Parental role in managing children’s sporting injuries

sports-injury

We all know that playing sport has a number of benefits for our children such as improved fitness levels, self-esteem, coordination and self-discipline; however it can also put them as risk of incurring sports injuries. These injuries range from minor scrapes and bruises to more traumatic injuries like a broken leg or overuse conditions such as spondylolysis (defect of a back vertebra) or even life threatening neck and head injuries. As parents you can play a major role in the successful management of these injuries by displaying appropriate behaviours before and after they occur.

Minor Injuries

Minor injuries occur fairly frequently in young sportsmen and women and usually require some immediate attention and tender loving care from a parent and the child is able to resume playing sport quickly. Try not to overact in these instances as inappropriate over-concern can have negative effects and may lead to a more frightened child or eventually to a more vulnerable child in the long-term. Scrapes and bruises are part and parcel of physical activity and growing up and should be expected from time to time as your child experiments with different activities.

However, always treat your child with respect. Never ridicule or belittle them in front of their peers, as this may be harmful to their developing self-esteem and enjoyment of sport. Reassure the child that he/she will be cared for and the injury will be evaluated however small it may be. Acknowledge the child’s feelings (pain, fright, and/or anxiety), provide emotional support, and convey a sense of protection and caring.

Traumatic Injuries

These occur less frequently in young children, but may increase as they grow older and participate in more serious competition at senior levels. They are also more likely to occur in contact sports such as rugby, hockey, football, squash and basketball. Only last week we witnessed a teenage rugby player break both bones in his lower leg during a school match, viewed over 190,000 times on YouTube. Appropriate, immediate on field evaluation is a prerequisite in these instances particularly if the injury is to the head, neck or a limb where the growth plates maybe involved. Qualified medical personnel should be allowed to do their evaluation before parents get involved and again your reaction may determine the outcome of your child’s recovery.

Young athletes are not small adults. Their bones, muscles, tendons, and ligaments are still growing and that makes them more prone to injury. Growth plates—the areas of developing cartilage where bone growth occurs in growing children—are weaker than the nearby ligaments and tendons. As a result, what is often a bruise or sprain in an adult can be a potentially serious growth-plate injury in a child. Also, a trauma that would tear a muscle or ligament in an adult would be far more likely to break a child’s bone.

Don’t judge a child’s reaction to an injury based on the child’s age, sex, or size. Young children may vary greatly in their physical and mental development, temperaments, and reactions to and tolerance of pain and stress. Listen to the injured youngster and get his/her reaction to reentering a sport or activity. Sometimes hidden fears will be expressed that can be addressed by a caregiver who listens. A child’s mental health and development are as important as his/her physical health.

Following traumatic injuries or for that matter any sports injury, the question that often arises is how soon can my child return to playing? This of course will depend on the nature of the injury. Unfortunately, with the highly competitive nature and winning motives of youth sport these days, we witness youngsters returning too soon to the sports field, very often under pressure from parents and coaches who want the child to play in a particular match or compete in an event for the benefit of everyone except what is in the best interests of the child’s physical and mental health. Returning too soon not only exposes the adolescent to re-injury, risk of a chronic condition or injury to other parts of the body, but may also affect the child psychologically – increased fear and anxiety resulting in decreased performance.

No matter what the forces are for returning to sport, these general guidelines should be followed:

  • Seek and respect medical opinion
  • Your child is pain free
  • There is no swelling
  • Full range of motion has returned (compare the injured part with the uninjured opposite side)
  • They have close to 90 percent of their strength (compare with the uninjured side)
  • For lower body injuries – they can perform full weight bearing on injured hips, knees, and ankles without limping
  • For upper body injuries – they can perform throwing movements with proper form and no pain
  • They feel mentally ready to cope with the stress and demands of playing again

Concussion is an injury that requires specific guidelines particularly for, but not limited to the developing brain of the young athlete. It should be treated with the utmost care and responsibility and detailed protocols should be followed. These can be found at http://www.sportsconcussion.co.za/

In summary, following a concussion parents should not permit their child to return to sport unless:

  • Symptoms have cleared
  • General & neurological examination is normal
  • Computerised test has normalised
  • A non-contact exercise programme has been initiated

In terms of International Rugby Board (IRB) regulations all age group rugby players who are concussed have to sit out from all rugby matches and practices for a required 3 week rest period. If he incurs a second concussion he should sit out the season, and the third time he shouldn’t play rugby for a year.

