Overuse Injuries

Sometimes parents are concerned that their child's participation on a team that has hour-long daily practices and several hours of games on weekends may put the child at risk for overuse injuries.

Prior to puberty, children are at low risk for such injuries, Dr. Harris says. “A greater concern would be whether the sport is requiring too much time at the expense of other experiences that comprise a well-rounded lifestyle, such as school, friends, family and unstructured time.”

“Overuse injuries can be prevented by curtailing the activity associated with pain,” she says. “The philosophy of ‘no pain, no gain’ is not appropriate for children. Fortunately, most injuries in this age group are minor, such as bruises, abrasions, strains and sprains.”

An overuse injury may be developing when musculoskeletal symptoms happen more often and last longer, Dr. Harris notes. The progression of overuse injuries is typically:

• Soreness lasting several hours or less, but only after activity
• Soreness or pain during and after activity, and not resolved the next morning
• Soreness or pain during activities of daily living, as well as during sports

Symptoms showing this progression should be evaluated by your pediatrician for an overuse injury.

Treating a Sports Injury

All injuries should be treated initially with R.I.C.E. – rest, ice, compression and elevation. Your child should rest and take a break from any activity that’s causing pain. You should ice the injured area for 20 minutes at a time, making sure to protect the skin with a thin towel. Compress swelling with an ACE elastic bandage, applied firmly but not too tightly. Elevate the injured part above the level of your child’s heart.

Any injury in which there is significant swelling, deformity or limitation of function that does not improve quickly should be evaluated by a doctor.

Preventing Injuries

Dr. Harris says most sports-related injuries are preventable through appropriate supervision, training, rules and using proper equipment, especially if children are young.

Stretching and warming up are important for children and teens, particularly during periods of rapid growth, such as during the adolescent growth spurt, Dr. Harris notes.

Stretching should involve the major muscle groups and be done slowly and steadily, with each stretch held for 20 to 30 seconds and repeated several times. In general, physical activity sessions should be structured to include:

• Limbering up (5 minutes)
• Stretching (5 to 10 minutes)
• Warming up sports skills (5 minutes)
• Playing sport
• Cool down and stretching (5 to 15 minutes)

To prevent injuries, Dr. Harris recommends your child maintain good overall fitness, get plenty of sleep and use protective gear (helmets, shin guards, knee pads, mouth guards, protective eye wear).

You can also help prevent sports injuries by:

• Easing your child into new activities gradually.
• Identifying early on and modifying activities associated with pain, until your child can participate pain-free.
• Making sure your child is using the appropriate type and sized equipment (shoes, rackets, bats, balls, skis, etc.).
• Paying attention to your child’s biomechanics (throwing, swimming, racket swing, etc.) and correcting as needed.
• Not allowing your child to participate until prior injuries are fully rehabilitated. “The greatest predictor of injury is a previous injury at the same location,” Dr. Harris says.

Preventing Dehydration

About one cup of fluid is required for every 15 to 20 minutes of strenuous exercise to prevent dehydration. Young athletes should understand that even mild dehydration impairs performance and leads to fatigue, Dr. Harris says.

Water should always be readily available during exercise and typically is enough to keep your child hydrated. Sports drinks – which usually contain six to eight percent carbohydrate – are only beneficial for physical activities that last longer than 90 minutes. However, children may drink more of a flavored drink if they prefer the taste.

Salt loss is replaced through a normal diet, so avoid giving children salt tablets – they are unnecessary and can cause dangerous side effects. Do encourage your child to drink even if he or she doesn’t feel thirsty, as mild dehydration happens before you feel thirsty.