Sports Injuries in Children

There are many children who play sports for enjoyment. What students, parents and team members may not realize is that physical fitness can cause some physical problems. More than 38 million children and adolescents participate in sports per year CDC - Morbidity and Mortality Weekly Report (MMWR, vol. 56). High school students make up about 7.2 million of those athletes. With school sports in full swing, knowing what to do for the injured player is important for their short term and long term welfare.

The ever increasing level of competitiveness and intensity of training/playing that starts at younger ages may be contributing to sports related injuries. It is no coincidence that more injuries are reported at games than practices National Collegiate Athletic Association (NCAA). Have you ever seen the reaction of some parents regarding their child’s athletic performance? It can be scary. One must wonder if these parents are living vicariously through their child. If the child doesn’t meet their imagined level of proficiency, than instead of sports being a positive activity it can become a detriment to the child. A retrospective study was done involving basketball from 1997-2007. It noted that basketball related injuries had decreased by 21.8 percent. The problem was that the traumatic brain injuries (TBI) had increased by 70 percent. This means that the injuries are more severe, when they do occur. Are we pushing kids too hard? The (MMWR 7/27/07) reported that horseback riding, ice skating, gymnastics, cheerleading, and ATV use have the highest percentages associated with TBI emergency room visits. Can you guess what they all have in common? The answer is speed and impact.

The following are some facts about TBI:

1. There are multiple types of sports related injuries but TBI account for 1.1 million persons being treated at US hospitals yearly.

2. Of these 1.1 million people, 235,000 become hospitalized (CDC). Analysis from the National Electronic Injury Surveillance System (NEISS) showed from 2001- 2005 that the highest rates of sports related TBI occurred in children between the ages of 10-14. The second highest rate occurred in the older teenagers

3. Between the years 2001-2005, 2.4 million children aged 5-18 years old accounted for 2.4 million sports related emergency room visits. Of this number, 5.6 percent were TBI related. That 5.6 percent translates into 134,959 kids.

4. TBI is the leading cause of death in American children over one year of age. 

Traumatic Brain Injury is exactly what it claims to be. It is a brain injury that is usually mild but can have long term effects if severe, not treated and/or occurs frequently. We commonly use the term concussion for this mild form of TBI. The brain actually becomes injured due to movement within the skull. The soft tissue of the brain is normally protected by the skull and spinal fluid. A fall, forced trauma or a whiplash injury can damage blood vessels, nerves and tissue. The severity of the concussion is determined by the amount of time needed to recover. In essence, grading a concussion isn’t very practical because the goal is to eradicate the symptoms as quickly as possible.

The signs to look for in a child with a suspected concussion include:

1. A very recent history of head trauma

2. Headache

3. Altered mental state such as drowsiness, confusion or seizure

4. Dizziness, blurred vision, slurred speech, coordination problems

5. Nausea  and/or vomiting

If a child experiences any of these symptoms preceded by a recent head injury, seek immediate medical attention. Delaying medical attention can worsen the symptoms and lead to possible long term problems. The good news is that most concussions are mild and do not have long term effects.  Studies have shown that children and adults who have sustained multiple concussions can have permanent brain damage, which could eventually result in death.

Once the diagnosis of concussion is made, the health care provider will determine your course of medical action. It may vary depending on several factors. Treatment ranges from steroids to over-the-counter (OTC) pain medication. Computed tomograph (CT) scan and magnetic resonance imaging (MRI) may be used as diagnostic tools but are not mandatory in most cases. It is imperative that one follow the discharge instructions for care of the patient with TBI.

The best way to deal with a concussion is to educate everyone about TBI and the ways to fall, use protective gear appropriately and make players understand that inappropriate aggressive playing will be met with severe consequences.

Attached is a NCAA fact sheet used by coaches that encourages safe play and education about sports injuries.

Stay safe and play ball.