Keeping kids safe and in the game
Youth sports participation is at an all-time high in the United States. From Little League baseball to club soccer, kids are spending more and more time in organized sports. The athletes and their parents invest thousands of hours and dollars in competition, improving skills and hopefully having some fun.
There are multiple health and social benefits to youth participation in sports. Sports provide benefits to cardiac health, can improve respiratory conditions like asthma, and help overall fitness to combat the obesity epidemic in our country. There is also good evidence that youth who are active in sports develop healthy habits and have decreased incidence of diabetes and other health problems in adulthood.
Sports provide mental benefits as well. Young athletes grow socially and emotionally as they learn how to be part of a team, how to cope with wins and losses and develop self-affirming beliefs.
However, there are some downsides to youth participation in athletics. The most troubling trend over the last couple of decades has been the shift to single-sport specialization. Single-sport specialization is when an athlete participates in one sport at the exclusion of other sports. This is a relatively new phenomenon as most youth athletes previously participated in multiple sports throughout the year, changing with each season. Athletes generally did not previously specialize until high school or later. Now, many youth athletes are specializing in a single sport as early as age 7 or 8.
Studies have shown that youth athletes specializing in a single sport are 1.27 times more likely to sustain overuse injuries and 1.36 times more likely to sustain serious overuse injuries.
Physicians at Emory Sports Medicine have conducted some of the premier research on this subject. Athletes who participate in organized sports for more hours per week than their age are significantly more likely to suffer injury. For example, a 10-year-old should not participate in more than 10 hours per week of practice/games in his/her sport. Free play should also be encouraged. Our research has shown that more hours of free play (traditional, unorganized play/pick-up games) in relation to organized play reduce overuse injuries. Those athletes who specialize in a single sport are also more at risk for burnout and overtraining syndrome.
The primary area of concern for injury among youth athletes is the growth plates. The growth plate, or physis, is the region of the bone where new bone is laid down during periods of growth in youth and adolescents. It is not as strong as the surrounding bone and therefore prone to injury. Injuries to the growth plate can occur from acute trauma or gradually from overuse.
Apophysitis is a chronic stress on the growth plate where a tendon attaches to bone. The most common of these, known as Osgood-Schlatter disease, occurs at the patellar tendon attachment to the tibial tuberosity. Apophysitis is commonly referred to as “growing pains,” but it usually occurs in active, athletic patients who are going through growth spurts. They can usually be managed with stretching, ice and anti-inflammatory medications, but some patients will have to rest from their sport if the pain is too severe.
Acute injuries to the growth plate are of even greater concern. A fracture that involves the physis can cause serious concerns if not treated properly. If a fracture disrupts the growth plate and is not well aligned, it can prematurely halt the growth of the bone or make it grow irregularly. Growth plate fractures must be aligned and immobilized appropriately.
Concussions are also of particular concern in the youth athlete. We still have much to learn about the long-term implications of sports-related concussions, but we know that youth athletes are more susceptible to concussions than adult athletes. We also know that youth athletes take longer to recover from concussions.
In addition, all cases of Second impact syndrome (SIS) have been reported in youth athletes. Second Impact Syndrome is a condition that occurs when an athlete sustains a second hit while still recovering from the first injury. The athlete has rapid swelling of the brain, which often results in death or coma. Therefore, it is important to treat young athletes in collision sports and even non-collision sports cautiously when it comes to a head injury.
An athlete should never be returned to play if there is any suspicion of concussion after a blow to the head. He/she should only return when they are cleared by a medical professional who has experience in the management of concussions.
Heat illness is also a concern for youth athletes. Younger patients have greater surface area to body mass ratio, sweat less and take longer to acclimatize. They also do not realize the need to drink until they are often dehydrated.
Providers must educate coaches and parents on signs of dehydration and how to prepare for exercise in hot and humid environments. Those covering events in the heat should be on alert for heat exhaustion and heat stroke, especially when caring for youth athletes.
Lastly, unfortunately, there will be times when a youth sports injury results in surgical need. Our surgical team of orthopaedic sports medicine specialists are specially trained in managing the unique aspects of youth sports injuries that differ from adult injuries, including developing and validating a cutting-edge pediatric, anatomic ACL reconstruction technique. Certain surgical techniques in children need to be performed differently from adult patients to ensure that there is no disruption to the child’s growth plates.
As youth athletic participation rises in our country, so does the need for sports medicine to take care of and prevent injuries. Young, growing athletes require unique and special attention to recover from sports injuries. Through the Youth Sports Medicine Program, the physicians at Emory Sports Medicine work together to design age-appropriate, individualized treatment plans that help young athletes get back to their sport as quickly and safely as possible.
ESMC has the only program in the entire region where the same physicians and experts who care for multiple professional and college teams care for young athletes as well. Our expertise with all ages allows us to provide care for the athlete from youth into adulthood.
Jeff Webb, MD and Kyle Hammond, MD
Dr. Webb is an assistant professor in the orthopaedics and pediatrics departments at Emory University School of Medicine. He is the co-director of the Emory Youth Sports Medicine program. Dr. Webb serves as a team physician for the Atlanta Falcons and the Atlanta Braves. He is also head team physician for Blessed Trinity high school and provides sports medicine coverage for many events in the Atlanta metro area.
Dr. Hammond is an assistant professor in the orthopaedics department at Emory University School of Medicine. His practice is based at the Emory Sports Medicine Complex in Brookhaven. He is the Head Team Physician for the Atlanta Falcons, the Head Orthopaedist for the Atlanta Hawks and Team Orthopaedist for the Atlanta Braves. Dr. Hammond also works with local high schools and youth sports programs.
