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Category Archives: Sport

Sports Sense

Help your child avoid common athletic risks and injuries by taking a few basic precautions — and tuning out the pressures.

Playing sports is a big part of growing up and going to school for many children. But the pursuit of victory in any activity carries with it risks and responsibilities.

Managing the risks to a child’s health and safety is a duty shared by coaches, parents, and the student-athletes themselves. That’s why it’s important that everyone is clear on what those risks and responsibilities are. The issue extends to school-sponsored sports and athletics, and to recreational activities.

Parents should be aware of the training and competitive practices in each area, notes Joel Brenner, M.D., FAAP, lead author of the new AAP clinical report, “Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes.” “But non-school recreational sports tend to have fewer guidelines and rules,” he says. “Often there are no athletic trainers involved, so parents need to be especially proactive in making sure proper practices are followed.”

Along with the obvious concerns over sports-related injuries, there are three general risks that parents of young athletes should be aware of: overuse injuries, overtraining, and burnout.

Overuse Injuries

Overuse is by far the most common type of sports injury, accounting for as many as half of the total in the United States. An overuse injury is damage to bones, muscles, or tendons that results from the body being worked too hard. This type of injury causes stress to these tissues that takes time to heal.

But too often competitive pressures, practice and game schedules, and a sense of duty to the team compel many young athletes to ignore or deny symptoms of overuse injuries. Failing to allow these to heal only adds further stress to the painful areas, risking long-term damage.

Also, the “no pain, no gain” and “play through the pain” approach to ignoring the aches and pains of sports can discourage the healing process. A young person’s body is still growing. Bones simply cannot tolerate the high levels of stress common to competitive sports if healing isn’t allowed to happen. In more severe cases, continuing to exercise the overuse-injured area can have serious long-term health effects.

Parents should be alert to these common symptoms of overuse injury:

  • Pain in the muscle, tendon, or bone after practice or a game
  • Pain while playing or during practice (even if the child remains able to play)
  • Pain during play that affects the child’s ability to perform
  • Constant or chronic pain, even when not playing

Overtraining

The drive to succeed — along with the sheer joy many youngsters feel as a result of developing their sports talents — can lead to long hours of practice. That can reach the point of overtraining, and, eventually, overuse injuries.

The best way for parents to address this problem before it occurs is to stay on top of their child’s training schedule. Pay attention to the amount of time, energy, and interest the child applies to training for his or her sport.

Some good rules of thumb for keeping training in line include:

  • Limit your child to a single sport or team activity per season, and the training schedule to no more than five days per week.
  • Be mindful of the weather during summer and winter training seasons. Insist that your child make changes to the schedule if the weather is extreme.
  • Encourage your child to vary training exercises from day to day, if possible. For example, she could alternate formal track-and-field training with swimming.

Burnout

Enthusiasm is just as vital as physical skills in keeping children healthy during athletic seasons. Yet the very things that make sports participation so rewarding can also become overwhelming. When that happens, your child can lose interest in the sport that once gave so much pleasure. This is called burnout.

“Families need to be open in their communications about athletics,” Brenner says. “Parents should understand what the child’s goals are — and make sure the activity is driven by the child’s, not the parents’, goals.”

On a day-to-day level, burnout can produce moodiness, a loss of interest that spreads to other activities, such as academics, and a drop in performance in the sport. But there are physical consequences to burnout as well. These can include:

  • Constant or chronic muscle and joint pain
  • Fatigue
  • Increased resting heart rate

Keeping It All in Focus

The rewards — and lessons — of sports participation are a vital part of growing up for many students. The National Sporting Goods Association reports that every year, more than 45 million children and adolescents take to the fields, tracks, pools, and gym floors.

Many kids dream of athletic glory beyond their present level. But it’s crucial that they understand that less than 1 percent of student athletes reach the professional leagues. Taking on more than the body can handle can put a premature end to the fun of sports.

Football

Football is a fast-paced, aggressive, contact team sport that is very popular among America’s youth. Football programs exist for players as young as 6 years all the way through high school, college, and professional.

Injuries are common because of the large number of athletes participating. However, the risk of injuries can be reduced. The following is information from the American Academy of Pediatrics (AAP) about how to prevent football injuries. Also included is an overview of common football injuries.

