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Sports Injury Prevention for Kids’ Most Common Injuries

Watching your budding soccer star get sidelined with an injury is tough. Here’s how to reduce the odds of it happening in the first place.

This story was produced in partnership with Texas Scottish Rite Hospital for Children, a world-renowned leader in the treatment of pediatric orthopedic conditions, sports injuries, and fractures, as well as certain related arthritic and neurological disorders and learning disorders, such as dyslexia.

Jeff Veazey knows about raising kids who love sports. A former competitive swimmer himself, Jeff’s three sons were standouts at their local Dallas swim club. Although swimming is considered one of the least injury-prone sports for kids due to its low-impact nature, any sport taken to excess can have a toll. That’s why Veazey monitored for overtraining and repeatedly emphasized stroke fundamentals to reduce the risk of injuries down the road. But that didn’t prevent his middle son, Liam, from getting injured while playing football. “He was also a ball sports guy who wanted to branch out and play soccer and football as well as swim,” says Veazey. So he encouraged his son to explore these activities, but just three weeks into the middle school football season the 8th grader found himself tackled during a game, bending his knee backward and partially tearing a ligament. With time and physical therapy, Liam healed. But watching his son cope with the setback “was rough,” says Veazey. “When you’re a kid, missing practice or a game feels like the end of the world.”

Veazey is hardly alone in his experience. Of the 60 million children who participate in sports in the U.S. every year, one in three of them will be injured seriously enough to miss games or practices, according to the non-profit research group Safe Kids Worldwide. Furthermore, many injuries can be prevented. We talked to the pediatric sports medicine physicians at Texas Scottish Rite Hospital for Children, one of the preeminent facilities in the world for pediatric orthopedics, to offer advice for keeping kids on the healthy track.

Don’t Specialize Too Early
To keep them active, introduce them to other sports. “New research [in the November issue of Pediatrics] supports sports diversification in younger athletes,” says Shane Miller, M.D., a sports medicine physician at the hospital’s Center for Excellence in Sports Medicine in Plano, Texas, which will move to a new state-of-the-art facility in Frisco, Texas this fall. “Parents should encourage their child to wait until later in adolescence to focus on just one activity. Diversification helps kids grow socially, physically, and emotionally, as well as lowering their risk of injury.” That’s because playing a range of sports allows kids to develop different muscle groups — quads and calves in soccer, arms in baseball, core strength in gymnastics  —  instead of constantly working the same muscles, joints, and ligaments over and over, which can lead to injury.

Exercise According to Your Age
Getting better at a sport is exciting, and motivated kids will want to work even harder. But when it comes to preventing injury, less is more. A study in the American Journal of Sports Medicine found that kids who practice sports for more hours a week than their age in years, or whose ratio of organized sports to free play time is greater than two-to-one, are at significantly higher risk for injury. “As a rule of thumb, a child should exercise no more hours in a week than his age in years,” agrees Dr. Miller. That means if your son is 8 years old, his sport practices and games should be limited to no more than 8 hours total for the week.

Pay Attention to Soreness
At least half of sports injuries in children are the result of overuse, and most overuse injuries begin with soreness after a tough practice session or game. While it isn’t severe enough to prevent a child from playing, the soreness is a sign of inflammation due to microscopic tears in muscles or ligaments after a tough training session. Rest allows the tears to heal. Without proper recovery time, the post-practice soreness will turn into during-game discomfort, and eventually all-the-time pain that prevents a child from participating. The most common overuse injury for kids is called apophysitis, or inflammation that occurs where the tendon attaches to a growth plate. “A child’s bones are still growing,” says Jane Chung, M.D., also a sports medicine physician at the hospital’s Center for Excellence in Sports Medicine. “If the tendons and muscles are overworked or tight, it can lead to stress at the growing area and lead to inflammation and irritation, causing pain. That makes them susceptible to stress which can lead to apophysitis injuries that include Little League elbow and Osgood–Schlatter disease in the knee.”

Schedule Rest Days
A good night’s sleep is an important recovery tool as are healthy meals and sufficient hydration. Equally beneficial: Having your child take one or two days off from her sport each week, and one-to-two months off entirely at some point during the year. That doesn’t mean lounging in front of the TV until spring rolls around again. “Activity is still good, but taking a breather from a favorite sport helps prevent injury and also burnout,” advises Dr. Miller.

When In Doubt, Sit Them Out
Up to 3.8 million sports- and recreation-related concussions occur every year and in 90 percent of the cases, the child does not lose consciousness during a hit to the head, making it harder for a coach or parent to definitively determine whether a concussion has taken place. “You may see signs that your child looks dazed or stunned, and he or she may complain of headaches or dizziness,” says Dr. Chung. Still not sure? “When in doubt, sit them out,” says Dr. Miller. Monitor your child for a day or two for any adverse effects, and consult a pediatrician or specialist if you are still concerned. Don’t make the mistake of thinking that if your child was wearing a helmet, he’s probably OK. “Helmets can prevent skull fractures and may reduce the risk of concussion in skiing or snowboarding, but there is no concussion-proof helmet,” says Dr. Miller. 

Encourage Warm Ups and Cool Downs
An easy way to lower your child’s injury risk is to make sure his body is properly prepared before launching into aggressive drills or maneuvers. “A thorough warm up before practice will get the blood flowing to the muscles and tissues,” says Dr. Chung. After practice or a game, your child may want to perform cool-down stretches — poses held for a period of seconds that gently extend the muscles’ range of motion. 

Never Let Them Play Through Pain
At the end of the day, despite your best efforts, your little athlete may get injured: In fact, 2.5 million of them will be hurt badly enough to require an ER visit. Missing a week — or month — of practice can feel like the end of the world to kids, but it is unwise to allow your child to play through pain. “Not only does this increase the risk of further injury, but it can negatively change your child’s attitude toward sports in the future,” cautions Dr. Miller. While the injury heals, focus on what your child can do: Swimming and biking are often OK when running is not an option. Not every situation requires complete rest, and finding ways to fill her time and maintain some level of fitness can help bridge the gap until she’s back in the game again.