Protecting Your Child from Sports Injury

Youth sports can be unpredictable, but sports injury does not have to be part of your child’s season, says J. Mica Guzman, MD, MS, DABFM, CAQSM, serves as the Primary Care Clinical Director and Family Medicine Specialist at the Sports and Injury Clinic within the Musculoskeletal Institute at UT Health Austin.

“The Centers for Disease Control and Prevention (CDC) estimates that there are around three and a half million injuries in the pediatric population, of which 50% are essentially preventable,” says Dr. Guzman. Here, he shares his expertise on how to keep young athletes in the game.

What are the most common sports injuries treated at the clinic?

While sports injuries such as muscle strain and ligament sprain can occur in any part of the body, Dr. Guzman says that injuries treated at the Sports and Injury Clinic most frequently affect the lower extremities (hips, legs, and feet). He lists sprained ankles, ACL injury, and hamstring pulls as some of the most common injuries treated at the clinic. Injuries also depend on the time of the year as changes of season also have coinciding changes in sports and recreational activities that can lead to upper extremity injuries and concussions. Because various sports and recreational various activities are played at different times of the year, the most common injuries change seasonally and can also include upper extremity injuries and concussions. Dr. Guzman adds that most sports injuries treated at the clinic are preventable overuse injuries rather than those resulting from acute trauma.

Are certain athletes more prone to injury?

Athletes in contact sports such as football, ice hockey, and basketball are more prone to injury, says Dr. Guzman, but he cautions that just because a sport is not classified as a contact sport doesn’t mean athletes are not at risk. “Volleyball and tennis, for example, are amazingly listed as non-contact sports, but there’s lots of contact and throwing and falling and impact-related activities with those sports,” he says.

Within a sport, athletes who play certain positions are more vulnerable to impact injury, citing strikers and defensive linemen as roles within soccer and football respectively that face more direct physical insult than some of their teammates. Outside of the likelihood for collision, the specific actions an athlete performs in their sport can put one at risk. “Athletes that run track are prone to injury because they’re doing an explosive movement and utilizing an optimal or peak portion of their muscular strength in the onset.”

What are the long-term effects of a pediatric sports injury?

“Children are not little adults, they’re very different,” says Dr. Guzman. “Their bones typically are more pliable and flexible.” In some cases, this facilitates the healing of skeletal injuries- fractures that would require surgery in adults may not require such an intervention in children.

“On the other hand,” he continues, “because they’re skeletally immature, the growth plates aren’t closed. The growth plates are responsible for the growth of the skeletal system into adulthood until it matures and closes off.”

“If there’s a growth plate injury in the pediatric population, it can damage those growth plates, which then can lead to disruption of their growth,” he says.

How are pediatric sports injuries treated at the clinic?

When an injured athlete first comes to the Sports and Injury Clinic, the care team will first ensure they are diagnosed accurately based on a clinical exam and the patient’s broader medical history. While imaging techniques such as x-rays, MRI, or ultrasound are not used to diagnose a patient, these methods may be employed to confirm a diagnosis.

“Once we make that diagnosis, we then transition into a treatment,” says Dr. Guzman. “That treatment is going to typically include understanding what that mechanism of the injury was so that we can address the effects and the cause of the injury specific to that individual.”

Rehabilitation can begin once the cause and effect of the injury are established. This can involve a self-directed, individualized rehabilitation program or a more formal physical therapy regimen. Patients can undertake the latter through the Musculoskeletal Institute or with an outside physical therapy practitioner of their choosing.

An individualized focus on sports-specific activities and movements can begin once patients regain a complete range of motion and 90% or more of their strength and their pain has subsided to a tolerable level. Patients are cleared to return to play once there are no more deficits with these sports-specific movements.

“Individuals are at highest risk for re-injury during that return of play because they’re just coming off that injury even though they feel well throughout that entire time,” warns Dr. Guzman. “We encourage them to do maintenance exercises so that they can continue with their activities in a reduced risk of injury.”

He notes that associate providers at the Musculoskeletal Institute may be involved in an athlete’s recovery. These include social workers, nutritionists and dietitians, nurse practitioners, physician assistants, physical therapists, and chiropractors. “As an interdisciplinary team, we can pull from any of those other providers anytime during the recovery process.”

How can sports injuries be prevented?

“The athletes themselves, their family or guardians, and their coaches or team members all have an interplay in the safety, protection, and injury prevention of a student athlete,” says Dr. Guzman

He advises against an exclusive focus on a single sport at an early age. “There has been a lot of focus on sports specialization, with either family members or coaches saying, ‘If I get a sport or activity early, then their chances for becoming a professional skyrocket,’” he says. “That has not been shown to be true, and it’s actually been shown to be pretty detrimental.”

“Kids benefit from a wide variety of activities in sports, which utilize different portions of our body and musculoskeletal system,” says Dr. Guzman. “That’s very protective to children.”

No matter the activity, Dr. Guzman recommends the following to prevent sports injury in children.

Tips for athletes

• Stay hydrated
• Avoid playing when you’re too fatigued, de-energized, or sick

Tips for caregivers

• Schedule a sports physical prior to the sports season. This is required for participation in UIL Athletics, the body that governs school sports in Texas. Download the UIL physical form here
• Ensure that all protective equipment is properly fitted and used appropriately

• Follow the American Academy of Pediatrics’ guidance allowing children a break from a sport-specific activity
  • 1-2 days per week
  • One full month three times a year

Tips for coaches

• Take time to do a proper warmup with your athletes
• Emphasize sporting for the love of play and competition rather than winning

For more information about how the Musculoskeletal Institute’s Sports and Injury Clinic helps protect athletes of all ages year-round, click here or call 1-833-UT-CARES (1-833-882-2737).

To schedule an appointment at the Sports and Injury Clinic, complete the UT Health Austin appointment request form.