Injury prevention and safety tips

  • Supervision. Athletes should be supervised and have easy access to drinking water and have body weights measured before and after practice to gauge water loss.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes. Football shoes should be appropriate for the surface (turf versus cleats). Laces should be tied securely.
    • Pants. Football pants should fit properly so that the knee pads cover the knee cap, hip pads cover the hip bones, the tailbone pad covers the tailbone, and thigh pads cover a good share of the thigh. Pads should not be removed from the pants.
    • Pads. Shoulder pads should be sized by chest measurement. They must be large enough to extend ¾ to 1 inch beyond the acromioclavicular joint. Athletes should have adequate range of motion, and the pads should not ride up into the neck opening when raising the arms.
    • Helmets. The helmet should be fitted so that the eyebrows are 1 to 1½ inches below the helmet’s front rim. The back of the helmet should cover the back of the head, and the athlete’s ear openings should be in the center of the helmet ear openings. Jaw pads should be snug against the athlete’s jaw. The chin strap should be centered over the chin and tightened to prevent movement of the helmet on the head. The helmet padding and chin strap should be tight enough to prevent any rotation of the helmet on the head. Face masks should be attached to the helmets. Additional protection can be provided by a clear Plexiglas shield.
    • Mouth guards can help prevent oral or facial injuries but not concussions.
  • Environment. A safe playing field is level and cleared of debris, equipment, and other obstacles. Field goal posts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle injuries

Ankle sprains are some of the most common injuries in football. They can prevent athletes from being able to play. Ankle sprains often happen when an athlete gets blocked or tackled with the foot firmly in place, causing the ankle to roll in (invert). An ankle sprain is more likely to happen if an athlete had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays may be needed.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains and enable an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays may be needed. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs, and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Medial collateral ligament sprains can be treated in a hinged brace and allowed to return to play. Athletes who return to play with a torn anterior cruciate ligament (ACL) risk further joint damage. Athletes with an ACL tear should not return to their sport until the ligament has been reconstructed and they have been cleared by the surgeon.

Shoulder injuries

Shoulder injuries can occur from diving for a ball or from blocking or tackling.

Athletes usually feel their shoulder pop out of place when it is dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called adislocation. Risk of dislocation recurrence is high for youth participating in football. Shoulder strengthening exercises, stabilization braces and, in many cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in football, usually due to weak muscles of the back and trunk. Often rehabilitation exercises and rest from excessive blocking or tackling drills are all that is necessary to treat this type of pain.

Eye injuries

Eye injuries commonly occur in football usually due to a finger poking through the face mask. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from high-impact and repetitive arching of the back. Symptoms include low back pain that feels worse with back extension activities. Treatment of spondylolysis includes rest and physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes are advised to limit repetitive arching of the spine (blocking and weight lifting) and high-impact activities (running and jumping). Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Head injuries

Concussions occur if the head or neck hits the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. If a concussion has occurred, it is again important to make sure the helmet was fitted properly. If the concussion occurred due to the player leading with the head to make a tackle, he should be strongly discouraged from continuing that practice.

Golf

In the past, golf was seen by many as a leisure activity for people with extra time and money to spend. Today golf is seen as a sport, and one that appeals to younger participants.

While golf is not thought of as a dangerous sport, the long hours of practice and the physical demands of learning and playing the game can lead to injuries. While not all injuries can be prevented, the risk of injuries can be reduced.

The following is a chart from the American Academy of Pediatrics of common golf injuries and an overview of symptoms and treatment. Also included are diagrams of 2 exercises.

Common injuries, symptoms, and treatment

Golf injuries can be divided into those that occur from swinging a club and those that occur from the miles of walking on a golf course. To prevent injury, athletes must have an understanding of the stresses golf puts on the body and must prepare their bodies to handle these stresses.

Most golf injuries develop over time rather than as a result of a single event. It is important to recognize the early signs of an injury and seek treatment before the condition gets worse.

Also, a general warm-up before practicing or playing can help prevent injury. This should consist of exercises that increase circulation to the muscles and stretch the shoulders, back, hips, and legs. It also helps to take warm-up swings with a weighted club (or 2 clubs) and hit practice shots when possible.

Exercises

Rotational stretch and warm-up

This is a dynamic stretch for shoulders, back, and hips and a good warm-up that can easily be done at the golf course or practice range.

  1. Stand while holding club behind upper back.
  2. Rotate back and forth while keeping feet planted.
  3. Try to feel stretch in shoulders, spine, and hips.

Hip/low back flexibility

This exercise improves flexibility in hips and low back; increases rotation and ability to “turn” when hitting ball.

  1. Lie on back; cross legs.
  2. Use top leg to push opposite knee to floor; keep shoulders flat and pelvis on the floor.

Ice Hockey

Ice hockey is one of the fastest sports and requires good physical conditioning and skating skills. It is a team sport played from the ages of 5 to 6 years through adulthood.

The severity of injuries is related to speed and physical contact (body checking). In the United States, body checking is allowed in league hockey at the age of 11 to 12 years, although the age can be younger in some leagues.

