An increasing number of youth athletes are choosing to play only one sport, all year-round. More time on the field leads to more exposure, less recovery and a greater risk of experiencing sports-related injuries.

Whether an athlete enjoys recreational sports or competing at the elite level, it is important to take the necessary time to properly train muscles, tendons and joints to minimize the chance of injury.

Sports medicine expert Mark Wood, MD answers eight of the most common youth sports injury questions to help keep your youth athlete in the game.

Q: What age-related concerns are there for children participating in organized sports?

While there are no concerns for starting sports at a young age, parents should consider exposing their children to several different sports and have realistic expectations. Sports participation has a positive effect on bone and muscle health and social development. Parents should focus on teamwork, sportsmanship and the value of exercise. Most importantly, children should be having fun.

Q: Is there a “best way” to introduce children to sports to avoid injuries?

When introducing children to sports, moderation and variation of different sport seasons are important factors to consider. By participating in multiple sports in different seasons (i.e., soccer in the fall, basketball or volleyball in the winter, and baseball or softball in the spring or summer) and not specializing in one sport, year-round, the risk for overuse injuries decreases.

Unfortunately, the increased number of young athletes choosing to specialize in one sport – without a break – to reach elite or select team status has made overuse injuries more common. Overuse injuries (such as tendinitis or stress fractures) occur when increasing activities to quickly or not allowing proper time for rest and recovery between activities. This coupled with intense training and repetitive activity five or more days a week leads to increased stress and breakdown of the athlete’s growing muscles, tendons, bones and joints.

Q: How can I tell if my youth athlete has an ACL injury?

Acute injuries, including sprained ankles, broken bones and ligament injuries occur from a sudden event such as landing awkwardly or having a direct contact or collision with another athlete.

For ACL injuries, athletes often report landing awkwardly and have the sensation of the knee shifting with an associated “pop”. Studies have shown that with this mechanism, when combined with subsequent knee pain and swelling, there is a 75% chance the ACL has been torn.

Q: Are there ways to prevent ACL and other sports injuries?

Unlike many orthopaedic injuries, the risk of an ACL tear does not increase with age. Instead, ACL tears are most closely linked to participation in sports where there are bursts of activity that involve jumping/landing, cutting, pivoting and sudden decelerations. Research shows there are several ways to prevent ACL tears and other sports from occurring.

For starters, a preseason sports physical is a great way to determine if a young athlete is fit to play. Sports physicals screen for any areas of concern athletes before athletes begin an activity and identifies conditions that may need to be treated.

In addition to preseason physicals, injury prevention programs have proven to be effective at reducing the risks of hip, knee and ankle injuries in athletes across all sports. In fact, youth athletes that participate twice a week in a simple warm-up with an injury prevention focus are 50% less likely to sustain a sports related injury. Research also shows that programs which focus on correctable neuromuscular deficits and modifiable risk factors have proven to reduce the risk of ACL injury in female athletes by up to 88% while also improving strength and performance.

Wake Orthopaedics offers free injury prevention assessments and personalized injury prevention exercise programs to address each athletes’ unique needs.

Q: What are the major contributors to injury?

Inflexibility, muscle strength deficits and imbalance, and cardiovascular fatigue are major contributors to sports-related injuries. To decrease the chance of injury, focus should be placed on improving flexibility through dynamic stretching and foam rolling and increasing the strength of weak muscle groups. The most common targeted areas in youth athletes include hamstrings, core and gluteal muscles. Improving cardiovascular endurance prior to returning to training can also reduce the effects of fatigue associated with sports-related injury.

Lack of rest is another a key contributor to injury. Athletes of all ages need to allow time for recovery between practices, games and other events. Appropriate sleep and the presence muscle fatigue can predispose an athlete to injury. Young athletes must learn to listen to their bodies and pay attention to the warning signs of pain in order to prevent overuse injuries.

Q: Is simple stretching prior to a workout or playing a game sufficient?

Stretching is an important prevention technique that should become a habit for all athletes before starting an activity or sport. Improving flexibility is important and should be supplemented with muscle activation, balance and plyometrics/agility work to create the ideal warm-up. A warm-up routine not only increases blood flow, but will improve balance, flexibility and coordination for maximal performance while minimizing injury risk.

A proper dynamic warm-up accounts for all demands that will be placed on the athlete’s body during a sporting event. The FIFA 11+ basic warm-up program provides a great resource on how to warm-up properly and can be tailored to any sport. This simple warm-up has been proven to reduce all sports injuries by 50%.

Q: What should post-workout/play recovery look like?

A proper cool down after a practice or a game is a great way to end each session and begin recovery. This can include light jogging exercises and dynamic stretching which will reduce muscle soreness.

Hydration to replenish fluids lost during a training session is also essential. In fact, even losing just 1% of your body’s water content to sweat and dehydration can make you less effective as an athlete.

For athletes experiencing soreness, applying cold therapy such as an ice pack to painful areas for 20 minutes can also help provide relief.

Q: What is the best injury prevention advice to help kids, parents and coaches?

It is important to recognize injuries and seek help early. Not all injuries can be prevented, but most can be significantly reduced. Keeping our young athletes safe is the responsibility of parents, coaches and medical providers.

Athletes will often compensate due to pain and avoid seeking help due to fear of lost playing time. Unfortunately, this approach can lead to a more serious injury. While mild pain is common and expected with increased activity, more severe pain or pain lasting more than two to three days may be a “warning sign” for a more serious injury and may warrant further evaluation from an athletic trainer, physical therapist or sports medicine physician.

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About Mark Wood, MD

Dr. Mark Wood was born and raised in North Carolina. He received his bachelor’s degree from North Carolina State University and completed medical school at the University of North Carolina at Chapel Hill, earning the degree of Doctor of Medicine with Honors. He continued his training in Orthopaedic Surgery at UNC prior to earning Board Certification in Orthopaedic Sports Medicine.

Dr. Wood’s focus is sports medicine and the diagnosis and treatment of knee and shoulder injuries and disorders. His specialty interests are in arthroscopic surgery, with an emphasis on rotator cuff repair, shoulder instability and minimally invasive knee procedures including ligament (ACL) reconstruction.

Dr. Wood continues to be recognized for his achievements and excellence to the profession and his unbending dedication to his patients and community. He serves as the medical director and provides sports medicine coverage for North Carolina FC Youth, the largest youth-to-pro soccer club in the nation, and serves as the sports medicine doctor for Trinity Academy and Grace Christian School for each organization’s athletic trainers. He is the chief medical officer at Swing Racquet and Paddle, a facility dedicated to racquet sports with a focus on sports science, injury prevention/prediction, physical therapy, sports medicine, health and innovation. He was honored to be selected to serve as the venue medical director for the CONCACAF Women’s Soccer World Cup qualifier tournament featuring the 2019 US Women’s National Team en route to their 4th World Cup Championship.

He has expertise in youth sports overuse and ACL injury prevention and has directed educational collaboratives with North Carolina FC Youth, WakeMed, SafeKids USA, the Carolina Railhawks, the Capital Area Soccer League (CASL) and the FIFA, US soccer/DePuy Sports Medicine programs. He helped create and oversees the safe return to sports protocols as part of the North Carolina FC Youth sports medicine team.

Sources:

Webster et al, J of Ortho Res. 2018

Mandelbaum et al, Am J Sports Med. 2005

Gilchrist et al, Am J Sports Med. 2008