Monthly Archives: August 2016

Football

 Football is a fast-paced, aggressive, contact team sport that is very popular among America’s youth. Football programs exist for players as young as 6 years all the way through high school, college, and professional.

Injuries are common because of the large number of athletes participating. However, the risk of injuries can be reduced. The following is information from the American Academy of Pediatrics (AAP) about how to prevent football injuries. Also included is an overview of common football injuries.

Injury prevention and safety tips

  • Supervision. Athletes should be supervised and have easy access to drinking water and have body weights measured before and after practice to gauge water loss.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes. Football shoes should be appropriate for the surface (turf versus cleats). Laces should be tied securely.
    • Pants. Football pants should fit properly so that the knee pads cover the knee cap, hip pads cover the hip bones, the tailbone pad covers the tailbone, and thigh pads cover a good share of the thigh. Pads should not be removed from the pants.
    • Pads. Shoulder pads should be sized by chest measurement. They must be large enough to extend ¾ to 1 inch beyond the acromioclavicular joint. Athletes should have adequate range of motion, and the pads should not ride up into the neck opening when raising the arms.
    • Helmets. The helmet should be fitted so that the eyebrows are 1 to 1½ inches below the helmet’s front rim. The back of the helmet should cover the back of the head, and the athlete’s ear openings should be in the center of the helmet ear openings. Jaw pads should be snug against the athlete’s jaw. The chin strap should be centered over the chin and tightened to prevent movement of the helmet on the head. The helmet padding and chin strap should be tight enough to prevent any rotation of the helmet on the head. Face masks should be attached to the helmets. Additional protection can be provided by a clear Plexiglas shield.
    • Mouth guards can help prevent oral or facial injuries but not concussions.
  • Environment. A safe playing field is level and cleared of debris, equipment, and other obstacles. Field goal posts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle injuries

Ankle sprains are some of the most common injuries in football. They can prevent athletes from being able to play. Ankle sprains often happen when an athlete gets blocked or tackled with the foot firmly in place, causing the ankle to roll in (invert). An ankle sprain is more likely to happen if an athlete had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays may be needed.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains and enable an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays may be needed. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs, and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Medial collateral ligament sprains can be treated in a hinged brace and allowed to return to play. Athletes who return to play with a torn anterior cruciate ligament (ACL) risk further joint damage. Athletes with an ACL tear should not return to their sport until the ligament has been reconstructed and they have been cleared by the surgeon.

Shoulder injuries

Shoulder injuries can occur from diving for a ball or from blocking or tackling.

Athletes usually feel their shoulder pop out of place when it is dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called adislocation. Risk of dislocation recurrence is high for youth participating in football. Shoulder strengthening exercises, stabilization braces and, in many cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in football, usually due to weak muscles of the back and trunk. Often rehabilitation exercises and rest from excessive blocking or tackling drills are all that is necessary to treat this type of pain.

Eye injuries

Eye injuries commonly occur in football usually due to a finger poking through the face mask. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from high-impact and repetitive arching of the back. Symptoms include low back pain that feels worse with back extension activities. Treatment of spondylolysis includes rest and physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes are advised to limit repetitive arching of the spine (blocking and weight lifting) and high-impact activities (running and jumping). Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Head injuries

Concussions occur if the head or neck hits the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. If a concussion has occurred, it is again important to make sure the helmet was fitted properly. If the concussion occurred due to the player leading with the head to make a tackle, he should be strongly discouraged from continuing that practice.

Golf

 In the past, golf was seen by many as a leisure activity for people with extra time and money to spend. Today golf is seen as a sport, and one that appeals to younger participants.

While golf is not thought of as a dangerous sport, the long hours of practice and the physical demands of learning and playing the game can lead to injuries. While not all injuries can be prevented, the risk of injuries can be reduced.

The following is a chart from the American Academy of Pediatrics of common golf injuries and an overview of symptoms and treatment. Also included are diagrams of 2 exercises.

Common injuries, symptoms, and treatment

Golf injuries can be divided into those that occur from swinging a club and those that occur from the miles of walking on a golf course. To prevent injury, athletes must have an understanding of the stresses golf puts on the body and must prepare their bodies to handle these stresses.

Most golf injuries develop over time rather than as a result of a single event. It is important to recognize the early signs of an injury and seek treatment before the condition gets worse.

Also, a general warm-up before practicing or playing can help prevent injury. This should consist of exercises that increase circulation to the muscles and stretch the shoulders, back, hips, and legs. It also helps to take warm-up swings with a weighted club (or 2 clubs) and hit practice shots when possible.