As player size and the speed of the game increase, injury rates and the severity of injury also rise. However, the risk of injuries can be reduced.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent ice hockey injuries. Also included is an overview of common ice hockey injuries.

Injury prevention and safety tips

  • Equipment. Safety gear should fit properly and be well maintained.
    • Skates should fit well with socks on. Skates that are too tight can lead to blisters and frostbite.
    • Pads. Elbow, knee, and shoulder pads that fit properly and allow for full movement. Kidney- and thigh-padded shorts that overlap protective socks and shin guards so no skin is showing. Padded hockey gloves to protect the fingers and wrists from stick slashing and sharp skates.
    • Protective guards (neck guards, protective cups, and mouth guards)
    • Helmets with face guards approved by the Hockey Equipment Certification Council (HECC). Cracked helmets or helmets with outdated HECC certificates should not be used.
    • Goalie equipment is even more specialized, with a different helmet and mask, thicker padding, and skates with longer, thicker blades for stability and reinforcement along the inner foot for protection from pucks and sticks.
  • Equipment care. Dirty hockey equipment can lead to skin infections, especially where the hockey gear touches the skin directly. The “infamous” hockey bag smell is due to the growth of bacteria and other germs. Almost all equipment can be washed in a commercial washing machine. Helmets and face masks can be disinfected with antibacterial wipes, and the inside of leather gloves and gear bags can be cleaned with spray cleaners. Mouth guards should be washed after each use.
  • Many rinks have special “dry” cleaning machines that disinfect an entire bag of gear. To decrease the growth of germs, gear should be taken out of the bag after every practice or game, and the bag and gear dried out completely before repacking.
  • Environment. Only walk or skate on a pond or natural body of water that has received safe ice approval from local officials. Also, goal net posts should be easily removed so they are not dangerous obstacles during fast play.
  • Emergency plan. Hockey programs can organize and train a team to respond to injuries during games, as it is rare to stop play while players are treated off the ice. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Special concerns

Dehydration

There is a common misconception that athletes who play in cold weather do not need to drink as much as those playing in warm weather. In fact, hockey players training in cold environments wear more clothing and may be unaware they are losing body moisture. Dehydrated athletes often perform poorly in multiple game situations like tournaments and during the last period of a game.

Hydration should take place before, during, and after games and practices. In general, athletes should drink 5 to 8 ounces of water or an appropriate sports drink every 20 minutes, even if they do not feel thirsty. Players not responding well, unable to drink, or with difficulty breathing may need emergency medical attention.

Exercise-induced asthma

  • Exercise-induced asthma is prevalent in hockey players who are prone to asthma because hockey is played in cold weather under dry conditions. Skaters should have a personal asthma action plan. Asthmatic skaters can prevent episodes by taking their medicines and using an inhaler before practices or games. Inhalers and spacers should always be on hand during activity. Skaters should stop skating and see a doctor if they have difficulty breathing while skating.

Frostbite

Cold weather, wet clothing, and tight-fitting skates can lead to poor circulation andfrostbite. Early signs of frostbite are pale or white skin with numbness and tingling of the exposed body part. It is important to dress in layers and wear wicking, fast-drying wool or polypropylene underwear and socks. Cotton clothing is not warm when wet and can contribute to frostbite and hypothermia by lowering the body temperature. Treat frostbite by increasing circulation and warming cold body parts in a heated room or under the clothes. Change wet clothing often.

Common injuries

Head injuries

Concussions in hockey most often occur from a blow to the head, from falls, or from being checked into the boards. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion may be more susceptible to another injury than an athlete with no history of concussion.

All concussions are serious, and all athletes with suspected concussions should not return to play until they see a doctor.

Youth hockey programs in the United States and Canada have active head injury prevention programs for athletes and coaches. Safe play and properly fitting helmets can prevent concussions, as does striking the boards at an angle with the head up when a collision can’t be avoided.

Arm and leg injuries

Injuries of the extremities should be treated with rest, ice, compression, and elevation (RICE). Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and swelling, but should be taken with food. Injured athletes should see their doctor if they have pain while playing.

  • Upper extremity injuries of the shoulder, arm, and wrist occur during falls or from being checked into the boards. Shoulder dislocations are very painful until put back into place. Persistent wrist or arm pain after a fall can signify a broken bone (even if there is no visible swelling or deformity) and should be iced and immobilized until it can be treated by a doctor.
  • Groin strains are pulled or torn muscles or tendons of the inner thigh. Hockey players and goalies doing forced push offs or slides on skates may get this injury. Treatments that may help are ice, NSAIDs, thigh wraps, physical therapy, and modification of activity. Groin strains can be prevented by warming up properly and doing muscle stretching as a part of team practices and games.
  • Knee injuries are more common in hockey than ankle injuries because the ankle and Achilles tendon are protected by a stiff boot. Knee injuries happen when the knee is forced or twisted to the side or back. If a ligament or cartilage is torn, a pop may be felt or heard, followed by visible swelling around the knee.
  • Overuse injuries, such as Osgood-Schlatter disease (irritation of the growth plate causing a painful bony bump below the knee), occur in 10- to 15-year-olds who play active sports with running, jumping, or skating. In hockey, a combination of off-ice training, overtraining, and frequent practices and games may lead to Osgood-Schlatter, thus limiting or changing activity may help.

