What to know about sports injuries in kids

With physically active children always comes some level of injury risk, especially when the activity is an organized sport. Whether competitive or not, sports and recreational activities present more opportunities to get hurt, either from overusing a certain body part or a mishap between teammates or opponents.

At Lurie Children's, pediatric orthopedic and sports medicine experts Dr. Rebecca Carl and Dr. Brooke Pfister help families figure out how to identify, respond to and treat sports injuries when they occur.

“Most commonly we see kids and adolescents injured from things like concussions, sprains and strains, and fractures — especially in the forearm,” Carl said. “We also see apophysitis, or irritation of a minor growth plate. This typically occurs in feet, around the knee and around the hip. Children can also have growth plate irritation or overuse injuries around the shoulder and elbow.”

Generally speaking, most sports injuries can be classified as acute (such as a broken bone or ankle sprain) or chronic, due to overuse (such as apophysitis). A pediatric sports medicine specialist will help families determine the most accurate diagnosis and recovery plan. Knowing most young athletes are still growing and developing, it's important to seek specialized pediatric care to ensure the injury is looked at and treated from the appropriate perspective.

Signs of a sports injury may include things like sudden pain, headache, a bone or joint that appears out of place, weakness in the injury area, not being able to move a joint, or not being able to put weight on the leg, knee, ankle or foot.

Carl and Pfister advise that for more serious and concerning symptoms, consult a pediatric orthopedic/sports medicine specialist. These might include pain that doesn't go away after two or three days, severe pain, an obviously swollen joint, limping or a suspected concussion.

“When a child is unable to walk on their own or their bone or joint appears out of place, you should seek a more immediate evaluation at either an urgent care or pediatric emergency department,” Carl said.

When deciding how to help care for a child's sports injury at home, Carl and Pfister recommend the RICE method (Rest, Ice, Compression, Elevation), which is suggested for acute injuries only.

“These interventions are focused on helping with pain and minimizing swelling immediately following an injury,” Pfister said.

An exception to this is if a child is experiencing back pain or muscle spasms; applying heat to the injury area will be recommended over ice. Additionally, if a concussion is suspected, Carl and Pfister say to contact a doctor right away for guidance vs. trying to treat at home or with RICE.

“The general rule with concussions is relative rest — avoiding or taking frequent breaks during activities that may worsen symptoms, like loud environments and screen time, and avoiding any vigorous exercise or contact sports until cleared by a medical provider,” Pfister said.

A specialist can also help advise whether the injury is best kept immobilized (i.e., fractures) or if guided range of motion exercises early on will support quicker recovery (ankle sprains).

The experts say returning to sport after sustaining an injury will vary widely depending on the injury or condition.

“In general, a child should be pain free, or nearly pain free, able to fully move a limb and have no swelling and no limp before returning to sport,” Carl said. “Depending on injury, the child may need to do physical therapy or strengthening exercises before returning.”

Experiencing an injury can be a difficult time for a kid, especially if it's one that takes them out of the game for a few weeks or months. In addition to the physical issue, it can be mentally and emotionally challenging to feel isolated from their teammates and the outlet they rely on.

Carl and Pfister note that pediatric sports medicine specialists can work with patients on coping with periods of injury and make suggestions for exercise or activity they can continue to do despite their injury.

“For example, if the patient has an upper extremity injury, they may be able to participate in lower body conditioning,” Pfister said. “And there may be opportunities during recovery for a patient to participate in practice with a team in a modified way.”

Parents and caregivers can also use this recovery time to emphasize their child's value and worth outside of athletics. Recovery can be an impactful time for kids to dive into their other interests or discover new ones — they just need to be reminded of that opportunity.

Many parents ask if there are things they can do to help prevent sports injuries in their children. Carl and Pfister say the below activities may promote better sports health.

• Actively warm up for even just 10 minutes to increase circulation to muscles and make them less prone to injury.

• Prioritize rest and recover between workouts. Schedule at least one or two days off each week and consider extended time off from organized sports activity each year.

• Play a variety of sports. Encouraging involvement in multiple sports and delaying specialization in one sport may help prevent injury and burnout in young athletes.

• Stay hydrated in hot and cold weather. Water should be the first choice for hydration for most exercise and sports programs, and children and adolescents should have frequent breaks during sports for this.

• Respond promptly to injuries and consult a physician if pain or symptoms don't subside within a day or two of rest post-injury. Don't play through pain.

• Get a sports physical. Find a pediatrician or pediatric sports medicine physician who can help assess readiness for sports, address any medical issues that may cause risk of injury and offer recommendations to ensure safe sports participation.

“When a child has recovered and is ready to return to their sport post-injury, avoid over training and make sure appropriate safety gear and precautions are being used and in place,” Pfister said.

To learn more about Lurie Children's Division of Sports Medicine, visit www.luriechildrens.org/en/specialties-conditions/pediatric-orthopedic-surgery. Lurie Children's also offers a free Knee Injury Prevention Program to coach and athletes. Learn more about that at www.luriechildrens.org/en/specialties-conditions/knee-injury-prevention-program.

The Lurie Children's Division of Orthopedic & Sports Medicine is now offering Open Scheduling at luriechildrens.org/en/specialties-conditions/orthopedic-fracture-clinic, where new and existing patients can easily see available appointments at various hospital and satellite locations and schedule at their convenience.

• Children's health is a continuing series. This column was contributed by Ann & Robert H. Lurie Children's Hospital of Chicago.