Youth Is No Shield Against Sport Injuries

As more kids play competitive sports, care must be taken to ensure safety, experts say

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By Janice Billingsley
HealthDay Reporter

FRIDAY, Aug. 26, 2005 (HealthDay News) -- With more children playing competitive sports, the number and severity of their injuries have increased, according to orthopedic surgeons who treat children between the ages of 8 and 18.

"Five years ago, overuse injuries in kids constituted about 15 percent of my practice; now it's about 40 percent," said Dr. Jordan Metzl, medical director of the Sports Medicine Institute for Young Athletes at the Hospital for Special Surgery in New York City.

In adults, overuse injuries usually refer to muscle strains that can be repaired by rest, a proper stretching and strengthening program and sometimes surgery.

But for children, overuse injuries can mean serious damage to growth plates at the ends of bones.

"Kids' bodies are different than adults'," Metzl said. "They have cartilage growth plates at the edge of bones that are soft and still growing."

And those are much more susceptible to injury, he added, because overuse can cause the cartilage to spread apart, interrupting the normal growing process.

Bone fractures, too, are on the rise among children who participate in sports like football, snowboarding and running, and need attention, otherwise they can lead to lifelong problems, Metzl said.

"When kids complain about pain, it's real," added Dr. Elton Strauss, chief of orthopedic trauma and adult reconstruction at the Mount Sinai Medical Center in New York City. Early intervention is important, he said.

For instance, a young gymnast who complains of foot pain can be suffering from repetitive fatigue on one spot on a bone on the foot. If he continues to work out, the bone can eventually crack, causing a stress fracture that takes far longer to heal and, in worst cases, requires surgery where a pin would be placed in the bone to hold it together, Strauss said.

Metzl said if a child feels pain while playing a sport, parents should take her to the doctor. The child might need an X-ray or imaging scan to get a proper diagnosis.

If there is an injury, doctors often suggest that young athletes change their competitive routines, add strength training to their regimen, and improve their nutrition.

Metzl said common injuries that are sometimes ignored include "Little League Shoulder," a pitching overuse injury; "Runner's Shin Pain," which can potentially mean a stress fracture in the leg; and wrist injuries that could indicate a hairline fracture.

"It's tough for parents to sort out the aches and pains of their kids, but if pain is limiting their child's ability to perform in a sport, they should take them to the doctor," he said.

"Parents know their kids, and if you think something's wrong, don't stop until you get answers," he added.

Judy Young, vice president of the American Alliance for Health, Physical Education, Recreation and Dance, said the increase in competitive sports participation by children hasn't been accompanied by research into the best ways to prepare young bodies.

"These children are perhaps being subject to adult training techniques that might not be appropriate for children," she said. "This is an area where we need lots of research: What is the best way to condition young athletes; how do we prevent injury; what are the differences between the 8- to 12-year-old body and the 18- to 35-year-old body?"

Part of conditioning for sports, especially rigorous fall sports like football, should be to ensure that young athletes are properly protected from the heat. A report last week that a 21-year-old football player from Illinois Wesleyan University died of heatstroke during practice in 90-degree weather is a somber reminder that even young, strong athletes need to work out safely, the experts said.

Doctors recommend drinking 4 to 8 ounces of water every 15 to 20 minutes if young athletes have been working out for an hour or less, including warm-up sessions. For workouts longer than an hour, they should drink sports drinks to replenish carbohydrates and electrolytes such as sodium and potassium that are lost through sweating.

Also important, especially for football players, is to begin serious training slowly and be aware of the added heat and stress of wearing heavy equipment.

More information

The National Institute of Arthritis and Musculoskeletal and Skin Diseases offers helpful information to parents who want to keep young athletes safe while on the sports fields.

SOURCES: Jordan D. Metzl, M.D. medical director, Sports Medicine Institute for Young Athletes, Hospital for Special Surgery, New York City; Judy Young, vice president, the American Alliance for Health, Physical Education, Recreation and Dance, Washington, D.C.; Elton Strauss, M.D., chief of orthopedic trauma and adult reconstruction, Mount Sinai Medical Center, New York City

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