Eye injuries

In the past, blows from hockey sticks and flying pucks caused many eye injuries. Now helmets with face masks have decreased the number of eye injuries, but they still can occur. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

What is Lacrosse ?

Lacrosse is one of the fastest-growing sports in the United States. It’s both a contact (boys) and noncontact (girls) sport. Injuries differ between the contact game of boys’ lacrosse (body contact and stick checking allowed) and the noncontact game of girls’ lacrosse.

Game and practice injuries include injuries to the knee, ankle, wrist/hand, and face/head. Many injuries occur because of contact with the stick, ball, or another player, while some injuries happen because of overuse. Most lacrosse injuries are sprains/strains or contusions.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent lacrosse injuries. Also included is an overview of common lacrosse injuries.

Injury prevention and safety tips

  • Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routine well-child checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport specific conditioning. Also important are proper warm-up and cool down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Helmets with face masks are required for male athletes and both male and female goalkeepers. Soft helmets made of foam-type material are optional for female athletes.
    • Protective eyewear. Female athletes are not required to wear helmets but are required to wear eye guards. These are made specifically for lacrosse and consist of a metal cage that covers the eyes and nose and should be worn at all times.
    • Mouth guards
    • Gloves
    • Additional gear for goalkeepers includes separate throat protectors, padded gloves, chest protectors, mouth guards, pads (shins and thighs; arms and shoulders)

Common injuries

Ankle injuries

Ankle sprains are a common lacrosse injury and can prevent athletes from being able to play. Ankle sprains usually occur while an athlete is running or cutting. Ankle sprains are more likely to happen if an athlete had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays may be needed.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains. Tape and an ankle brace can also support the ankle, enabling an athlete to return to activity more quickly.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury. Anterior cruciate ligament (ACL) tears are more common in females than males.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. They should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Athletes who return to play with a torn ACL risk further joint damage. Athletes with an ACL tear are usually unable to return to their sport.

Head injuries

Concussions usually occur with body to body, body to object (ball or stick), or body to ground contact. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who havehad concussions may report feeling normal before their brain has fully recovered. With most concussions, an athlete is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. While helmets have not been shown to prevent concussions, they are recommended for use in contact boys’ lacrosse to prevent head, neck, jaw, and dental injuries.

All concussions are serious, and all athletes with suspected concussions should not return to play until they see a doctor.

Eye injuries

Eye injuries commonly occur in sports that involve balls but can also result from a finger or another object (like a stick) in the eye. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear. Both boys and girls are now required to wear eye/face shields to help protect them from serious injuries.

Wrist/hand injuries

Contusions, sprains, and fractures are common injuries to the wrist and hand in lacrosse. Getting hit with the stick is the most common way to injure the wrist and hand. Boys wear hockey style gloves to protect their hands from injuries, whereas girls usually wear batting-style gloves.

Treatment begins with RICE. Athletes should see a doctor if their wrists are swollen or painful the next day. X-rays may be needed.

Martial Arts

More than 6 million children in the United States participate in martial arts. Martial arts are known to improve social skills, discipline, and respect in children. Children can also improve their abilities to concentrate and focus on activities, as well as bettering their motor skills and self-confidence. Martial arts can be fun and beneficial at any age.

While the martial arts are relatively safe, injuries can happen because there is physical contact between opponents. The following is information from the American Academy of Pediatrics (AAP) about how to prevent martial arts injuries. Also included is an overview of martial arts forms.

Injury prevention and safety tips

  • Instructors. Experienced instructors will teach at a level appropriate for your child’s age and maturity. Lessons should emphasize technique and self-control. Experienced instructors will carefully advance your child through more complex training. Lessons should also be fun. Visit a variety of instructors and ask about their experiences with young children and their teaching philosophy.
  • Technique. An instructor’s emphasis on technique and self-control is very important in limiting the risk for injury. Children should learn to punch and kick with their hands and feet in proper position and using the appropriate amount of force. Kicks and punches with the hand or foot in the wrong position can cause injuries to fingers and toes. Punches or kicks that are too hard can cause pain or bruises. Contact to the head should be discouraged.
    • Equipment. Safety gear should fit properly and be well maintained.
    • Headgear. When the rules allow, protective headgear should be worn for sparring or for activities with risk of falling, such as high jumps or flying kicks.
    • Body pads can help protect against scrapes and bruises and limit the pain from kicks and punches. Arm pads, shin pads, and chest protection for sparring.
    • Mouth guards.
  • Environment. Mats and floors should be safe to play on. Gaps between mats can cause sprained ankles. Wet or worn floors can cause slips and falls.

