Expert Advice: Sports Injury Prevention

Washington Post—October 20, 2011

Sports-related injuries in the increasingly competitive world of youth sports have lately had some devastating consequences.

For this weekís Expert Advice, I turned to a specialist in the field to offer some guidance on sports and safety. Below, Dr. James Kinderknecht, a sports medicine physician from New Yorkís Hospital for Special Surgery, shared with me the top questions he fields every year from parents, and his answers:

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Q 3. My 10-year-old wants to start gymnastics. Will that stunt his/her growth? What can I do to make sure this doesnít happen?

A. With gymnastics, the biggest issue we run into is with the wrist. Young athletes tend to use their wrists and hands as pogo-sticks, especially in events like the floor exercise and vault, which can stress the growth plates in the wrist as they absorb continued weight and impact.

My advice is for parents to be attentive to their young athletes complaining of wrist pain.

Q 4. My son/daughter was complaining of a sore ankle yesterday, but now it ďdoesnít hurt,Ē just in time for the most important game of the year. Should I let him/her participate?

A. I think a good rule of thumb with kids and pain is limping. Kids are not always easy to read when it comes to pain measurement, but if they arenít walking regularly, thatís telling you something. Itís really important though, that if the athlete starts limping during the game, he or she comes out to avoid further, potentially more serious injury.

Q 5.My son wants to start golf this year, like his father, but back problems run in our family. Are there any ways we can try to prevent that?

A. The issue with golf and back pain most of the time is lack of flexibility and lack of core strength, which tend to be less of an issue the younger the athlete.

To prevent back pain, it can be helpful to incorporate core strength and stretching programs, including the hip muscles as well. If the athlete is experiencing any pain in the back, have him evaluated by a specialist. The good news with these injuries is that they can usually be addressed through strength exercises and stretching regimens.

Q 6. My 10-year-old is going to start football this fall. What should I watch out for during the season?

A.  At age 10, you donít see as much of a difference because these players havenít yet hit puberty. This means the injury rate is fairly low.

The 13- and 14-year-olds have a much larger differential, which makes for a mismatch in size and strength. The most important thing is to make sure that your son is somewhat matched in terms of his size with the kids he is playing with.

Good technique is also very important. You want to make sure that the teamís coach is teaching proper blocking and tackling, so that kids learn early on how best to position their body to avoid injury.

Q 7. I have heard that girls are much more likely than boys to have problems with their ACL. My daughter is starting basketball this year. What can she do to help prevent injury?

A. The fact is that girls, especially when playing soccer or basketball, tear their ACL about six times more often than guys do. There are exercises that can be done to strengthen the surrounding muscles, which can help prevent tears.

Girls tend to land jumps and cut across courts or fields with their knees straight, which leaves the ACL more vulnerable to injury. Boys are more likely to bend their knees and stay lower to the ground, which cushions their landing and protects the knee ligaments. I often refer my patients to sources on the HSS Web site for more details on helpful exercises and stretches.

Q 8. My son is a baseball pitcher and Iím worried about his throwing arm. What types of injuries is he susceptible to?

A. The most important factors in young athlete pitching injuries are pitch count and throwing technique. Elbow and shoulder problems are more likely to arise with the more pitches thrown, because overuse is such a significant trigger for injury.

The other aspect is technique. For example, physicians and coaches alike will discourage trying to throw a curve ball at an early age because most kids canít perform the proper technique, and can end up getting injured.

If your child hasnít hit adolescence yet, his skeleton hasnít matured and he typically canít throw the ball that hard, which limits his risk for injury. This becomes more of an issue in the 14- to 15-year-old range, as the skill level can get ahead of skeleton development, which leaves the athlete more susceptible to growth plate injuries.

Read the full story at washingtonpost.com.

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