Sports Injuries in Children


Participation in sports activities provides numerous health benefits by improving fitness and coordination, as well as teaching important life values, such as teamwork, sportsmanship and discipline. However, sports participation also carries the risk of injury and children are particularly susceptible.

Why Children And Adolescents Are At Higher Risk

  • Younger children are less coordinated and have slower reaction times because they are still growing and developing. Children between 5 and 14 account for almost 40% of all sports-related injuries.
  • Kids mature at different rates so that there is often a substantial difference in height and weight between children of the same age. However, children tend to participate in sports with others the same age. When kids of varying sizes play sports together, the risk of injury in the smaller child increases.
  • Kids are still growing and that makes them more prone to injury than adults. Growth plates- the areas of developing cartilage where bone growth occurs in growing children- are weaker than the nearby ligaments and tendons. As a result, trauma that might tear a ligament in an adult (a sprain) would be more likely to break a bone in a child.
  • As kids grow, the potential for injury increases because the forces involved increase. Two 8 year olds making contact in Pee-Wee football do not apply the same force as two 16 year olds weighing 200 pounds each would if they made contact in a high school football game. Similarly, as skill levels increase, so does the intensity of competition.
  • Kids don't assess risk as well as adults and thus attempt things that may lead to injury.

Common Sports Injuries

  • in general, most sports injuries are either acute injuries that occur suddenly and are usually associated with some type of trauma; or overuse injuries that occur from repeated stress on bones and muscles.
  • Acute Injuries
    - usually bruises, sprains (a stretching or tearing of a ligament that connects bones at a joint like the ankle) and strains (an injury to the muscle or tendon).

         - ankle sprains are the most common sports injury

         - knee sprains are more common in girls, especially soccer players (see later)

         - hamstring strains are common in long distance runners while quadricep strains are   common in soccer, rugby and football players

o   more severe acute injuries include eye injuries (e.g., scratched corneas, detached retinas, blood in the eye), brain injuries (e.g., concussions, bleeding in the brain), and spinal cord injuries.

  • Chronic, or Overuse Injuries
    • injuries that occur from repetitive actions, often of increased intensity or frequency, that put too much stress on bone, muscle or tendon.
    • often very painful and can occur after, during or even when not playing a sport
    • especially problematic in children because their bodies are still developing. Any damage can lead to long-term chronic pain.
    • These injuries can be made worse by:

             - not warming up well

             - playing the same sport for an extended period or multiple sports at the same time

             - poor technique

             - improper equipment

o   Types of overuse injuries:

             - "Little League" elbow

             - "Swimmer's" shoulder

             - forearm and wrist pain in gymnasts

             - shin splints

             - pain in the anterior part of the knee

             - Sever's disease, or heel pain

             - spondylolysis, or persistent lower back pain caused by repeated flexing, twisting or overextension of the back muscles. Common in soccer, football, gymnastics, wrestling and diving.

  • Heat-Related Injuries
    • Children can easily become dehydrated leading to either heat exhaustion (nausea, dizziness, feeling faint) or heat stroke (severe headache, confusion and potentially coma or death)
  • Reinjuries
    • Occurs when an athlete returns to a sport before a previous injury has healed
    • Often forces the athlete to compensate for weakness on the injured body part, leading to an increased risk of injuring themselves somewhere else.
    • In concussions that are not completely healed, a second injury to the brain could have severe consequences.


Injuries In Boys

  • Up to 40% of all high school male athletes suffer an injury each year
  • Most male injuries occur in football (69 severe injuries per 10,000 athletic exposures) and wrestling (52 per 10,000)
  • Boys are more likely to injure their ankles than their knees.
  • There are strict guidelines on head injuries and concussion (e.g., if an athlete has a loss of consciousness or has concussion symptoms such as dizziness and nausea lasting more than 15 minutes, they should be benched until symptom free for more than a week). However, a recent study of football players found that 16% who lost consciousness returned to the field the same day.


Injuries In Girls

  • With more girls participating in sports than ever before, the action is now faster and more aggressive than in the past. As a result, injuries in girls have risen.
  • In directly comparable sports (e.g., those other than football and wrestling), girls suffered a higher severe injury rate than boys (29 per 10,000 athletic exposures vs. 23 per 10,000)
    • basketball had the highest discrepancy, 34 per 10,000 exposures in girls compared to 24 per 10,000 in boys.
  • Girls are more likely to injure their knees than their ankles
    • Studies show that girls are 4-6 times more likely than boys to tear their anterior cruciate ligament (ACL), which is important for knee stability.
    • When girls injure their ACL, it is usually in their non-dominant (non-kicking) leg, whereas in boys it is usually their dominant leg.
    • The reason for the increased incidence of ACL tears in girls is unclear although there are suggestions that the female hormone estrogen may loosen ligaments while lower levels of the male hormone testosterone limit muscle growth that can be protective of joints exposed to stress.
  • Girls have been shown to be more susceptible to heat illness
    • A study of heat illness over several years in a large youth soccer tournament found that girls were nearly twice as likely as boys to suffer heat-related injuries when the heat index exceeded 840F.

Preventing Sports Injuries- Parents And Coaches

  • Group youngsters according to skill level and size, not chronological age, when possible (especially in contact sports)
  • Match the child to the sport and don't push too hard if the child is not physically capable of performing
  • Be sure that safety rules are enforced
  • See that all children get a preseason physical exam
  • Don't let (or insist that) a child play when injured
  • Get the child medical attention, if needed
    • any symptoms that persist or affect athletic performance
    • any visible abnormalities of or severe pain in the arms or legs
    • any signs that a head injury is anything more than a mild bump
  • Provide a safe environment
    • Poor playing fields, unsafe gym sets, unsecured soccer goals all contribute to injury
  • Try to find programs where certified athletic trainers are present
  • Make sure kids get days of rest and take occasional breaks from a sport


Preventing Sports Injuries- Athletes

  • be in proper condition to participate
  • follow the rules
  • make sure to wear all available protective gear
  • know how to use athletic equipment
  • maintain proper hydration
  • avoid playing if very tired or in pain
  • make warmups and cooldowns part of the routine


 Dr. Jeffery Schor, an expert on Pediatric Emergency Medicine, is the founder of PM Pediatrics in Long Island.