There has been plenty written in the news lately about how kids are specializing in sports earlier these days, training harder than ever—in team sports in particular—to compete at higher and higher levels. This puts extra stress on growing bodies and often leaves parents on uncertain ground. As a parent of an athlete, I often wonder when my kid says, "It hurts here," how seriously I need to take it. Is this a bath and a good night's sleep after a tough work out, or is it a trip to the doctor? Like many parents I know, I sometimes find myself asking the coach for input, when really I should be asking a specialist.
Knowing a good resource for kids' sports injuries is a big help—which is why I'm excited to be writing about LA's Orthopaedic Institute for Children. It has given me a chance to get some of my own questions answered on the topic of parenting an athlete, and to share the info with other sports parents. I posed a few questions to the associate director of the Orthopaedic Institute for Children’s Center of Sports Medicine in Los Angeles, Dr. Jennifer Beck, who gave me some great information about supporting a young athlete, and about why the demanding nature of sports while a young body’s musculoskeletal system is rapidly changing can sometimes cause injuries.
Injuries in child athletes are different from other childhood injuries.
"The typical child who plays on the playground or does soccer informally with friends," explains Dr. Beck, might "get acute injuries, or a sudden onset, new injury. For example, they fall off the monkey bars and break an arm." Child athletes, on the other hand, deal with chronic injuries and/or overuse. Young pitchers can injure their growing arms by throwing the ball too hard, too often, and without proper rest. Young cross country runners might get stress fractures in their legs if they don’t allow their bones enough time to rest and recover between training sessions.
Dr. Beck advises parents and coaches to work together to ensure that players don’t skip warm-ups, never play through pain, and drink enough fluids. Dehydration can make muscles more susceptible to damage; players should drink water before, during, and after practice and games.
Children's sports injuries are different from adults' sports injuries.
As we all know, but occasionally forget, children are NOT tiny adults. The temptation to place adult expectations on them is constant, right down to wanting them to remember where they left their socks. But the most eye-opening thing I learned this week was when Dr. Beck explained to me about growth plates. These plates at the ends of children's bones represent the most significant difference between kid bodies and grown-up bodies (with the emphasis on grown).
"The growth plate is responsible for making bone bigger and is inherently the weakest part of the musculoskeletal system in children," explains Dr. Beck. Adults no longer have these plates and therefore can't injure them; we might get sprains or strains of the soft tissues that attach muscle to bones, but these are rarely truly harmful. "Young athletes more often injure their growth plates," she continues, "and these injuries can lead to long lasting, permanent effects on their bones." A young volleyball player, for example, could land awkwardly and seem to "twist" or "sprain" her ankle—a ligament injury common to adults—but in young athletes there is a growth plate at the end of the fibula, in the ankle, which often is injured in this situation. This is actually a bone fracture and needs to be treated differently than an adult's ankle sprain, even though the symptoms may seem the same.
"A child should NEVER be told to 'work through the pain'" says Dr. Beck, "as this can lead to devastating consequences."
Photo credit: Bob Young
Child athletes need special care to avoid injury.
Injury prevention is a major element of sports medicine. Kids' injuries can often be prevented with proper education, but that education is hard to find.
Specialists know, for example, that female soccer players are 8 times more likely to tear an ACL as their male counter parts. Dr. Beck works to educate young patients on proper lower extremity biomechanics and training techniques to help reduce the chance of these injuries. She and her colleagues also keep their eyes on bone development, which for some young athletes doesn't progress properly. This condition, known as Relative Energy Deficiency in Sport (REDS), is most common among wrestlers, long distance runners, gymnasts, dancers, and figure skaters. A sports specialist is more likely than anyone else to catch this syndrome early .
How to know when an ordinary ache or pain has gone too far
The good news is that specialists agree parents know their children best and are typically very good at identifying serious vs. non-serious injuries. Some children are better than others at hiding pain, though—especially when faced with being removed from a sport or activity they love. Low level, chronic pain can be difficult for a parent to determine severity. Dr. Beck offers the following red flags to watch out for:
- swelling of a joint
- the feeling of a joint “getting stuck,” “giving out,” or “moving out of place”
- pain requiring frequent attention
- pain for more than one or two weeks
Rest, ice, and ibuprofen can help reduce soreness and inflammation, but if pain persists, or a child has to take him or herself out of sports activities because of any combination of these symptoms, it's time to see a physician for a medical evaluation.
Follow the Pitch Smart Campaign Guidelines.
With the onset of baseball season, Dr. Beck particularly encourages coaches and parents to follow the Pitch Smart campaign guidelines that are endorsed by Major League Baseball and USA Baseball. The guidelines provide pitch count limits by age group and encourage younger athletes to play other positions, not just pitcher. “Injuries related to overuse can be prevented with this type of common sense approach,” she says, “while failure to address a sports injury properly can lead to lifelong problems.”
This post is sponsored by Orthopaedic Institute for Children Orthopaedic Institute for Children (OIC), which focuses solely on musculoskeletal conditions in children. With locations in Downtown Los Angeles, Santa Monica, Westwood, and Calexico the institute treats the full spectrum of pediatric orthopaedic disorders and injuries.
Top photo courtesy of OIC.