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Coping with kids' sports injuries

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Editor's note: Of all the worries on parents’ minds, their children’s health often tops the list. Considering this, we’re presenting a three-part health series in our April, May and June 2017 editions. Each installment will tackle a common health challenge faced by today’s families.

Part one will look at kids and sports injuries, exploring how to prevent and treat the aches and pains that often plague young athletes.

Part two will focus on health and technology, and part three will delve into the sensitive topic of mental health. 

We hope this series will serve as a helpful resource for families facing complex health issues and striving toward wellness. Learn more at LowcountryParent.com/Health.

Haley Baker is like a lot of high school athletes. She’s ambitious, driven and disciplined. A junior at Wando High School in Mount Pleasant, she’s spent years training and perfecting her sport, track and field, to become her best and dreaming about the  opportunities that can come with being a star athlete.

“I love the sport,” Haley said. “Going to practice is the highlight of my day.”

But all of her time practicing and competing has given her more than great form and a spot on the varsity team: It has also led to aching joints and bones.

As kids’ athletics become increasingly competitive, sports injuries like Haley’s are more common than ever, experts say.

More than 2.6 million children ages 19 and younger are treated in the emergency department each year for sports and recreation-related injuries, according to the Centers for Disease Control and Prevention.

Haley had been practicing her favorite events — triple jump, high jump and long jump — for two hours every day, and pushed her body to its limits. All of that time practicing is likely what spurred overuse injuries in her knees, shins and feet — common trouble spots for track athletes. At one point, she was in so much pain that she couldn’t walk normally, and even experienced joint pain while she slept.

She’s spent the last year working hard to heal so she can get back to the sport she loves. Haley's seen two orthopedic surgeons, a rheumatologist, a physical therapist and her school’s athletic trainers. Now, she says her pain is manageable, but she’s still not 100 percent. She continues to work at it daily with hopes to compete her senior year and in college, too.

Wear and tear

Participating in sports and recreation activities benefits kids' well-being and fitness, health experts agree. But as youth athletics become more competitive, health practitioners like orthopedic surgeons, physical therapists and athletic trainers report seeing greater numbers of sports injuries.

“Sports have changed,” said Dr. Kenneth Caldwell, a sports medicine specialist board certified in orthopedic surgery, and the team physician for The Citadel military college in Charleston. “You see these kids put into a position that they are forced by the culture to declare what sport they’re going to be involved in at a young age. Then they’re constantly training. That has been a change in the last 15 or 20 years.”

While focusing on one sport year-round might boost a child’s chances of getting a future college scholarship, it also increases their risk of getting hurt. Athletes who continuously use the same muscle groups and repetitive motions are more prone to overuse injuries, Caldwell noted. That’s why it’s more common to see knee and foot injuries in track athletes and soccer players, and shoulder injuries in volleyball players and swimmers, for example.

“Stress-related injuries are more common because of emphasis on one particular thing at a younger age,” Caldwell said. “Baseball players are throwing more, swimmers are swimming more, power athletes such as football players are doing more weight lifting at a younger age.”

In "collision sports" such as football and lacrosse, you are more likely to see cuts, bruises, fractures and head injuries, resulting from impact rather than overuse.

Mark Buchman, head athletic trainer at Wando High School, treats a lot of sprained ankles — an injury that can occur in any type of sport by simply landing on your foot at the wrong angle, he said. “We’re also dealing with concussions, muscle strains, knee injuries — you name it we deal with it.”

Younger athletes tend to have different types of injuries than high school-age athletes. Children younger than 15 don’t have many overuse injuries, said Caldwell. That’s partially because very young children aren’t playing at the same intensity level as older kids.

The child’s age will affect their treatment plan, as well. “A growing bone has different types of injuries than a mature bone,” Caldwell said. “For example, growth plates dictate the pattern of the fracture.” Younger children also heal a bit faster, he notes.

Whatever the activity, no sport is without risk. Locally, Caldwell said he sees many injuries in soccer players, swimmers, baseball and football players. However, he thinks that has more to do with the popularity of the sports and the seasons here, which allow players to be outdoors and practicing year round.

Treatment plans

So, how do sports injuries affect children when they grow up? It depends on the type of injury, but one of the things sports medicine specialists pay close attention to is "growth plates," areas of growing tissue at the ends of long bones that determine the way a child’s bones will grow. When a child younger than 15 fractures a bone, it’s imperative that injuries to growth plates are recognized and treated early on to avoid deformities or alignment problems in the joints at the end of the bone as the child grows, Caldwell said.

“It’s not as common now as it would have been a generation ago because the techniques of recognition that we’ve been taught,” he added. “[Growth plate injuries] are recognized now more than they used to be.”

Of course, the science of sports medicine is a complex and always evolving field, so having an open dialogue with your child’s doctors is the most important thing a parent can do. “The bottom line is, have an index of suspicion when you see an injury to a child, and make sure you see someone who can help you deal with the injury or refer you to someone who can,” Caldwell said.

While there is a vast pool of online information available about sports injuries, Caldwell doesn’t advocate using the Internet as a primary of source information. It can be helpful for general information, but he advises it’s always best to see a medical professional in person for a proper diagnosis and treatment plan.

Safety tactics

As the public becomes more aware of the risks involved in sports, some are advocating for stricter safety measures.