Common injuries

Scrapes and bruises

Scrapes and bruises are by far the most common injuries seen in the martial arts. They often result from falls onto mats, kicks and punches that are “off target,” or when proper padding is not worn. All scrapes and cuts should be washed with soap and water and bandaged before returning to activity. Bruises are best treated with ice applied for 20 to 30 minutes. They will slowly get better and fade over 2 to 3 days.

Sprains and strains

Sprains and strains become more common as children get older. Ankles, knees, and elbows are the joints most often sprained. Muscle strains usually happen in the front (quadriceps) or the back (hamstrings) of the thigh. Most knee and ankle sprains occur either by landing awkwardly after a jump or by improper contact with a partner. Elbow and wrist injuries happen with falling, punching, or blocking. Muscle strains can occur with trying to kick too high or punch too hard without using correct form or having properly warmed up.

Finger and toe injuries

Finger and toe injuries are often due to the large amount of kicking and punching of padded targets. They may also happen when sparring with a partner. These injuries are usually the result of poor kicking and punching technique. Contact with the target should never be initiated with the fingers or toes. Jammed fingers result from holding the hand in the wrong position (fingers spread) or if the toes are used to hit the target(instead of the heel or top of the foot).

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays are usually needed. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs, and range of motion exercises are important for treatment.

Head injuries

Concussions can occur in martial arts if children fall and strike their heads, or if they are kicked or punched in the head. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. Once a concussion has occurred, it is important to make sure the helmet is fitted properly. If the concussion occurred due to the player leading with the head to make a tackle, he should be strongly discouraged from continuing that practice.

All concussions are serious, and all athletes with suspected concussions should not return to play until they see a doctor. The AAP recommends children avoid sports that reward blows to the head.

Types of martial arts

The term martial arts can be used to describe any number of styles or disciplines of self-defense practices. There are many different styles practiced around the world, with the most popular forms being karate, tae kwon do, and judo.

  • Karate (KAH-rah-teh) means “empty hand,” as it
    is normally practiced without weapons.
    Karate is a traditional Japanese form. The hands and feet are trained and prepared for use in a weaponless form of self-defense.
  • Tae kwon do (tahy-kwon-doh) means “the way of foot and fist.” This is a traditional Korean martial art. It is also the most popular. This form highlights discipline, respect, and personal growth and focuses on the use of the feet for powerful kicks in self-defense.
  • Judo (joo-doh) means “gentle way” and is known for a variety of throwing techniques. It uses many methods to control an opponent while on the ground. In many ways it is more similar to wrestling than to the other martial arts.
  • Kung fu (kung-foo) most commonly translates to “hard work” and is one of the oldest forms of martial arts. The term may be used to describe all of the hundreds of Chinese martial arts. Kung fu is mainly a “stand-up” form of the martial arts, known for its powerful blocks. Wushu is the most popular and modern form of kung fu.
  • Aikido (eye-key-do) means “way of harmony.” This Japanese martial art is known as a throwing style. It teaches a nonaggressive approach to self-defense, focusing on joint locks, throws, and restraining techniques, rather than kicks and punches. While aikido may be learned at any age, it is especially popular among women and older adults. Aikido is not practiced as a competitive sport.
  • Jujitsu (joo-jit-soo) means “the art of softness” and emphasizes techniques that allow a smaller fighter to overcome a bigger, stronger opponent. First practiced in Japan, jujutsu is considered a ground fighting or grappling style of the martial arts. Many of the forms have been incorporated into other martial arts such as judo, karate, and aikido. The arm lock and submission techniques have been taught to police all over the world.

