Sports

1. Sports Injury Prevention:
It’s Not Whether You Win or Lose
Michael A. Gittelman, MD
Assistant Professor, Division of Emergency Medicine
Cincinnati Children’s Hospital Medical Center
Cincinnati, Ohio

2. Background
•Millions of children participate daily
in sports activities
•Children learn to improve:
– Physical fitness
– Coordination
– Team play
•There is a risk of injury just by
participating

3. Problems with Surveillance
•Difficult to track injuries
– All injuries don’t get reported
– Best data from team physicians and
trainers
•No standard method of reporting
– May report by
• Body part injured
• Amount of time a player missed practice
or a game
• Type of injury sustained

4. Magnitude of the Problem
•3.5 million sports injuries for children
< 15 years of age treated in medical
settings
– ¼ of all Emergency Department visits
•For children involved in organized sports
– 770,000 physician visits
– 90,000 hospitalizations / year
– 70-80% injuries are minor (< 1 wk of practice
missed)
– 60% occur during practice

5. Injury Mechanisms
•< 10 years of age
– Often injured during individual recreational
activities
– Usually within the first week of the activity
– Examples = bike riding, roller skating,
sledding
•Pubertal child
– Greater weights, greater force = more
severe collision
– Usually occur during organized sporting
events
– Examples = Football, Wrestling, Basketball

6. Sports Causing Significant
Injuries at High School &
Intercollegiate Level
•Football
•Wrestling
•Gymnastics

7. Types of Injuries
Acute vs. Chronic
•Both types usually involve muscle & bone
•Acute
– Result from a collision or sudden twist
– Examples = Sprains/Strains, Contusions,
Fractures
•Chronic / Overuse
– Repetitive, small injuries due to repeat motions
– Increased today as children strive for
excellence at younger ages
– Examples = Pitching a baseball, Running cross
country

8. Body Parts Injured May Vary By
•Sport Played
– Some sports emphasize different body parts
– Lower extremity = soccer, basketball
– Upper extremity = tennis, baseball
•Equipment Used
– Projectiles may cause ocular injury
– Examples = baseball, tennis

9. Body Parts Injured May Vary By
(Continued)
• Age
– Younger children often injure upper
extremity
– Older children usually injure lower
extremity
• Sex
– Some sports injure one sex differently than
an another
– Females tend to have more knee injuries in
basketball than males
– In general, shoulder more male, knee/ankle
more female

10. Catastrophic Injuries
•Injuries that result in permanent,
severe neurologic disability
•Direct Catastrophic Injury
– Trauma from active participation in sport
– Example = Football, Ice Hockey
•Indirect
– Result from overexertion while playing a
sport
– Causes – Dehydration or sudden cardiac
death

11. Preventing Sports Injuries
•Field / Equipment
Changes
•Rule Changes / Coaching
•Individual Preparation

12. Field/Equipment Changes
•Add equipment as injuries become
evident
– Examples
• Helmets & Face Masks in youth hockey
• Chin protector in Little League Baseball
•Field modifications to prevent injuries
– Avoid potholes, grates, rocks near field
– Change field as injuries seen
• Example = Anchoring soccer goals

13. Rule Changes/Coaching
•Rule changes to adjust for injury
patterns
– Example = “spearing” in football
•Officials must enforce the established
rules
•Coaches
– Teach the appropriate techniques
– Encourage discipline in preparation
(stretching, etc)

14. Individual Preparation
Prior to Participation
•Learn about the game prior to signing
up
– Is this sport appropriate for your child?
– Does your child wish to participate?
– Who will be supervising practices/games?
•Purchase the recommended
equipment
•Pre-participation physical exam
•Preseason conditioning

15. Individual Preparation
At Participation
•Practice within your limits
•Stay well-hydrated
•Know and follow the rules of the game
•If injured
– Seek medical attention prior to returning to
play
– Adequate rehabilitation is essential

16. Summary
•All sports pose a risk of injury
•Research the interested sport prior to
participation
•Know the rules, equipment needed, and
who will supervise / coach your child
•Seek a pre-participation physical exam
•Have fun and play hard

17. Resources/Links
• Widome MD, ed. American Academy of
Pediatric’s Committee on Injury and Poison
Prevention. Sports safety. In: Injury Prevention
and Control for Children and Youth, 3rded.
1997. American Academy of Pediatrics
• Rice SG. Risks of injury during sports
participation. In: Sullivan JA, Anderson SJ, ed.
Care of The Young Athlete. 2000. American
Academy of Orthopedic Surgeons & American
Academy of Pediatrics
• www.hooah4health.com
• www.aaos.org