Sports Injury Prevention:

1
Sports Injury Prevention Its Not Whether You
Win or Lose
Michael A. Gittelman, MD Assistant Professor,
Division of Emergency Medicine Cincinnati
Childrens 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 dont 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 lt
  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 (lt 1 wk of practice
  missed)
• 60 occur during practice

5
Injury Mechanisms

• lt 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 Pediatrics
  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