Tips to Coaching

What Coaches Can Do to Create a Positive Youth Sports Experience

  • Redefine success.
  • Be knowledgeable about the sport you are coaching.
  • Be knowledgeable about the age group you are coaching.
  • Understand the unique developmental skill patterns of that age group and make adjustments for that skill level.
  • Remember that the inability to perform a certain skill may just be a lack of developmental timing, rather than a true lack of ability.
  • Reinforce and refine the skills that are achieved without pushing too quickly for other skills.
  • Give kids small tasks to learn to increase chances for accomplishment.
  • Be enthusiastic and genuine.
  • Make kids feel comfortable so they are not afraid to try new skills.
  • Let everyone play and substitute players frequently.
  • Focus your verbal support on what skills they do right. Then your coaching support can more easily be directed at making constructive corrections in other skills.
  • Understand chemical development so you do not train a child like an adult, risking overtraining and injury.
  • Know the limitations of aerobic development so you can maintain a solid aerobic base without overtraining, and concentrate on technique.
  • Use caution in warmer conditions and hot environments and take frequent water breaks.
  • Know when the circumstances are appropriate for weight training.
  • Make your rewarding statements sincere.
  • Have realistic expectations and communicate them so the active youngster can see improvement and acknowledge accomplishment more frequently and be more protected from societal pressure to perform for an ultimate prize.
  • Be alert for signs of overtraining and burnout.
  • Keep kids motivated with positive feedback.
  • Remember the importance of positive effects on early psychological development.
  • As kids progress, give meaningful input on winning and losing and emphasize that every practice and competition is an opportunity to learn and improve.
  • Teach how to learn from successes, disappointments, and everything in between.
  • Do not coach by intimidation.
  • Be a good role model.
  • Instill good sportsmanship (they are watching your example).
  • Teach good fundamental skills that the child can use to build on with the next coach or activity.
  • Foster a sense of self-worth and confidence in the child or teen.
  • Emphasize effort and accomplishment more than winning.
  • Gear the activity toward fun and a positive experience.You may be the very coach that helps inspire a child to stay involved in a sport and truly maximize his or her potential for reality success.

Diving

 Diving is considered a collision sport because of the impact with the water on entry. A diver entering the water from the 10-meter platform is traveling almost 40 miles per hour. These forces are enough to break bones and dislocate joints. Divers are also at risk of injuries from hitting the board or platform as well as overuse injuries similar to gymnasts from frequent jumping, back arching, trunk flexion, and back twisting. Injuries can also occur from training on “dry land.” This type of training usually includes weight lifting and the use of spotting belts, trampolines, and springboards.

While injuries do occur in competitive diving, unsupervised or recreational diving is associated with a far greater risk of serious injury or even death. The following is information from the American Academy of Pediatrics (AAP) about how to prevent diving injuries. Also included is an overview of common diving injuries.

Injury prevention and safety tips

  • Rules. Swimmers should follow pool rules at all times, including
    • Never swim alone. The pool should be supervised.
    • Don’t run on pool decks and wet areas. Abrasions and contusions (bruises) commonly occur from careless falls.
    • Don’t dive in shallow water or any water where the depth is not known.Swimmers should know how deep the pool is and avoid diving into shallow pools less than 3 feet deep. This will help prevent serious head and neck injuries.
  • Equipment. Safety gear includes
    • Swim caps
    • Sun protection (sunscreen, lip balm with sunblock) when outdoors
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations in or out of the water. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Shoulder injuries

Shoulder injuries typically occur during water entry when arms extended overhead get forced back. Athletes usually feel the shoulder pop out of joint when their shoulders are dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called a dislocation. Risk of dislocation recurrence is high for youth participating in these sports. Shoulder strengthening exercises, braces and, in some cases, surgery may be recommended to prevent recurrence.

Chronic shoulder pain is usually due to a pinching of the rotator cuff (the tendons around the top of the shoulder). This is more common in athletes with weak shoulder blade muscles. Symptoms include a dull pain or achiness over the front or side of the shoulder that worsens when the arm is overhead. Treatment involves exercises to strengthen the shoulder blade muscles and the rotator cuff.

Neck injuries

Repetitive extension of the neck on water entry can cause an irritation of the neck joints. This results in muscle spasms and stiffness when rotating the neck or looking up. Athletes with tingling or burning down the arm may have a cervical disc herniation or “stinger” and should see a doctor. Stingers are stretch injuries to the nerves in the neck and spine. Because the force of impact is greater with 10-meter platform diving, there are more complaints of neck problems with tower divers.

Elbow injuries

Elbow pain can occur when an athlete’s elbow hyperextends on entry into the water. The ulnar nerve (“funny bone”) can be stretched and cause pain, numbness, or burning down the arm into the fingers. If the ligament of the elbow is stretched, it can cause pain, weakness, and instability of the elbow. Athletes with pain on the outside of the elbow may have a condition called osteochondritis dissecans. This condition can cause an inability to straighten the elbow and locking, catching, or swelling of the elbow. X-rays may beneeded to confirm diagnosis.

Wrist/hand injuries

When divers enter the water, they grasp their hands one on top of the other with the palm facing toward the water. As they try to “punch” a hole in the water, thewrist gets bent backward. Doing this repetitively causes pain, swelling, stiffness, and irritation of the wrist joint. This can be treated with rest, ice, and nonsteroidal antiinflammatory drugs. Taping or bracing the wrist can also prevent further injury.

