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September 2016

Preventing Musculoskeletal

Sports Injuries in Youth:

A Guide for Parents

Childhood Sports Injuries: A

Common and Serious Problem

Although sports participation provides

numerous physical and social benefits, it also

has a downside: the risk of sports-related

injuries. According to the Centers for Disease

Control and Prevention, more than 2.6 million

children 0 to 19 years old are treated in the

emergency department each year for sports

and recreation-related injuries.

These injuries are by far the most common

cause of musculoskeletal injuries in children

treated in emergency departments. They are

also the single most common cause of injuryrelated primary care office visits.

The Most Common Musculoskeletal

Sports-Related Injuries in Kids

Preventing and Treating

Musculoskeletal Injuries

Keep Kids Exercising

Sport-Specific Safety Information

Treat Injuries with “RICE”

Play It Safe in the Heat

Safety Tips for All Sports

For More Information

Other Useful Links

The Most Common

Musculoskeletal Sports-Related

Injuries in Kids

Although sports injuries can range from

scrapes and bruises to serious brain and

spinal cord injuries, most fall somewhere

between the two extremes. Here are some of

the more common types of injuries.

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Sprains and Strains

A sprain is an injury to a ligament, one of the

bands of tough, fibrous tissue that connects

two or more bones at a joint and prevents

excessive movement of the joint. An ankle

sprain is the most common athletic injury.

A strain is an injury to either a muscle or a

tendon. A muscle is a tissue composed of

bundles of specialized cells that, when

stimulated by nerve messages, contract and

produce movement. A tendon is a tough,

fibrous cord of tissue that connects muscle to

bone. Muscles in any part of the body can be

injured.

Growth Plate Injuries

In some sports accidents and injuries, the

growth plate may be injured. The growth

plate is the area of developing tissues at the

end of the long bones in growing children and

adolescents. When growth is complete,

sometime during adolescence, the growth

plate is replaced by solid bone. The long

bones in the body include:

the long bones of the hand and

fingers (metacarpals and phalanges)

both bones of the forearm (radius and

ulna)

the bone of the upper leg (femur)

the lower leg bones (tibia and fibula)

the foot bones (metatarsals and

phalanges).

If any of these areas becomes injured, it’s

important to seek professional help from an

orthopaedic surgeon, a doctor who

specializes in bone injuries.

Repetitive Motion Injuries

Painful injuries such as stress fractures (a

hairline fracture of the bone that has been

subjected to repeated stress) and tendinitis

(inflammation of a tendon) can occur from

overuse of muscles and tendons. Some of

these injuries don’t always show up on

x-rays, but they do cause pain and

discomfort. The injured area usually

responds to rest, ice, compression, and

elevation (RICE). Other treatments can

include crutches, cast immobilization, and

physical therapy.

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Preventing and Treating

Musculoskeletal Injuries

Injuries can happen to any child who plays

sports, but there are some things that can

help prevent and treat injuries.

Prevention

Enroll your child in organized sports

through schools, community clubs,

and recreation areas that are properly

maintained. Any organized team

activity should demonstrate a

commitment to injury prevention.

Coaches should be trained in first aid

and cardiopulmonary resuscitation

(CPR), and should have a plan for

responding to emergencies. Coaches

should be well versed in the proper

use of equipment, and should enforce

rules on equipment use.

Organized sports programs may have

adults on staff who are certified

athletic trainers. These individuals are

trained to prevent, recognize, and

provide immediate care for athletic

injuries.

Make sure your child has – and

consistently uses – proper gear for a

particular sport. This may reduce the

chances of being injured.

Make warm-ups and cool-downs part

of your child’s routine before and after

sports participation. Warm-up

exercises make the body’s tissues

warmer and more flexible. Cool-down

exercises loosen muscles that have

tightened during exercise.

Make sure your child has access to

water or a sports drink while playing.

Encourage him or her to drink

frequently and stay properly hydrated.

Remember to include sunscreen and

a hat (when possible) to reduce the

chance of sunburn, which is a type of

injury to the skin. Sun protection may

also decrease the chances of

malignant melanoma – a potentially

deadly skin cancer – or other skin

cancers that can occur later in life.

Learn and follow safety rules and

suggestions for your child’s particular

sport. You’ll find some more sportspecific safety suggestions below.