Overuse Injuries

Although they also occur in adults, overuse injuries are becoming more common among young sports people and thus parents need to be aware of their prevention and management. An overuse injury occurs from repetitive actions that put too much stress on the bones and muscles. In young athletes these can become more problematic because of the effect that may have on bone growth, which is only completed towards the end of the teenage years.

Some of the common types of overuse injuries which parents may hear their children diagnosed with are:

Anterior knee pain: A sore and swollen knee under the kneecap usually caused by muscle tightness in the hamstrings or quadriceps, the major muscle groups around the thigh.

Little League elbow: Pain and tenderness in the elbow typically occurring after the follow-through of the throw.

Swimmer’s shoulder: Inflammation (swelling) of the shoulder caused by the repeated stress of the overhead motion associated with swimming or throwing a ball.

Shin splints: Pain and discomfort on the front of the lower parts of the legs often caused by repeated running on a hard surface or overtraining at the beginning of a season.

Spondylolysis: Resulting from trauma or from repetitive flexing, then overextension, twisting, or compression of the back muscles. This can cause persistent lower back pain. Spondylolysis is commonly seen in kids who participate in cricket, soccer, football, weight lifting, gymnastics, wrestling, and diving.

A common characteristic of these overuse injuries in the young sports person is the amount of time the child spends playing the sport and as such parents should carefully monitor the intensity, frequency and duration of both training and competition of their child. Some sporting federations provide guidelines for the amount of training and competition that children should be allowed to do at the varying age groups. Overuse injuries can also be aggravated by:

  • growth spurts or an imbalance between strength and flexibility
  • inadequate warm-up
  • playing the same sport year-round or multiple sports during the same season
  • improper technique (for example, overextending when bowling a ball)
  • unsuitable equipment (for example, non-supportive athletic shoes)

If any of the above become a concern parents should communicate with their child’s coach to find out what is happening and intervene as necessary to prevent long term problems. As with other injuries pain is the body’s way of saying there’s a problem. Do not tell a child or adolescent to “play through the pain”. Seek and follow medical advice. Depending on the symptoms and severity of the injury, treatment may vary from rest, to medication, to physical therapy to a modified technique or training schedule to prevent the injury from flaring up again.

Parental guidelines for preventing and managing injury in young sports people

  • Enrol your child in an organised and properly managed sports programme
  • Determine that coaches are properly qualified to coach the sport as well as trained in first aid and CPR
  • All equipment should be properly used and safety/protective gear worn at all times
  • The correct warm up and cool down exercises should be incorporated into practice sessions and matches
  • Conditioning exercises such as age appropriate muscle strengthening and flexibility should be part of each practice session
  • Proper techniques should be reinforced during the playing season
  • Regular breaks both during practice and during the season should be instituted
  • Play safe and within the rules of the game at all times
  • Avoid heat injury by providing plenty of water to drink before, during and after exercise
  • Prevent your child playing if in pain or very tired
  • Stop the activity if there is pain
  • Seek and respect medical advice for all serious and traumatic injuries
  • Educate yourself regarding the different medical disciplines such as physiotherapist, biokineticist, podiatrist, chiropractor, occupational therapist, sports physician that may be able to assist with your child’s care
  • Communicate with your child regarding their injury
  • Understand and be sensitive to their feelings regarding their injury
  • Avoid early specialisation that may result in overuse injuries
  • Don’t rush you child back to the sports field for the wrong reasons
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