Feature Story

August 2018

Be Ready for Back-to-School Sports

By Dave Ramont

Hard to believe, but it’s already back-to-school time, which also means that young athletes are getting back to training, practicing and competing. And many parents are once again concerned for their kids’ safety. Recently, sports medicine and orthopaedic experts from the American Orthopaedic Society for Sports Medicine (AOSSM) and the American Academy of Orthopaedic Surgeons (AAOS) hosted an event titled “Fall Forecast: Settling the Youth Sports Safety Score.” Panelists shared new study findings and discussed injury prevention and management.

Event moderator Charles Bush-Joseph, M.D., immediate past president of AOSSM, pointed out that as more athletes under age 12 focus on just one sport and year-round training, coaches and parents need to encourage youth to consider participating in a variety of activities to prevent injuries. “Overuse injuries in children can have a lifetime effect on their game and quality of life,” he said, adding that kids who specialize are more likely to develop overuse injuries due to their repetitive movements.

Statistics were presented highlighting the risk of overuse injuries. For example, baseball players in the 9-to-14 -year-old age group who pitched more than 100 innings per year were more than three times as likely to suffer an injury, resulting in time lost from the sport. And studies showed that elbow pain in youth players is between 20 and 30 percent for 8- to 12-year-olds, about 45 percent for 13- to 14-year-olds and more than 50 percent for high school and college athletes.

Cordelia Carter, M.D., and Elizabeth Matzkin, M.D. are authors of “Sex-Based Differences in Common Sports Injuries,” and they shared results from their review article. They point out that the risk factors for experiencing sports-related injuries are different for males and females. Their research team focused on concussions, ACL tears, shoulder instability, stress factors and hip impingement.

Some of the findings in this research include: while the number of ACL injuries in male youth athletes is higher, females playing similar sports are two to eight times as likely to suffer the same injury; after an ACL injury, females are less likely to return to sports; research shows a higher rate of concussion in females playing sports such as basketball, soccer and lacrosse; the risk of stress fracture is higher for females, secondary to a relative energy deficiency in sport compared to males; up to 36 percent of female athletes don’t consume enough and/or the right type of calories to properly fuel their athletic endeavors, which may be associated with bone stress injuries and menstrual dysfunction for many young athletes.

Carter explained that understanding the sex-based differences can help orthopaedic surgeons be better equipped to care for patients with these injuries and improve their treatment outcomes. “Anatomic and physiological characteristics such as skeletal structure, muscle mass, ligament flexibility and hormone levels differ between the sexes and may contribute to variations in injury risk.”

Immature bones, insufficient rest after injury, and poor training and conditioning can contribute to overuse injuries, according to Matzkin, who added that overuse injuries account for half of all sports injuries in middle school and high school. “Although we can treat most youth injuries, they can have consequences later in life, so it is vital to reduce or prevent incidence now and avoid the onset of chronic conditions. Equally important is nutrition as it is vital to proper bone health.”