Tips to Help Teens Train and Compete Safely in Sports

Participation in team sports and athletic activities has numerous benefits for young people. In addition to promoting physical fitness, sports can boost kids' self-esteem and help them develop discipline, form new friendships, and learn the value of collaboration and teamwork.

Injuries do happen, though, and when young athletes get hurt, it can turn their world upside down. Just ask 15 year-old Justin Hayes. The 6-foot-1-inch point guard says basketball means everything to him. So when he landed the wrong way and hurt his knee during a game, he feared the worst.

His mom made an appointment with orthopedic surgeon Dr. Daniel Green at Hospital for Special Surgery. After a thorough exam, x-rays and an MRI, Dr. Green diagnosed a sprained anterior cruciate ligament. Commonly called the ACL, it's one of the four main ligaments in the knee and connects the thigh bone to the shinbone. Luckily, Justin's ACL wasn't torn, and he didn't need surgery. But he would have to stop playing basketball for a while, and that was the last thing he wanted to hear. "I felt desperate when the doctor said I couldn't play," Justin recalls. "Basketball is my life."

That was back in August. Today Justin feels relief more than anything else. After wearing a knee brace for several weeks, going to physical therapy at HSS, and diligently performing his prescribed exercises, Justin is back in practice, getting ready for the tryouts.

As far as injuries go, Justin is not alone. "According to recent studies, about 60 million kids ages 6 to 18 participate in organized athletic activities, and almost one-third are injured seriously enough each year to miss practice or a game," says Joe Molony, Justin's physical therapist and coordinator of the Young Athlete Program at Hospital for Special Surgery. "It's been found that 62 percent of the injuries happen during practice, probably because young athletes take fewer precautions for injury prevention than they would take during a game."       

Teen Injury Prevention

It's difficult to predict and prevent a sudden injury on the field, such as a torn ACL.  But another type of injury, which begins gradually and happens over time, is from "overuse," and it is preventable, according to Joe. Overuse injuries, which include knee pain, stress fractures, pulled muscles and tendinitis, account for about half of the injuries seen in young athletes. Like the term implies, an overuse injury arises from overdoing it. Spending hours and hours playing the same sport puts stress on muscles, bones, tendons and ligaments.

One way to prevent overuse is to reduce the amount and intensity of activities if one starts to feel pain or gets to the point of exhaustion, although that's not always easy for a kid passionate about his or her sport. "Young athletes often don't tell you when they get hurt because they're motivated to continue playing," Joe says. "They need to know that the best way to stay in the game is to listen to their body and take a break if they start having aches and pains."

A number of medical groups have published guidelines recommending that young athletes avoid playing the same sport all year round to avoid overuse injuries. They advise them to participate in a variety of sports at different times throughout the year.

The Young Athlete Program at HSS seeks to raise awareness of good practices for injury prevention. When working with Justin, for example, Joe provided physical therapy exercises not only to heal his sprained knee, but for overall muscle strengthening, including his upper body. Getting stronger and being in good condition can help prevent injuries and lead to a quicker recovery if a teen does get hurt.

"The care and attention Joe provided to my son were extraordinary," says Tawana Hayes, Justin's mother. "Joe considered him as a whole person, not as just a basketball player, and Justin really looked up to him. He spent a lot of time answering all of our questions, and the results speak for themselves."

Teen Sports Best Practices

While certain injuries are more common in specific sports, good practices overall promote safety, according to Joe. The first step to prevent a problem when playing a rigorous sport, and a requirement at most schools before the season begins, is medical clearance to certify that a young athlete has no underlying health problems. It's important for children to receive a thorough pre-season physical.

Joe has additional tips to ensure safe play and prevent injury in team sports:

Be ready.

• Make sure the athlete is going into the season in good shape and prepared. He or she should progressively increase athletic activity as sports season begins.
• Players should warm up properly to prepare the body for the intensity of practices and games.
• Athletes need to stay hydrated.  Water is adequate, but fluids with electrolytes may be needed if they exercise more than two hours a day.
• Ensure use of the right footwear and proper equipment for each sport. It should be the correct size and fit well.
• Athletes should be educated on the rules of the game: make sure they understand their role and position, as well as where to be to avoid being in harm’s way.
• Kids need to know that they should not “tough it out.” Any athlete who feels dizzy, light-headed or short of breath needs to stop participation. Players should be encouraged to talk to their parents or coaches if they feel they’ve been injured.

Be aware.

• Coaches and parents should stay on the lookout for signs of injury or exhaustion and, if noticed, should pull the athlete off to the side and determine if something is wrong. “When in doubt, sit them out” is a good rule of thumb to follow, particularly for concussions.
• Keep in mind that there is no such thing as a mild concussion. Signs of a concussion include a headache, light sensitivity, appearing confused and clumsiness. Symptoms may not be fully apparent immediately, but can worsen slowly over time. Any player suspected of having a concussion needs to be evaluated by a doctor.
• Injuries should be promptly evaluated and treated. A severe injury may not only end a young athlete’s career, but cause ongoing pain and disability.  Minor injuries should also be assessed.
• Parents should be vigilant to signs of burnout such as fatigue, poor academic performance and complaints of general muscle aches or joint problems.

"You can't underestimate the benefits of regular exercise and team sports for youth," Joe says. "Many young athletes are devoted to their sports, and good practices to prevent injury will keep them on the field safely."