From a Pediatric Sports Medicine Expert- Eight Proven Ways to Reduce Youth Sport Injuries

Question: As a pediatric sports medicine specialist, when do you usually see injuries in sports?

1) When not wearing appropriate protective equipment.

Bike helmets do no good when they are strapped to the handlebars, just like shin guards can not work if they are left in the gym bag. Make sure the equipment is in good condition, fits well (especially with growing children), and is always properly used.

2) Within a month of a new season or activity

Good studies on Marine recruits show that foot stress fractures are most commonly seen three weeks into boot camp. My experience with young athletes is quite similar as about three weeks into a new sport, I will start to see overuse injuries. The body is unable to handle the stress of a new activity, and breakdown occurs. How can this be minimized? Have the athlete prepare for the new activity with some light conditioning. Going straight from X-box football to double days on the field can be a recipe for disaster. Also, start slow and increase intensity or length of workouts slowly to allow the body to adjust- and do not forget those rest days.                                                                                        

3 )When an athlete steps up to a higher level

This often includes playing with older, more mature (and bigger) athletes, attending an intense sport camp, or starting high school or college training. No matter what success the athlete has enjoyed in the past, these situations can overtax a young body. Limit situations where 9 year-olds play with 12 year-olds. Prepare well for camp or a new school, and gradually increase the training. Sports medicine physicians use the mantra TOO MUCH, TOO FAST, TOO SOON as a recipe for overuse injuries.  

4) Playing more than one sport at a time

Many athletes can handle playing club soccer and running cross country at the same time, while some cannot. Other athletes can handle summer football, baseball, and basketball camps without missing a beat while some cannot. I will often see athletes who are burned out from too much activity and once they take a brief rest period and then focus on one sport the majority return refreshed and are more successful.

 5) Playing too much of one sport

The more is better philosophy may work for some, but is has also caused the demise of many young bodies. Repetitive activity strengthens bones and joints, but too much repetitive activity can over stress bones and joints, leading to injury. Thus, swimming for two club teams, or playing on three baseball teams may be detrimental in the long run. Do not forget that private throwing lessons or personal training sessions also add to the cumulative stress placed on the body. Factor all activities into the equation when determining limits for your young athlete.      

6) Playing through pain or discomfort

No child should ever play through any significant pain. I use a 1-10 pain grading scale (1= no pain, 10= major pain). Any pain rating higher than 2-3/10 is significant pain. Schedule an appointment if there also is pain that causes a limp, changes technique, or forces a child to change position or not want to continue activity.

7) When an athlete is tired

Fatigue minimizes the ability to make quick decisions and movements that can help avoid injuries. Tired muscles and ligaments are less able to withstand forces on the field. Make certain the athlete is getting sufficient sleep (at least 8 1/2 hours a night, especially in high school ages) and enough rest between practices and games. Despite what many young athletes think, rest is your friend.  As a parent, it is your responsibility to help your child take appropriately placed rest days.

• Children ages 5-10 should participate in organized sports no more than 3-4 days/week
• Children ages 11-15 should take at least two rest days off per week.
• High school-aged athletes should take at least one day off per week.
• Another good rule- take at least two months (preferably 2 separate months) away from a sport per year for overall rest and to enjoy alternate activities.  
• Proven science: keeping the number of organized activity hours/week equal to or under the age of the child (in years) can reduce risk of injury. Thus, if an 11 year old is playing organized sports more than 11 hours a week, there is a statistically increased risk of injury.

8) Too much running in cleats

Cleats are designed for a particular sport (soccer, baseball, football, etc) and not designed for prolonged running. In early season practices with lots of running and conditioning, have young athletes wear running shoes to run, and use cleats for the sport-specific drills. Will make a huge impact in reducing lower leg/heel pain and limit missed time.

What happens if an injury is not treated correctly?    

Children tend to heal quickly (that is why I chose pediatrics) so most injuries are not a long-term concern. However, in a worst-case scenario: the athlete has life-long pain or disability. Serious growth issues can develop if a minor injury is allowed to mature into a major injury. Injuries are a common reason why kids stop playing sports, and why athletes fail in the quest for a starting job, a varsity letter, or a scholarship. Certain injuries label the child as damaged goods, for example once a pitcher has a shoulder or elbow injury- it is common for coaches and scouts to automatically write off that athlete.

Have no regrets- call and get a qualified opinion on any childhood injury.

Teens: 7 Essential Tips to get 8-9 Hours of Sleep and Decrease Injury Risk

Not quite able to get that elusive 8-9 hours of sleep per night?

Figure there will be catch up on the weekend, or once summer starts, or after the upcoming tournament ends?

Maybe you just don't think that sleep is that important in general safety, training and competition?

Well, if your goal is to optimize overall performance while limiting risk of injury, then wake up and take notice of the following studies on the importance of sleep:

• Colleagues from Children's Hospital of Los Angeles found that adolescent athletes who slept more than 8 hours a night were 68% less apt to be injured than peers who did not get that much sleep per night. Athletes who reached higher grade levels in school actually had higher injury risks, so the additional sleep recommendations are even more important for older adolescents versus younger adolescents.

• The USA Centers for Disease Control reports that teenagers who got 7 or fewer hours of sleep a night had a higher prevalence of risky behaviors such as not wearing bike helmets or seatbelts, driving a car after drinking or riding in a car with a driver who had been drinking, or texting while driving when compared with teenagers who got 9 hours of sleep a night.
• Check out the wonderful infographic below from fatiguescience.com that compares a well rested athlete with a tired counterpart in a visual description of how poor sleep directly leads to poor performance. The graphic also illustrates the sleep habits of several well-known athletes and gives sensible tips on how to increase the quantity and quality of your sleep.

• For those who must deal with frequent long-distance travel and the demise of regular sleep habits, there's an App for that. Researchers at the University of Michigan utilize smartphones to monitor circadian clocks and make recommendations on lighting and other tips to more rapidly adjust to new time zones with travel.

Now, even when young athletes try to get this adequate amount of sleep, It is very common to have struggles with falling asleep, especially in the junior high or early high school years. If this scenario sounds familiar, start with the following recommendations:

1. Use bedrooms only for sleeping and changing clothes

2. Eliminate or reduce electronic exposure (TV, DVD, smartphones, computers, etc) in the bedroom

3. If must have electronic devices in bedroom, set to silent mode and turn upside down so screen is not visible

4. Try to go to sleep within 1/2 hour of the same bedtime every night, even on weekends and other days without school

5. Stop all electronic exposures at least one hour before bedtime

6.  Limit caffeine use at or after dinner time

7.  If having trouble falling asleep, turn your clock/timer around so you can't see the time

Many teenagers report awaking frequently during the night, or even more perplexing, getting the recommended 8+ hours a night, but still awakening tired or feeling fatigued during the day. In in these cases, highly recommend scheduling a medical evaluation to review sleep habits and hygiene, with focus on possible tonsil/adenoid enlargement, overtraining, uncontrolled asthma or allergies, depression/mood disorders and other illnesses that might contribute to interrupted sleep or poor sleep quality.