Sport injuries account for 34% of all injuries to children aged 5-14 years. Exercise is important for children and teenagers for maintaining healthy weight, creating strong bones, learning teamwork and improving emotional well-being.
How do we minimise the risk?
Firstly we need to understand the factors that increase the risk of injury which are:
- Passionate participator
- Rigorous training
- Rigorous events
- Elite adult sport
- Early specialisation
- “Musculoskeletally unsound”
“Musculoskeletally unsound” is the factor which a physiotherapist will be able to help with. It describes a situation where the demands of the skills or training load are greater than the body’s capacity to meet those demands.
This may be an intrinsic problem such as joint hypermobility (being “double jointed”), tight muscles or insufficient strength or co-ordination. This can be improved either with the correct drills in training and warm-up or specific exercises prescribed by a physiotherapist. Research shows that specific exercises incorporated into training such as “bounding”, walking lunges, balance and correct technique for jumping and landing reduces the incidence of knee injury by 40-60%. FIFA (Soccer’s governing body) has developed an excellent program based on these principles which can be found at www.f-marc.com/11plus/home.
Growth spurts
During a “growth spurt” a child will also be more vulnerable to injury as the muscles have not yet “caught up” to bone growth in strength and length. Growth spurt can correspond to in-coordination and performance deterioration (e.g. slower times) and injury.
The common injury seen during this time is called an apophysitis, which is an irritation of the point where the muscle joins the bone. These can occur at the heel (known as Sever’s), the bottom of the knee (known as Osgood-Schlatter’s), the kneecap, the hip and the pelvis. Treatment for these injuries includes ice, massage, taping, strengthening of some muscles and checking of leg and foot alignment. It may feel good to stretch but it is usually better to limit stretching in the early stages as it tends to pull on the point where the problem is occurring. The child may also need to modify the amount of sport such as reduce training sessions or play half a game. Kids are often doing a lot of hours of sport especially if they play several sports for school, clubs and maybe at a representative level. Communication with the coaches is important so they understand why the child may need to reduce participation for a short time. The simple guideline is “too sore to play” vs “not too sore”. If symptoms do not improve with this approach, there may need to be a further investigation for a more significant problem.
Cricket bowling is the classic example where many of the injury risk factors coincide and there has been much discussion of this in the media. Bowling is a technically demanding and difficult action (rigorous activity) for the body and many coaches will say you can only improve by increasing of practice (rigorous training). Good cricketers often increase their participation at the peak growth spurt age for boys of 16 years (musculoskeletally unsound). Also at this age they are often invited to participate in grade cricket with adults (adult sport) so they may find themselves bowling in up to 3 games on a weekend. Anecdotally amongst the junior representative cricket community, there are many stories of players who are “young gun” fast bowlers one season and become spin bowlers or specialist batsmen the next due to back injury. Analysis of their technique, reduction of load and a musculo-skeletal screening to formulate a program of specific exercises should help to reduce the incidence of injury.
Total Physiotherapy is an accredited provider for the New South Wales Institute of Sport (NSWIS). Due to this we are able to use up-to-date sports specific screenings of many sports if you would like to identify areas your child can work on to reduce the risk of injury and maybe improve performance.
