Dr. Koutures Co-Authors American Academy of Pediatrics Report on Martial Arts Safety

NEW AMERICAN ACADEMY OF PEDIATRICS REPORT ENCOURAGES SAFER PARTICIPATION IN MARTIAL ARTS 

Nation’s pediatricians offer guidance on injury risks among various forms of martial arts, including mixed martial arts

Karate, taekwondo, judo and other martial arts can boost fitness, motor skills and emotional development for the estimated 6.5 million youth participants in the United States. But these increasingly popular activities also come with injury risks, which are strikingly higher for some techniques and movements within various disciplines.

A clinical report from the American Academy of Pediatrics (AAP) in the December 2016 journal Pediatrics, “Youth Participation and Injury Risk in Martial Arts” (published online Nov. 28), promotes safer participation in martial arts by guiding families to choose non-contact forms of martial arts that provide health benefits but lower risks of serious injury.

• Click here for a full copy of the clinical report

"There are so many different types of martial arts for families to consider and enjoy, but such a difference in injury risk between the different non-contact and sparring forms,” said author Chris Koutures, MD, FAAP, a member of the AAP Executive Committee on Sports Medicine and Fitness. “We hope that this report will enable pediatricians to help families select the most appropriate options for their child and realize how strongly certain practices and rules can impact a participant’s safety.”

Most martial arts injuries, such as bruises and sprains, are not life-threatening. But more serious injuries such as neck trauma, concussions and fractures do occur, especially during free sparring in competitions. Injury rates vary from 41 to 133 injuries for every 1,000 athletic exposures, depending on the form of martial art. Protective equipment such as soft helmets and mouth and face guards are not proven to prevent concussions and may provide a false sense of safety, according to the AAP.

The AAP recommends martial arts competition and contact-based training be delayed until children and adolescents demonstrate adequate physical and emotional maturity. The AAP calls for the elimination of certain rules, such awarding extra points during tournaments for kicks to the head, a rule recently enacted in taekwando, that can have particular impact on concussion rates.

The AAP strongly discourages youth participation in practices common in mixed martial arts (MMA) such as direct blows to the head, repetitive head thrusts to the floor and choking movements, which can dramatically increase risk of concussion, suffocation, spine damage, arterial ruptures or other head and neck injury. The AAP also cautions against excessive media exposure to MMA contests, which can put children at risk of injury if they imitate what they see.

How Can Children Enjoy Safe Participation in Martial Arts?

What should families know about Martial Arts to maximize the benefits of this vigorous physical  activity that develops balance, strength and body control while best minimizing injury risk?

• Be aware of the difference between non-contact and contact Martial Arts
  • Non-contact forms or movements are fairly safe and will give all the benefits of increased body control and strength that lead to development of overall athletic ability without greatly amplifying acute injury risk.
  • There is no doubt that incorporating contact, often known as sparring, definitely increases the injury risk, Free sparring is more risky than controlled sparring where an instructors oversees and potentially limits the overall amount of contact.
  • When selecting a studio and instructor, do not be hesitant to ask about how contact is included in the program.
  • May opt to delay introduction of contact until a child is more physically and emotionally ready with a greater grasp of basic skills and movements.
• Grouping of children participating in all forms of of Martial Arts, and especially with contact disciplines, should take into account physical size, development, and experience
  • Decisions on pairing children for sparring are often a challenge and should not simple rely upon age or "belt color". While having children participate with peers a few years older or younger is generally discouraged due to significant physical or emotional differences, there may be situations where experience or overall aptitude may warrant matching kids who are at different ages, 
  • This is another area where discussions with instructors can be insightful and helpful
• Soft protective helmets are often used, but do they provide sufficient protection for head injuries and/or concussions?
  • he current medical literature does not have evidence that soft protective helmets reduce the risk of concussion, head lacerations, and facial trauma. 
  • Do not rely on soft helmets to prevent concussion or think that one can engage in more risky activity simply because a soft helmet is being worn.
  • Improving defensive block maneuvers to protect the head may be helpful, but discouraging and ultimately eliminating direct  impacts  to the head (kicks, arm strikes, etc) are likely the only true ways to reduce concussion in the Martial Arts.
  • Rapid head thrusts to the floor (even a padded floor) should also be discouraged due to the risk of head or neck injuries
• There is also insufficient evidence proving that other types of soft protective padding (arm, chest, foot) can prevent injuries.
• Rules prohibiting contact or excessive force to certain areas (head, throat, stomach, groin) must be enforced
  • f a family elects to participate in contact forms of martial arts, appropriate instruction and rule enforcement has been shown to reduce to risk of more serious injuries.

Are there any other recommendations you have to increase safety and enjoyment of the Martial Arts?