports medicine.