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Treatment

Treatment for sports-related injuries

will vary by injury. But if your child

suffers a soft tissue injury (such as a

sprain or strain) or a bone injury, the

best immediate treatment is easy to

remember: RICE (rest, ice,

compression, elevation) the injury.

Get professional treatment if any

injury is severe. A severe injury

means having an obvious fracture or

dislocation of a joint, prolonged

swelling, or prolonged or severe pain.

Keep Kids Exercising

It’s important that kids continue some type of

regular exercise after the injury heals.

Exercise may reduce their chances of

obesity, which has become more common in

children. It may also reduce the risk of

diabetes, a disease that can be associated

with a lack of exercise and poor eating

habits. Exercise also helps build social skills

and provides a general sense of well-being.

Sports participation is an important part of

learning how to build team skills.

As a parent, it is important for you to

encourage your children to be physically

active. It’s also important to match your child

to the sport, and not push him or her too hard

into an activity that he or she may not like or

be capable of doing. Teach your children to

follow the rules and to play it safe when they

get involved in sports, so they’ll spend more

time having fun in the game and be less likely

to be sidelined with an injury. You should be

mindful of the risks associated with different

sports and take important measures to

reduce the chance of injury. For sport-specific

suggestions, see the following information

below.

Sport-Specific Safety Information

Here are some winning ways to help prevent

an injury from occurring.

Basketball

Common injuries and

locations: Sprains,

strains, bruises, fractures,

scrapes, dislocations,

cuts, injuries to teeth,

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ankles, and knees. (Injury

rates are higher in girls,

especially for the anterior

cruciate ligament or ACL,

the wide ligament that

limits rotation and forward

movement of the shin

bone.)

Safest playing with: Eye

protection, elbow and

knee pads, mouth guard,

athletic supporters for

males, proper shoes,

water. If playing outdoors,

wear sunscreen and,

when possible, a hat.

Injury prevention:

Strength training

(particularly knees and

shoulders), aerobics

(exercises that develop

the strength and

endurance of heart and

lungs), warm-up

exercises, proper

coaching, use of safety

equipment.

Track and Field

Common injuries:

Strains, sprains, scrapes

from falls.

Safest playing with:

Proper shoes, athletic

supporters for males,

sunscreen, water.

Injury prevention: Proper

conditioning and

coaching.

Football

Common injuries and

locations: Bruises,

sprains, strains, pulled

muscles, tears to soft

tissues such as ligaments,

broken bones, internal

injures (bruised or

damaged organs),

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concussions, back

injuries, sunburn. Knees

and ankles are the most

common injury sites.

Safest playing with:

Helmet, mouth guard,

shoulder pads, athletic

supporters for males,

chest/rib pads, forearm,

elbow, and thigh pads,

shin guards, proper

shoes, sunscreen, water.

Injury prevention: Proper

use of safety equipment,

warm-up exercises,

proper coaching

techniques and

conditioning.

Baseball and Softball

Common injuries: Soft

tissue strains, impact

injuries that include

fractures caused by

sliding and being hit by a

ball, sunburn.

Safest playing with:

Batting helmet; shin

guards; elbow guards;

athletic supporters for

males; mouth guard;

sunscreen; cleats; hat;

detachable, "breakaway

bases" rather than

traditional, stationary

ones.

Injury prevention: Proper

conditioning and

warm-ups.

Soccer

Common injuries:

Bruises, cuts and scrapes,

headaches, sunburn.

Safest playing with: Shin

guards, athletic supporters

for males, cleats,

sunscreen, water.

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Injury prevention:

Aerobic conditioning and

warm-ups, and – when

age appropriate – proper

training in “heading” (that

is, using the head to strike

or make a play with the

ball).

Gymnastics

Common injuries:

Sprains and strains of soft

tissues.

Safest playing with:

Athletic supporters for

males, safety harness,

joint supports (such as

neoprene wraps), water.

Injury prevention: Proper

conditioning and

warm-ups.

Treat Injuries with “RICE”

Rest: Reduce or stop using the injured area

for at least 48 hours. If you have a leg injury,

you may need to stay off of it completely.

Ice: Put an ice pack on the injured area for

20 minutes at a time, four to eight times per

day. Use a cold pack, ice bag, or a plastic

bag filled with crushed ice that has been

wrapped in a towel.

