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Preventing Kids’ Sports Injuries: Sprains, Splints, Concussions

Monday, April 29, 2013
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Dr. Rosemarie Boehm, a sports medicine physician and Dr. Tom Watanabe, clinical director of the Drucker Brain Injury Center/Moss Rehab at Einstein Healthcare Network, discuss sports injuries in children.
 
Are certain injuries more common in kids than adults?
 
“No matter the age group, there are two kinds of injuries: acute and overuse,” Boehm explains. “An acute injury is from a single traumatic event, like sliding into base, getting hit with something or falling off a bike. In acute injuries, we’re talking about fractures, sprains, strains and dislocations. 
 
“Overuse injuries are much more common in both adults and kids,” Boehm says. “They result from repetitive movements. Those are injuries like tennis elbow, pitching elbow, runner’s knee, stress fractures and shin splints.”
 
Are certain injuries more common in girls than boys?
 
“When it comes to overuse injuries, definitely,” Boehm says. “The most common overuse injuries in boys are shoulder problems from pitching. Girls typically don’t get those because they play softball and pitch differently.
 
“The most common overuse injuries in girls are shin splints. That’s because girls have wider hips and their stance makes them prone to stress fractures. They are part of what we call the female athlete triad: eating disorder, amenorrhea, stress fractures. When girls limit their calorie intake, they usually eat more protein but less of everything else. That results in a calcium deficiency that puts their bones at risk. We see this a lot in cheerleaders or gymnasts who need to look good.”
 
What can be done to prevent overuse injuries?
 
“There are mechanisms that we teach kids,” Boehm says. “For example, girls have weaker muscles in different areas and they don’t bend in the hip and knee the way boys do. Their quads are strong, but their hamstrings are weaker. To compensate for that, we teach girls plyometrics, which includes things like how to land and how to jump. That can prevent devastating injuries.
 
“The other problem is constant practicing and playing of one sport,” Boehm says. “Not only does the body need to rest, but it needs cross-training. But many kids are not diversifying their sports because they are vying for college scholarships. That’s dangerous because they are then at higher risk for injury.”
 
What are the signs of concussion?
 
“Losing consciousness is the most obvious,” Watanabe says. “There are more subtle signs: confusion, problems with balance, dizziness, trouble with concentration, headache. If these issues begin after a blow to the head, that is cause for concern.
 
“These symptoms could be immediate or emerge in 24 hours or longer, so parents need to be vigilant. Also, concussions can occur even without a direct hit to the head. They can result from significant whiplash that follows a blow to another part of the body.
 
“The biggest concern with concussion is allowing the athlete to resume play without the injury healed,” Watanabe says. “That puts them at risk for more severe concussions and other bodily injuries because it will alter how they play. So if any athlete takes a hit or a fall and a concussion is at all suspected, he or she should come out of the game and be monitored.”
 
What can be done to prevent concussions?
 
“There are things like proper hydration and diet so that kids are at their best and not fatigued,” Watanabe says. “But proper protective gear is the most important thing. That is padding or mouth guards and, of course, helmets.”
 
“The other aspect of preventing concussion is knowing that it can happen in any sport that involves a ball,” Boehm says. “I say that field hockey is not a contact sport, but the ball doesn’t know that. If it hits a player’s head, it can do damage. Beyond that, there are changes that coaches and referees can make to game play. I think we’ll see more of that as more research is done into the long-term effects of concussions.”

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