More than 2.6 million emergency room visits for youth sports injuries are reported annually, and that figure doesn’t take into account the number of children and teens who visit an orthopaedic or primary care physician for care.
These injuries fall into two categories:
- An acute injury that occurs in a single moment like a fracture, sprain or strain
- An overuse injury that is the result of repeated impact or trauma over time without allowing the body sufficient time to heal
About half of all injuries that send young athletes to sports medicine physicians are related to overuse, said Endeavor Health sports medicine specialist Carey Ellis, MD, who offers some strategies for effective treatment and injury prevention.
Common injuries and treatments
Upper extremity injuries are common in throwing sports, particularly for baseball and softball players who often develop growth plate injuries in their throwing shoulders and elbows.
One third of all pitchers will experience elbow or shoulder pain at some time, and those issues are exacerbated in younger players with skeletal immaturity, said Dr. Ellis. “Little Leaguers elbow and Little Leaguers shoulder occur when there is irritation on the open growth plate. This is fairly common and results in significant time missed from sport,” he added.
Other common acute injuries include wrist fractures from Falling on an Outstretched Hand (FOOSH), which is the most common fracture in kids. Shoulder dislocations are also very common in gymnasts, football, rugby and lacrosse players, and skiers and snowboarders, added Dr. Ellis. Shoulder dislocations that happen before the age of 20 are followed by a high rate of recurrence, up to 75%, he added.
The first line of treatment for overuse injuries in the upper extremities is to avoid throwing and pitching for anywhere from six weeks to three months depending on the injury, said Dr. Ellis. Physical therapy and targeted strength training exercises to strengthen the muscles around the shoulder or elbow are also an important part of rehabilitation.
For shoulder dislocations, brief immobilization followed by physical therapy and targeted strength training before a return to sport are important for full recovery. Often these injuries require surgery to repair injured structures and prevent recurrence.
Common lower extremity injuries include ACL and meniscus tears. These occur mainly in soccer, basketball, football and lacrosse players and gymnasts.
Patellofemoral syndrome, characterized by pain at the front of the knee is very common, particularly in adolescent girls involved in sports like basketball, track and volleyball, and can worsen with overuse without rehabilitation and occasional bracing. Definitive treatment for knee injuries requires surgical intervention and extensive physical therapy.
Shin splints or medial tibial stress syndrome common in high-impact sports like running, gymnastics and dance can lead to stress fractures and worse when not treated.
The most common lower extremity injury we see in the clinic are ankle sprains/rolled ankles. Treatment includes ice, elevation, anti-inflammatories, bracing and physical therapy, said Dr. Ellis.
Once they are relatively symptom-free, athletes should complete a return-to-sport protocol before returning to their activities.
Prevention
Dr. Ellis recommends these five tips for preventing youth sports injuries:
Avoid single-sport specialization. Dr. Ellis advised against single sport specialization. “Kids should play multiple sports. It is well known that multi-sport participation helps prevent injuries, makes better and healthier athletes and kids ultimately have more fun,” said Dr. Ellis.
“The biggest thing for preventing overuse injuries in young athletes is to avoid single sport specialization at least until high school,” said Dr. Ellis. “We see a lot of kids specializing in one sport by age 8, playing in multiple leagues year-round, and not giving their growing bodies a chance to rest, this significantly increases their risk of injury.”
- Wear proper fitting gear. Wearing the right gear — from the right shoes for different surfaces to properly fitted pads and helmets — is just as important for young athletes as it is for the pros, said Dr. Ellis, who is one of the Chicago Bears and Chicago Fire team physicians. “Proper shoes are an important consideration, and replacing running shoes every six months or 400-500 miles can be a good rule of thumb.”
- Learn proper technique. An important take-home message for injury prevention is teaching proper technique, said Dr. Ellis. For example, to avoid upper extremity injuries, “Proper technique for throwing is very important for injury prevention,” said Dr. Ellis. “Abiding by reasonable, accepted pitch counts is also critical.”
- Practice strength-training exercises. Regular strength training and flexibility exercises can help prevent an injury. Plyometric and strength training exercises to build up hips, hamstrings and core can reduce knee injuries by close to 75%, explained Dr. Ellis.
- Take breaks. “It’s important to take a break from running or the high-impact activity that led to the overuse injury. We encourage athletes to modify their activity or cross train with activities like stationary cycling or swimming to retain fitness while they heal,” said Dr. Ellis.
“I recommend all athletes take one day a week off from their sport for rest and recovery,” advised Dr. Ellis. “We see some kids participate in multiple practices a day during the week and play multiple games during weekend tournaments just beating their bodies up without time to heal.”
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