Participation in organized sports in the United States has grown greatly in the past years. More than 38 million children and adolescents are involved in sports, and even more participate in informal recreational activities. With this increase in participation, comes an increase in the number of injuries sustained. In fact, sports injuries are the second leading cause of emergency room visits for children and adolescents, and the second leading cause of injuries in schools. According to the Centers for Disease Control (CDC), more than 3 million youth are treated in emergency departments each year for sports and recreation-related injuries. An additional 5 million youth are seen by primary care physicians or sports medicine clinics. Typical injuries include sprains and strains, growth plate injuries, overuse injuries such as stress fractures and tendinitis (inflammation of a tendon), and heat-related injuries. In team sports, 62 percent of injuries occur during practice, not during the game.

RICE

Luckily, most of these types of injuries can be treated with basic first aid and RICE:

Rest

• Avoid using injured area until seen by a physician (if necessary)
• Use crutches if walking with a limp

Ice

• Apply ice to the injured area to decrease pain and swelling for the first 48 – 72 hours after the injury
• Apply ice 15-20 minutes at a time (crushed/cubed ice or frozen peas/corn work best)
• Never sleep with ice on the injured area

Compression

• Use elastic wrap or a compression sock to reduce swelling, beginning below the injured area and wrapping upward, leaving toes/fingers exposed
• Check for numbness, discoloration, or temperature changes, and loosen wrap if needed

Elevate

• Use gravity to control swelling, keeping the injured area higher than the heart

Concussions

Concussions are a more severe injury and one of particular concern. Concussions are a type of traumatic brain injury (TBI) caused by a blow or jolt to the head and are the most common type of brain injury sustained in sports. It is estimated that between 1.3 and 3.8 million sports- and recreation-related concussions occur in the United States each year. This accounts for 21% of all traumatic brain injuries among children. For children and youth ages 5 to 18, the five leading sports or recreational activities which account for concussions include bicycling, basketball, playground activities, soccer, and football. Tackle football is of particular concern, as a new study found that youth athletes competing in tackle football had 15 times more head impacts than those who played flag football. As a result, non-contact (flag) football is recommended as a safer alternative for youth ages 14 and below.

A bump to the head should never be ignored. Concussions cannot always be seen and do not always lead to unconsciousness. More than 90% of sports-related concussions occur without the loss of consciousness. If your child hits their head while playing sports (s)he should tell a coach or teammate and immediately be taken out of the game to evaluate for a concussion. If needed, medical treatment should be sought.

Symptoms of a concussion:

• nausea (feeling that you might vomit)
• dizziness or balance problems
• double or fuzzy vision
• sensitivity to light or noise
• headache
• feeling sluggish or tired
• feeling foggy or groggy
• confusion
• trouble concentrating

You and your child should pay attention to any physical changes and problems with thinking. Be aware that symptoms can begin to show up immediately or may take a few weeks to appear. The symptoms of a concussion generally begin to decrease in a few weeks or months, depending on the severity of the concussion. Children should get plenty of rest and should not resume sports activities until evaluated by a qualified health care professional. Play should only resume once a child is completely free of all symptoms of a concussion and remains symptom-free during and after physical testing.

For more information on concussions and other brain injuries, contact the Brain Injury Association of America.

Evaluating Youth Sports Programs

The National Youth Sports Safety Foundation Inc. (NYSSF) addresses key safety issues regarding sports activities. This national non-profit, educational organization is dedicated to reducing the number and severity of injuries youth sustain in sports and fitness activities, When considering enrolling your child in a youth sports program, whether in school or out, they recommend looking into the safety of the program. The following list of questions should be asked to guide you in determining the level of safety in a program your child is interested in.

• Are the coaches certified in sports first aid, CPR, and AED?
• Are the coaches certified by either the national governing body of their sport or another organization such as American Red Cross Sports Safety Training Program, National Youth Sports Coaches Association, American Sport Education Program, National Athletic Trainers’ Association Sports Safety for Youth Coaches, National Center for Sports Safety (PREPARE), or National Federation of State High School Associations?
• Do coaches undergo background checks before they are hired?
• Does the coach have a written emergency plan in case of an accident, and has it been rehearsed?
• Is there a first-aid box and ice at the site of all practices and games?
• Does the coach have the players do warm-ups, stretching, and cool-down exercises?
• Are conditioning programs provided before signups so the children know before they go out for a team what is to be expected of them physically?
• Is there a requirement for pre-participation physical exams for sports activities?
• Do facilities get checked for safety on a regular basis?
• Is safety equipment available or required?
  • If yes: Does it fit properly? Does it meet national standards? Is it in good condition?
• Does the team have a preseason meeting for parents outlining the program philosophy and safety procedures?
• Is there a sports parent code of conduct?

If the program you and your child are interested in does not meet some of these criteria, bring these points up to the organization or coach for discussion. Consider organizing with other parents to help facilitate making changes that will make the program safer. Remind children to follow rules, which are designed not only to promote safety, but also sportsmanship.

To promote safety among all children, even those not involved in formal sports, you can check sports fields and playgrounds in your community for hazards. Look for things such as broken glass, rocks, debris, potholes, and movable soccer goals which are not secured, as they may tip over when climbed on, leading to injuries. Also, remind children to wear a sunscreen with a SPF of 15 or higher whenever playing outside, and to drink plenty of water to remain hydrated. Children can lose up to a quart of sweat during two hours of exercise. They become overheated more quickly than adults and cannot cool down as easily.

For more information on safety in youth sports, visit the National Youth Sports Safety Foundation.

References:

A Concussion is a Brain Injury—Get the Facts: Sports & Concussions. Brain Injury Association of America.

April is National Youth Sports Safety Month, April 8, 2008: http://www.InsideNova.com &

Protecting Yourself Year Round; Why Spring Sports Safety is a Must. http://www.usa.safekids.org

Safety in Youth Sports For Safety’s Sake. Volume 1, Issue 4, April 2009

Concussions in Sports. For Safety’s Safe. Volume 1, Issue 3, March 2009.

Kids’ Sports Injuries – the Numbers are Impressive, Nationwide Children’s Hospital. http://www.nationwidechildrens.org/kids-sports-injuries-numbers-are-impressive

Sports Safety. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Prevention. http://www.cdc.gov/safechild/sports_injuries/index.html

Preventing Musculoskeletal Sports Injuries in Youth: A Guide for Parents. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/health_info/sports_injuries/child_sports_injuries.asp

Sports and Recreation Safety Fact Sheet (2015). Safe Kids Worldwide. https://www.safekids.org/sites/default/files/documents/skw_sports_fact_sheet_feb_2015.pdf

Youth Sports Injuries Statistics. Stop Sports Injuries. http://www.stopsportsinjuries.org/STOP/Resources/Statistics/STOP/Resources/Statistics.aspx?hkey=24daffdf-5313-4970-a47d-ed621dfc7b9b

Sports Safety Training Courses for Coaches Recommended. MomsTEAM Institute of Youth Sports Safety. http://www.momsteam.com/health-safety/coaching-education-programs-for-high-school-and-youth-coaches

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