Posted tagged ‘sports injuries’

Sports injuries part 1: Prevention

July 18, 2010

The Pediatric Insider

© 2010 Roy Benaroch, MD

Children are experiencing more sports injuries, and more serious sports injuries, at a younger age than ever before. Surgery that was once only considered for top athletes (including ACL repairs, “Tommy John” elbow reconstruction, and arthroscopic knee exploration) is now routine for teenagers.

Kids have unique risks for sports injuries. They’re still learning proper technique, and may not always be fully trained or trained well. Often, their equipment is ill-fitting, or not really designed for their size. Children or their parents may not be as quick to recognize an early injury that can affect a child’s mechanics, leading to further injury.

There seems to be less time available for children to recover from injuries, too. Sports seasons have gotten longer, with extended pre-training and prolonged “post-seasons.” Many children not specialize in a single sport, or even a single position, which dramatically increases their risk of over-use injuries, and doesn’t allow their bodies to heal from repetitive trauma. There may also be pressure from coaches, peers, and parents for the best-performing children to stay in the game despite pain and injuries.

Injuries may be an inevitable part of competitive sports. Still, many could be prevented with some simple steps. Kids should learn good technique and sportsmanship. Parents should insist on proper, well-fitting equipment that’s kept in good shape, and should encourage their children to play multiple positions in different sports during different times of the year.

Stretching and warming up are important, but they’re often over-stressed as a magical way to prevent injuries. In fact, injuries are as likely to occur in a stretched, warmed-up athlete as in someone who starts competing cold. Stretching itself, if done incorrectly, can lead to even more injuries.

Splints and supports, such as tight ankle wraps, tapes, and knee bands, are commonly used by professional athletes. But those athletes get paid to play. These kinds of devices may allow an injured child to keep playing, but do not prevent serious injuries; in fact, they might actually increase the risk of further damage by providing a false sense of security. Routine use of these is not a good idea.

Most importantly, teach your children to pay attention to signals from their bodies. Pain means injury, and a child should not “play through pain.” If something hurts, the child ought to be able to sit out for evaluation by a trainer; if pain persists, a pediatrician, orthopedist, or sports medicine specialist should be consulted. Depending on the cause and kind of injury, reasonable restrictions might be needed to allow healing—rarely is absolute restriction from all sports necessary, but children need to know that their parents are supportive of taking a break from a sport in order to heal.

Coming up: Sports Injuries, part 2: Treatment. Stay tuned.

Ice v Heat for injuries

January 25, 2009

Mark wants to know how to treat injuries: “Why do doctors say to alternate between applying heat and ice? Since these are opposites, how could they both help?”

Heat and ice do two different things after an injury. Knowing which one is more suitable depends on what you’re trying to accomplish.

Ice numbs tissue, so it reduces pain. It can also reduce bleeding and bruising. Coldness also helps prevent or treat swelling, which is important—swollen joints have altered mechanics, so they don’t work right, and are prone to re-injury. A swollen, painful joint will also change the way a person walks and moves, which can create a risk for further injury at other body parts. Immediately following a musculoskeletal injury, ice is often one of the best ways to help. Ice itself can be uncomfortably cold, especially in children, so a better option might be ice wrapped in a towel, or a cool wet washcloth from the refrigerator. Don’t leave bare ice on a body part for more than 15 minutes to avoid frostbite, and check any area that’s being iced frequently—the skin can feel cool, but should never be close to frozen.

Warmth works in a different way. It relaxes muscles that often tense up after an injury, and it feels good. Warmth is usually used the day after an injury, when swelling is less of a problem. It’s great for pulled muscles, whiplash, and other injuries that don’t typically involve a broken bone. Warmth can make swelling, bruising, and bleeding worse. Electric heating pads should not be used on unsupervised children. Instead, use one of those warm-up things you put in the microwave, and check carefully that it isn’t too hot before putting it on a child. Topical heating creams smell kind of weird, but do help muscle injuries feel better. They’re hard to remove if a child objects to the warmth or smell.

I can’t think of a time when I’ve ever suggested alternating heat and ice after an injury—when did a doctor suggest that to you? It doesn’t make sense to me, either!