When divers reach for the water and attempt to grasp their hands for entry, they occasionally hyperextend the thumb. This causes a sprain to the base of the thumb. Symptoms include pain, swelling, instability, and weakness of the thumb. This can be treated, and may be prevented, by taping the thumb while diving. Occasionally, a custom thumb splint or even surgery is necessary to stabilize the thumb.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from arching or extending of the back. Symptoms include low back pain that feels worse with back extension activities. Back or reverse dives are often more painful. Treatment of spondylolysis includes rest from diving, physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Disc injury may cause low back pain that occurs with flexion—including pike and tuck dives. The pain is usually worse on one side, extends into the buttock, and occasionally down the leg. Disc-related pain can also occur with sitting, lifting, jumping, and twisting. Successful treatment requires early recognition of the problem and timely treatment.

Knee injuries

There are thousands of jumps in practice for each dive seen in competition. Jumping causes pressure on the kneecap and can result in pain in the front of the knee. Patellar tendonitis (also called jumper’s knee) causes pain
just below the kneecap. Treatment requires identifying and addressing the causes of the pain.

The number of dives performed; dry land training; poor flexibility; strength imbalances; and malalignment of the hips, knees, and feet can also contribute to knee pain. Because corrective shoes, orthotics, and knee braces aren’t practical while diving, physical therapy, patellar taping, and training modifications are the mainstays of therapy.

Cheerleading

 Cheerleading is often thought of as a sport only for high school and college athletes. However, it is becoming more popular among younger athletes as well.

Cheerleading shares many of the same types of injuries seen in other jumping sports. However, the risk of injury can be reduced. The following is information from the American Academy of Pediatrics (AAP) about how to prevent cheerleading injuries. Also included is an overview of common cheerleading injuries.

Injury prevention and safety tips

  • Equipment. The American Association of Cheerleading Coaches & Administrators (AACCA) recommends using mats or a soft, even surface when learning new skills as well as during competition.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.
  • Coaches. It is important for coaches to be experienced and familiar with the rules. Cheerleaders are less likely to be injured if their coach has completed a coaching class such as from the AACCA Safety Course; has more than 1 year of coaching experience; and has a college degree. All coaches should be familiar with the National Federation of High Schools guidelines, which include restrictions on basket tosses, pyramid heights, and twisting/flipping stunts.
  • Spotters. All cheerleaders should be trained to spot properly. Spotters assist or catch the top person in a partner stunt or pyramid. Proper supervision and spotting should be available at all times.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact instructions. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle sprains

Ankle sprains are the most common cheerleading injury and usually happen when the cheerleader lands on the outside of the foot, twisting the ankle inward. Injuries to the bone are more common than injuries to the ligament, especially in younger athletes.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain, especially in the bony parts of the foot or ankle. X-rays are often needed.

Knee injuries

Knee injuries commonly occur when a cheerleader lands awkwardly from a jump. Ananterior cruciate ligament tear is usually associated with sudden knee pain and giving way from a twisting, knock-kneed, or hyperextension injury.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Knee fractures may not heal if the knee is not treated properly. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Cheerleaders can also get overuse knee injuries, such as patellar tendonitis orOsgood-Schlatter disease, which are common in sports that require a lot of jumping. They usually cause pain just below the kneecap. These injuries can be treated with rest, ice, taping or bracing, stretching, strengthening, and/or physical therapy.

Wrist injuries

Wrist injuries usually happen when a cheerleader falls onto an outstretched hand. Both bone and ligament injuries in the wrist can occur with a fall.

Treatment begins with RICE. Athletes should see a doctor if their wrists are swollen or painful the next day. X-rays are often needed.

Low-back pain

Spondylolysis, a stress fracture in the spine, is a common injury in athletes who do a lot of jumping, tumbling, and back-bending activities. Symptoms include low-back pain that feels worse with back extension activities, like back walkovers or back handsprings. Cheerleaders with low-back pain for longer than 2 weeks should see a doctor. X-rays are usually normal at first so other tests are often needed to diagnose spondylolysis.

Athletes with spondylolysis must rest from back extension activities for several weeks, and usually months. Physical therapy to strengthen the back and abdominal muscles will also help athletes recover.  Back braces are unnecessary in most cases.

Head injuries

Concussions in cheerleading usually occur when a cheerleader’s head hits the ground after a severe fall. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovery. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion may be more susceptible to another injury than an athlete with no history of concussion.

Catastrophic injuries

Catastrophic injuries can occur if a cheerleader falls from the top of a pyramid, lift, or basket toss. Head injuries, like concussions or skull fractures, and spine injuries, like fractures or paralysis, may occur after a severe fall. If a severe fall occurs, the athlete should not be moved and the emergency plan should be started right away. No athlete with a concussion or spine injury should return to sports unless it’s cleared in writing by a doctor.

