What Places Your Child At Risk for a Sports Injury?

ACL injuries in young athletes have spiked in recent years, and researchers may have found the reason. Kids are not only playing sports earlier in life, they’re also playing a single sport year-round at a high level, which overtaxes the muscles and ligaments.

So far, no one had been able to produce a tool that could measure a child’s fitness and activity level—information doctors need to evaluate the best treatment options after an ACL injury. So Dr. Daniel Green, a pediatric orthopedic surgeon at the Hospital for Special Surgery Lerner Children’s Pavilion, and a team of HSS researchers decided to create one.

Using as a foundation the adult activity scale created by their colleague in HSS’s Sports Medicine Service, Robert G. Marx, M.D., MSC, FRCSC, the group drew up a list of eight simple questions that measure how often in a given week a child does basic athletic activities and movements, like running, slowing down and pivoting. Called Pedi-FABS, it’s designed to be scored directly by young patients aged 10-18, though a parent can help if needed.

Getting the specifics about a kid’s daily activities is crucial, Dr. Green says. “If we casually ask any patient if they do sports more than three days a week, 95 percent of ambulatory patients would say yes,” he explains. “So with this scale, we’re trying to distinguish a kid who runs around the playground a few days a week versus a highly active travel soccer athlete who’s playing six games a week and practicing four days a week.”

But Pedi-FABS’ benefits extend far beyond customizing treatment options based on activity level. Doctors are also using the information to get a better handle on injuries. For instance, while developing the scale, researchers were able to pinpoint which sports contributed to the most ACL tears in young patients treated at the Lerner Children’s Pavilion. (Soccer was number one, followed by lacrosse, basketball, football and skiing.) And currently, HSS physicians are tracking whether young athletes who have undergone ACL reconstruction are able to play at their pre-injury level.

Perhaps the most valuable information Pedi-FABS can offer is how to prevent knee injuries in the first place. “We believe that the data collected at HSS will be critical for the development of injury prevention programs aimed at teaching children and teenagers to work on their core strength, balance and agility and for educating coaches, trainers and parents about the benefits of proper warm-up and training exercises that can help avert ACL tears,” Dr. Green says.