National Youth Sports Safety Month: Injury Management & Prevention

April is National Youth Sports Safety Month and that means shining a light on athletic injury management and prevention. If you’re anything like me you spend a LOT of time on the sidelines and in the stands watching your kids play, so it’s fitting to highlight safety measures that come in handy one day. I’ll note here early in this post that I’m not exclusively talking about sports; I’ve seen plenty of injuries due to marching band and drama club. As a pediatric emergency physician, I have seen all types of sports/activities injuries in all age groups. Let’s take a minute to go through a few key points worth knowing about ankle injuries.

Ankle injuries are the most common sports-related injury I see.. Most of the time in pediatrics this ends up being an ankle sprain, indicating a stretch in one of the many ligaments (not a break in the bone). One of the reasons for this is that there are just so many ligaments in the ankle that can get pulled and even torn during a quick and exaggerated movement. When an ankle injury occurs, inflammatory cells rush to the site to help with repair. This causes swelling and pain along with the inability to bear weight or walk in some cases. It can often be quite difficult for a parent, coach, or even healthcare professional to distinguish between sprains and broken bones with these types of injuries, as they can share several similar symptoms.

Sprains result when there is damage to the ligament, while ankle fractures mean that there is a break in the bone. Here are some signs or symptoms you can look out for in order to help distinguish between the two. Of course the only way to know for sure is to get an xray, although not all ankle injuries need an xray.

Broken Bone or Fracture: 

• Inability to bear weight on the ankle: immediately and several hours or even days after the injury occurs 
• Moderate-to-severe pain upon injury, sometimes with numbness
• Swelling and bruising are often immediate and very pronounced 
• Deformity of the ankle may be present 

Sprain: 

• If the child can bear some weight on the ankle upon standing with minimal pain and/or if the pain subsides and he/she can walk on the ankle a few hours following the injury, it’s usually a sign of a sprain versus a fracture 
• Pain level is variable 
• There will be some ankle instability following the injury 
• There will also be some swelling and bruising, but it may not be immediate

Injury Management

When faced with any kind of ankle injury, there are certain interventions that can be helpful at home.

R.I.C.E. – Rest, Ice, Compress, and Elevate the ankle several times per day, along with ibuprofen as needed for pain reduction as the healing process is underway. This is a method that most of us are familiar with if we played sports in our youth, and it still holds true when done consistently. 

If your child is given a splint and/or crutches, use them as directed. Regardless of the type of ankle injury, not bearing weight on the affected side means that healing happens the fastest. Don’t return to activities too soon; it just increases the risk of re-injury or further injury. In most cases, sprains heal slowly on their own over several weeks by simply following the above guidelines and taking it easy. 

I always encourage patients to get evaluated sooner rather than later if they are concerned about a potential broken bone, especially in the ankle. No one wants a young person walking around (or hobbling around) on a broken bone, which can worsen an already existing fracture. Playing it safe is the best way to ensure future successful seasons to come.

Injury Prevention 

As with many medical conditions, the best way to avoid a sports-related injury is to prevent it. Easier said than done, of course! However, a few preventive measures ARE under your control:

• Get a pre-season physical: A preseason physical exam is an important screening tool for your little athletes before they start an activity, and can prevent  them from further injuring themselves if a condition is present and requires treatment.
• Stress proper hydration + nutrition: Encourage children to stay well hydrated by drinking plenty of water before, during, and after play. Don’t forget to take into account the climate as heat-related health concerns are prevalent on hot and humid days. It’s also important to ensure  kids have a well-balanced diet full of fruits, vegetables, and lean proteins and try to stick to a regular schedule where meals are consumed around the same time each day for consistency and proper fueling.  
• Stretch, stretch, stretch!: Stretching is one of the most important injury prevention techniques. Stretching is most effective when a mix of both static and dynamic movements are included in the warmup routine pre-game or practice. This helps loosen the muscles and properly prepare them for physical activity. Be sure to ask your child’s coach/activity leader for a selection of stretches your child can do at home, and be nosy! Make sure this happens properly at practices.
• Rest + off-time: A lack of sleep and muscle fatigue can actively predispose an athlete to injury, and as a pediatric specialist it’s been my experience that patients in need of acute care due to sports injuries have often been “overdoing it”. Make sure your young athlete has sufficient “off days” and they are actually resting or doing very light, low impact activities on those days to avoid muscle fatigue and overuse which can contribute to injury.

I’ll close this blog entry by wishing your child endless success and enjoyment in sports and activities, and may all your seasons be injury free!