Last year, the National Football League settled a class-action lawsuit brought by former players, accusing the league of misleading them about the danger that repeated head traumas and concussions pose to the players.

In North Carolina, sports injuries in children have become so prevalent that state lawmakers have proposed legislation to increase awareness and education, particularly involving head injuries. A bill introduced recently calls for increased training and education to make sure all middle and high school coaches, school nurses, athletic directors, volunteers, and parents know the warning signs of concussions and other sports-related injuries. It also limits a child’s participation in sports after they’ve been hurt, until a medical professional gives the OK for the athlete to return to practice.

Taking some preventative steps, and watching for warning signs, can also help minimize the potential for sports injuries.

“If you play a sport, somewhere along the way you’re more than likely going to deal with injury,” Caldwell said. But that doesn’t mean you can’t minimize the risks of your child getting injured.

Leading a healthy, active lifestyle is one of the best way to prevent overuse injuries.

Caldwell recommends that kids participate in a variety of athletic pursuits, rather than specializing in one activity early on. “The more different activities you’re involved in overall, the safer it is because you’ll be using different body parts, and it’s better developmentally, too,” he said.

While this can be achieved through cross training or making sure children participate in more than one sport, simply making more time for recreational activities can also make a difference, health experts say. While free time can be hard to come by, especially for busy athletes, getting outside and being active as a family can be a great way to use new muscles and movements. Plus, it strengthens parent-child relationships.

Young athletes should also wear appropriate protective gear for the activity.  

“Preventative equipment is very important and it usually does its job,” Buchman said. “Think of the possible number of concussions, facial injuries or possible skull fractures we would have if helmets were not used in football, baseball or softball, lacrosse, and riding a bicycle.”

But it’s not uncommon for athletes to re-injure themselves when they don’t wear equipment designed to protect a previous injury — for example, an ankle brace worn for support after an ankle sprain has healed, Buchman noted.

Given the Lowcountry's warm climate, it’s also very important for athletes, coaches and parents to be mindful of outdoor temperatures. Staying well hydrated, and taking breaks on hot days, will help athletes avoid dehydration and overheating.

Taking responsibility

Young athletes might not always realize when they're at risk for an injury — especially when the discomfort is slow to progress, as in some overuse injuries. Parents need to watch for warning signs.

“Sometimes a child is having pain consistently with an activity, but they can’t remember when they did it,” Caldwell said. “The parent should be aware and paying attention.”

Overuse injuries can sometimes be prevented by giving the child’s body the time it needs to rest, which is often the first course of action with sports-related injuries.

Buchman agrees that parent involvement is a good way to help prevent little injuries from becoming something bigger. “[Parents] need to step in,” he said. “Kids get into the routine, and they enjoy the social aspect of a team sport. They want to keep going. When they’re tired or complaining of being sore, they need to take a day off or a couple days off.”

While it can be tough for parents to catch their child's every ache and pain, they should encourage their kids to keep them informed about health concerns.

Of course, there are also times when parents can push their young athletes too much. Ignoring the first signs of an injury, or encouraging a child to push through pain instead of resting, can be a problem.

“It’s an amazing thing how much pressure is injected into these athletes at a very early age,” Caldwell said. “The parents’ interests can go way beyond just their kids activities, but they’re looking ahead to college and beyond. You can’t ignore it. The emphasis isn’t just on the enjoyment of the sport; There’s a ticket that comes with it.”

Lessons learned

Though healing from a sports injury can be a long and frustrating process, the experience can sometimes magnify the benefits that kids see from playing sports, such as learning how to handle disappointment, and gaining confidence when they overcome challenges.

“Recovering from an injury is hard work, and there’s the disappointment that they’re out ... Sometimes they feel they’ve let their team down," Buchman said.

“My favorite part of what I do is seeing a kid go back and compete successfully after they’ve been out with something like an ACL tear or ankle surgery — watching kids overcoming adversity,” he added.

Despite the chance for injuries, most athletes and health practitioners say the benefits of athletics — from getting fit to learning discipline and teamwork — make up for the risks.

That includes track athlete Haley. Despite dealing with her injury for more than a year, and occasional recurring pain, she says wouldn’t trade in her sports experience. She’s even thinking about majoring in athletic training in college so she can go on to help other athletes heal from their injuries and get back to competing.

“I would say it’s been worth it,” she said. “I am still doing the sport that I love to do and I’ve become close to the athletic trainers. They are my teachers.”

Haley’s mom, Shari, agrees. While it has been difficult seeing her daughter in pain, and coping with the time and expense of so many doctor visits, the only thing she’d do differently is to catch the injuries sooner.

“Knowing how much she loves track, we’d do anything we could to help her and get her better,” Shari said. “If it was worth it to her, it was worth it to us.” LCP

Tips for preventing sports injuries:

  • Keep an open dialogue with your child.
  • Insist that your child wear proper protective equipment at all times.
  • Don’t push your child to specialize in one sport. Encourage a wide variety of activities both in organized sports and recreation.
  • Emphasize playing for the enjoyment of the game, instead of focusing on college scholarships and other far-off opportunities.
  • Encourage your child to rest when he or she feels pain.
  • If pain persists, see a medical professional soon to address the issue.

Helpful websites: