1. Sports Injury Prevention: It’s Not Whether You Win or Lose
Michael A. Gittelman, MD
Assistant Professor, Division of Emergency Medicine
Cincinnati Children’s 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
This slide is the standard background that will be on all slides unless otherwise noted

3. Problems with Surveillance
Difficult to track injuries
All injuries don’t 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 < 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 (< 1 wk of practice missed)
60% occur during practice

5. Injury Mechanisms < 10 years of age Pubertal child
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 Pediatric’s Committee on Injury and Poison Prevention. Sports safety. In: Injury Prevention and Control for Children and Youth, 3rded American Academy of Pediatrics
Rice SG. Risks of injury during sports participation. In: Sullivan JA, Anderson SJ, ed. Care of The Young Athlete American Academy of Orthopedic Surgeons & American Academy of Pediatrics