Young Athletes: Injuries And Prevention

Written by Catharine Paddock PhD

Published: Thursday 9 August 2012
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High profile events like the Olympics bring the hope that witnessing and celebrating dedicated
athletes at the top of their game, will inspire young people to take up sport and physical activities
that help them develop confidence, lead more satisfying lives, and not least, secure long-term
health by reducing their risk for developing chronic illness like diabetes, obesity, cancer and
cardiovascular diseases.
But unfortunately, if they don't take appropriate measures, young athletes can instead, end up in
pain, on a different path to poor health, due to avoidable sport injury.
James R. Andrews, a former president of the American Society for Sports Medicine (AOSSM),
said in May this year, the US has experienced a tremendous rise in the number of young people
taking up sport. Estimates show 3.5 million children aged 14 and under receive medical
treatment for sport-related injuries, while high-school athletes account for another 2 million a
year.
"This makes sports the leading cause of adolescent injury. Along with time away from school
and work, these injuries can have far-reaching effects," said Andrews.
This article looks at some of the common and less common injuries in young athletes. It then
reviews a new project that is tracking injuries in Olympic athletes, introduces some ideas about
avoiding and minimizing injury, and finishes with a list of tips for preventing sport injury in
children.

Common Sport Injuries

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, which is
part of the National Institutes of Health in the US, the most common sport injuries are due to
accidents, poor training practices or using the wrong gear or equipment. People can also
hurt themselves because they are not in shape, or because they don't warm up or stretch enough.
Some injury experts in the US have said they are also seeing more and more young athletes
injured because of overuse and doing too much, and this may partially explain the growing
numbers that drop out of sport by the eighth grade. The most common sports injuries are:

Knee injuries,
Sprains and strains,
Swollen muscles,
Achilles tendon injuries,
Pain along the shin bone, and
Fractures and dislocations.

While injuries in young athletes are similar to the ones that affect adults, they can't always be
treated in the same way because their bodies are not fully developed.

Take for example knee injury.

One type of knee injury is damage to the anterior cruciate ligament (ACL). This is a severe
injury that occurs most often in athletes who play football and other contact sports.

Twenty years ago, doctors were seeing few children or adolescents with ACL injuries. Today,
these injuries are more common because youngsters are taking up sports earlier, and pushing
themselves more competitively.Another reason for the rise in young people with ACL injury, say
researchers from the Hospital for Special Surgery (HSS) in New York City, is that more and
more young athletes are specializing in one sport, putting them at risk of injuries normally only
seen in professional athletes.
But this type of knee injury in young people is a particular concern because it is not easy to
repair in growing bodies, for instance ACL reconstructive surgery that works well in adults can
potentially cause uneven limb length or other deformities in growing bodies. That is why often
the best course has been "benign neglect". However, clinicians are beginning to realize that not
operating can also lead to problems, such as early arthritis.
There are alternatives to conventional ACL reconstructive surgery, that have lower risk of
damage in growing bodies, such as the All-Inside, All-Epiphyseal ACL Reconstruction (AE), but
this is not commonly available.Clinicians are calling for more research to be done into sports
injuries in younger people.

Back and Neck Injuries

Back and neck injuries are much less common in young athletes, but when they occur, they can
cause enormous frustration. The athlete must complete a comprehensive and demanding
rehabilitation program before returning to competitive sport: in some cases, they may never
return to their given sport.

Most back and neck injuries in athletes are sprains of ligaments or strains of muscles. Aside
from trauma, these are usually due to athletic overuse, improper body mechanics and technique,
being out of condition, or not stretching enough. The athlete will complain of back pain when
active and performing, and will feel relief when resting.
But, occasionally, a more serious condition can have similar symptoms. Because of this, proper
treatment of back and neck injuries in young athletes should always include a good evaluation by
a doctor, using imaging studies when necessary.
According to the North American Spine Society, the more serious back and neck injuries
include:

Spondylolysis and spondylolisthesis: a particular type of defect in the vertebra of the

spine (spondylolysis), and where one vertebra slips relative to another
 (spondylolisthesis). A common cause of back pain in young athletes, particularly
gymnasts because they have to twist and hyperextend their spines.
Stinger (also called "burner" or "nerve pinch"): where forcing the head back and to the
side compresses a nerve of the spinal cord in the neck, or where forcing the head
sideways away from the shoulder over-stretches the nerves in the neck and shoulder.
Most common in football and wrestling, the injury often goes unreported because
symptoms can resolve suddenly and quickly. Can recur and lead to persistent pain or arm
weakness if not treated.
Disc injury: a common cause of back pain in adult athletes, much less so among young
athletes, it may or may not be associated with sciatica (shooting pain down the leg).
Careful diagnosis, including MRI scans, can help to rule out other possible causes that
can mimic disc injury in young bodies that are still growing.
Scheuermann's Disease or juvenile kyphosis: another common cause of back pain in
young athletes during puberty that occurs in the mid- as opposed to the lower-back, and
leads to a roundness of the back that worsens to a dome shape on bending forwards.
Exercises are often not enough to correct this disease, and if wearing a brace does not
relieve the pain, surgery may be required, after which it is unlikely the athlete will be able
to resume their given sport.