Baseball and Softball

 Baseball and softball are extremely popular among America’s youth. Injuries are common because of the large number of athletes participating. While most injuries are acute, there are specific overuse injuries that commonly affect young ball players. Most of these injuries can be prevented.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent baseball and softball injuries. Also included is an overview of common injuries.

Injury Prevention and Safety Tips

Sports Physical Exam

Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routinewell-child checkups.

Fitness

Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.

Technique

Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. For example, baseball and softball players should avoid headfirst slides, and run bases with a helmet and break-away bases. Athletes should work with coaches and athletic trainers on achieving proper technique.

Equipment

Safety gear should fit properly and be well maintained

  • Protective eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials. Batting helmets and catcher’s masks with face masks also are recommended.
  • Shoes with rubber (not metal) spikes
  • Pads (knee and shin guards)
  • Athletic supporters and cups for boys
  • For catchers: helmets with face guards, throat guards, knee-saver pads, and chest protectors (Note: Chest protectors cannot prevent direct trauma to the heart.)
  • For batters: batting helmets, face guards
  • Safety baseballs (Softer balls decrease overall injury from getting struck by the ball in addition to lowering the risk of commotio cordis.)

Environment

  • Heat. Proper hydration and scheduling practices and games during cooler times of the day can prevent heat-related illness and dehydration.
  • Lightning. Guidelines should be in place to postpone play until a safer time. Play should be stopped for 30 minutes after the last strike if lightning is detected within a 6-mile radius (follow the 5 second per mile rule). A safe area (buildings with metal pipes or well-grounded wires) should be identified ahead of time. No one should stand under the bleachers or other non-grounded structures.
  • The field. A safe playing field is free of debris; holes and uneven surfaces should be repaired. The infield and pitcher’s mounds should be raked and smoothed regularly. Evening games should be well lit. Breakaway bases should be used to reduce injuries from sliding. A runner’s base placed to the right of the first base foul line in the runner’s lane is one way to help prevent collisions at first base. Safety screens should be in place to protect the dugouts from balls and thrown bats.

Emergency Plan

Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common Injuries

General Treatment for Acute Injuries

Rest, ice, compression, and elevation is the first step in treating an acute injury accompanied by pain and swelling. Athletes should stop playing and apply ice directly to the injured area for 20 minutes. After icing, an ACE bandage can be used to limit swelling. The injured area should be raised above the heart to limit swelling.

Shoulder Injuries

Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement is common in young athletes with weak upper back and shoulder muscles. Off-season stretching of the back of the shoulder and strengthening of the shoulder blade and core muscles can help prevent these injuries.

Baseball pitchers and other high-volume throwers (for example, catchers) are at risk for Little League shoulder, an irritation to the growth plate in the humerus bone of the shoulder. Limiting the number of pitches a player can throw during a practice or game can help prevent these types of overuse injuries (pitch count guidelines based on age are published by USA Baseball). Any athlete who has shoulder pain for more than 7 to 10 days should see a doctor.

Elbow Injuries

Elbow injuries are very common in baseball players, especially pitchers, and includeLittle League elbow (irritation of the growth plate of the humerus bone of the elbow). As with shoulder injuries, limiting the number of pitches a player throws during a practice or game can help prevent overuse injuries.

Ankle Injuries

Ankle injuries often occur as a result of uneven playing fields or sliding into bases, or from improper rehabilitation/ protection after injury. Fields should be well maintained and breakaway bases should be used. Use of ankle braces and ankle exercises that strengthen and improve balance of the ankles may prevent repeat injury.

Eye Injuries

Eye injuries typically occur from contact with the ball, bat, or a finger. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. Athletes should also stay a safe distance away from any player swinging a bat or playing catch. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Heat-Related Illnesses

Athletes who are dizzy or confused, or complain of a headache, are most likely suffering from heat exhaustion or heat stroke. Any athlete suspected of having heat illness should immediately be removed from play, cooled by any means available, and transported by emergency medical services (call 911).

Heat-related illnesses can be prevented when athletes are given adequate time to get used to exercising in the heat (usually takes 1 to 2 weeks). Drinking water or a sports drink before, during, and after training, as well as avoiding stimulants includingcaffeine, can also help.

Commotio Cordis

Sudden death as a result of a significant impact to the chest is known as commotio cordis. The usual cause is impact from a baseball, lacrosse ball, or puck, or a direct blow in football or hockey. Recognition and resuscitation alone are rarely successful; however, if available an automated external defibrillator can successfully resuscitate athletes with this condition.