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Children's Sports Injuries: The Price of Winning?

Extracurricular kids’ sports promote strength, confidence and teamwork.

They also send 3.5 million children to emergency departments and physician offices every year. Are parents pushing too hard, or are the risks overblown?

Bruce Summerville, MD, a board-certified orthopaedic surgeon with Northwestern Lake Forest Hospital and the team physician for Zion Benton and Waukegan Community high schools, brings some perspective to the issue.


Q: With so many kids’ sports injuries, are extracurricular sports less safe than we think?

A: Participation is much more widespread than it used to be, across all kinds of sports, so the overall number of injuries will be higher. But in that sense, kids’ sports are actually safer now because there are excellent guidelines for coaches and trainers.

Rising participation led organizations like The American Medical Society for Sports Medicine (AMSSM) to create very specific guidelines—like how many pitches a child can make, what age to start certain sports, or how long to postpone participation following an injury.

 

Q: The American Academy of Pediatrics (AAP) has publicly warned that overuse injuries among children are increasing. What do you think?

A: My experience is largely anecdotal from my own practice, but we are seeing an increase in overuse injuries. It’s due to a combination of factors: involvement at a younger age, greater intensity and competitiveness and more kids involved in multiple sports year-round.

An overuse injury unique to children is a stress fracture in the growth plate [an area of developing tissue at the end of long bones]. But this is soft tissue that generally heals without long-term damage. Other kids’ sports injuries can cause growth disturbances or deformities, but these are less common.

 

Q: Are parent’s attitudes about competition and winning fueling the rise in injuries?

A: Despite stories that you occasionally hear, most parents are reasonable and want what’s best for their child. They want to avoid injuries and risks to long-term health. But sometimes, it’s hard for them to say “no” to an injured or recovering child who really wants to play.

I consider myself the child’s advocate, and I’ll make a recommendation that takes the decision out of the parent’s and kid’s hands. If something happens that requires an adjustment to the child’s plans and participation, I’ll make myself the bad guy.

 

Q: Does football raise particular safety concerns, especially with practice starting at the hottest time of the year?

A: Football does have its own subculture, a “play against all odds” mentality. But responsible coaches try to minimize that attitude. And again, guidelines for kids’ sports provide clear information about things like ambient temperature, humidity, hydration, proper equipment and rest. Most high schools also require a physical in advance of the season.

The stories you occasionally hear about teen football-related deaths don’t relate to negligence or mistreatment during football practice. Thousands of kids practice football in August and do just fine.

 

Q: What can parents do to prevent injuries? Should they limit their kids’ sports activities?

A: Kids have become too sedentary, and we should keep encouraging them to remain active. But parents also need to use common sense, allow for some flexibility and not push too hard. They should be aware of the guidelines and tips from the AMSSM and AAP, which are thoughtfully considered and based on extensive clinical data.

Parents might also find it comforting to know that, at most games, I’m just standing on the sidelines. The vast majority of kids’ injuries are bruises and sprains that are handled by the trainer. Acute injuries that require orthopaedic care—broken bones, tears to soft tissues or twisted knees—are much less common. And, generally speaking, kids are pretty resilient.

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