Compression: Ask your child’s doctor about

elastics wraps, air casts, special boots, or

splints that can be used to compress an

injured ankle, knee, or wrist to reduce

swelling.

Elevation: Keep the injured area elevated

above the level of the heart to help decrease

swelling. Use a pillow to help elevate an

injured limb.

Play It Safe in the Heat

Schedule regular fluid breaks during

practice and games. Kids need to

drink 8 ounces of fluid – preferably

water – every 20 minutes, and more

after playing.

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Have your child wear light-colored,

“breathable” clothing.

Make player substitutions more

frequently in the heat.

Use misting sprays on the body to

keep cool.

Know the signs of heat-related

problems, including confusion; dilated

pupils, dizziness, fainting; headache,

heavy perspiration; nausea, pale and

moist or hot, dry skin, weak pulse,

and weakness. If your child

experiences any combination of these

symptoms or doesn’t seem quite

right, seek medical attention

immediately.

Adapted with permission from Patient Care

magazine, copyrighted by Medical

Economics.

Safety Tips for All Sports

Be in proper physical condition to play

the sport.

Follow the rules of the sport.

Wear appropriate protective gear (for

example, shin guards for soccer, a

hard-shell helmet when facing a

baseball or softball pitcher, a helmet

and body padding for ice hockey).

Know how to use athletic equipment.

Always warm up before playing.

Avoid playing when very tired or in

pain.

Get a preseason physical

examination.

Make sure adequate water or other

liquids are available to maintain

proper hydration.

Adapted from Play It Safe, a Guide to Safety

for Young Athletes, with permission of the

American Academy of Orthopaedic

Surgeons.

For More Information

For more information on sports injuries and

prevention, contact:

National Institute of Arthritis and

Musculoskeletal and Skin Diseases

(NIAMS)

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Information Clearinghouse

National Institutes of Health

1 AMS Circle

Bethesda, MD 20892-3675

Phone: 301-495-4484

Toll free: 877-22-NIAMS (877-226-4267)

TTY: 301-565-2966

Fax: 301-718-6366

Email: NIAMSinfo@mail.nih.gov

Website: https://www.niams.nih.gov

If you need more information about available

resources in your language or another

language, please visit our website or contact

the NIAMS Information Clearinghouse at

NIAMSinfo@mail.nih.gov.

For more NIAMS information about knee

problems, sprains and strains, growth plate

injuries, and shoulder problems, visit the

NIAMS website at: www.niams.nih.gov.

Other Useful Links

BAM! Body and Mind

Website: http://www.BAM.gov

President’s Council on Physical Fitness,

Sports & Nutrition

Website: http://www.fitness.gov

American Academy of Orthopaedic

Surgeons

Website: http://www.aaos.org (con

información en español)

American Academy of Pediatrics

Website: http://www.aap.org

American College of Rheumatology

Website: http://www.rheumatology.org

American College of Sports Medicine

Website: http://www.acsm.org

American Medical Society for Sports

Medicine

Website: http://www.amssm.org

American Orthopaedic Society for Sports

Medicine

Website: http://www.sportsmed.org

American Physical Therapy Association

Website: http://www.apta.org (con

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información en español)

Arthritis Foundation

Website: http://www.arthritis.org

National Athletic Trainers Association

Website: http://www.nata.org (con

información en español)

National Federation of State High School

Associations

Website: http://www.nfhs.org/

SAFE KIDS Worldwide

Website: http://www.safekids.org

This publication is not copyrighted. Readers

are encouraged to duplicate and distribute as

many copies as needed.

Additional copies of this publication are

available from:

National Institute of Arthritis and

Musculoskeletal and Skin Diseases

(NIAMS)

Information Clearinghouse

National Institutes of Health

1 AMS Circle

Bethesda, MD 20892-3675

Phone: 301-495-4484

Toll free: 877-22-NIAMS

(877-226-4267)

TTY: 301-565-2966

Fax: 301-718-6366

Email: NIAMSinfo@mail.nih.gov

Website: https://www.niams.nih.gov

NIH Publication No. 16-4821

Many of our publications are

available in print. Would you like

to order publications on

musculoskeletal disorders to be

mailed to you? Visit our online

order form.

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