Exercises

Rotational stretch and warm-up

This is a dynamic stretch for shoulders, back, and hips and a good warm-up that can easily be done at the golf course or practice range.

  1. Stand while holding club behind upper back.
  2. Rotate back and forth while keeping feet planted.
  3. Try to feel stretch in shoulders, spine, and hips.

Hip/low back flexibility

This exercise improves flexibility in hips and low back; increases rotation and ability to “turn” when hitting ball.

  1. Lie on back; cross legs.
  2. Use top leg to push opposite knee to floor; keep shoulders flat and pelvis on the floor.

Baseball and Softball

 Baseball and softball are extremely popular among America’s youth. Injuries are common because of the large number of athletes participating. While most injuries are acute, there are specific overuse injuries that commonly affect young ball players. Most of these injuries can be prevented.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent baseball and softball injuries. Also included is an overview of common injuries.

Injury Prevention and Safety Tips

Sports Physical Exam

Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routinewell-child checkups.

Fitness

Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.

Technique

Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. For example, baseball and softball players should avoid headfirst slides, and run bases with a helmet and break-away bases. Athletes should work with coaches and athletic trainers on achieving proper technique.

Equipment

Safety gear should fit properly and be well maintained

  • Protective eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials. Batting helmets and catcher’s masks with face masks also are recommended.
  • Shoes with rubber (not metal) spikes
  • Pads (knee and shin guards)
  • Athletic supporters and cups for boys
  • For catchers: helmets with face guards, throat guards, knee-saver pads, and chest protectors (Note: Chest protectors cannot prevent direct trauma to the heart.)
  • For batters: batting helmets, face guards
  • Safety baseballs (Softer balls decrease overall injury from getting struck by the ball in addition to lowering the risk of commotio cordis.)

Environment

  • Heat. Proper hydration and scheduling practices and games during cooler times of the day can prevent heat-related illness and dehydration.
  • Lightning. Guidelines should be in place to postpone play until a safer time. Play should be stopped for 30 minutes after the last strike if lightning is detected within a 6-mile radius (follow the 5 second per mile rule). A safe area (buildings with metal pipes or well-grounded wires) should be identified ahead of time. No one should stand under the bleachers or other non-grounded structures.
  • The field. A safe playing field is free of debris; holes and uneven surfaces should be repaired. The infield and pitcher’s mounds should be raked and smoothed regularly. Evening games should be well lit. Breakaway bases should be used to reduce injuries from sliding. A runner’s base placed to the right of the first base foul line in the runner’s lane is one way to help prevent collisions at first base. Safety screens should be in place to protect the dugouts from balls and thrown bats.

Emergency Plan

Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common Injuries

General Treatment for Acute Injuries

Rest, ice, compression, and elevation is the first step in treating an acute injury accompanied by pain and swelling. Athletes should stop playing and apply ice directly to the injured area for 20 minutes. After icing, an ACE bandage can be used to limit swelling. The injured area should be raised above the heart to limit swelling.

Shoulder Injuries

Shoulder impingement is an overuse injury that causes achy pain on the front or side of the shoulder. The pain is felt most when the arm is overhead or extended to the side. Shoulder impingement is common in young athletes with weak upper back and shoulder muscles. Off-season stretching of the back of the shoulder and strengthening of the shoulder blade and core muscles can help prevent these injuries.

Baseball pitchers and other high-volume throwers (for example, catchers) are at risk for Little League shoulder, an irritation to the growth plate in the humerus bone of the shoulder. Limiting the number of pitches a player can throw during a practice or game can help prevent these types of overuse injuries (pitch count guidelines based on age are published by USA Baseball). Any athlete who has shoulder pain for more than 7 to 10 days should see a doctor.

Elbow Injuries

Elbow injuries are very common in baseball players, especially pitchers, and includeLittle League elbow (irritation of the growth plate of the humerus bone of the elbow). As with shoulder injuries, limiting the number of pitches a player throws during a practice or game can help prevent overuse injuries.

Ankle Injuries

Ankle injuries often occur as a result of uneven playing fields or sliding into bases, or from improper rehabilitation/ protection after injury. Fields should be well maintained and breakaway bases should be used. Use of ankle braces and ankle exercises that strengthen and improve balance of the ankles may prevent repeat injury.

Eye Injuries

Eye injuries typically occur from contact with the ball, bat, or a finger. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. Athletes should also stay a safe distance away from any player swinging a bat or playing catch. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Heat-Related Illnesses

Athletes who are dizzy or confused, or complain of a headache, are most likely suffering from heat exhaustion or heat stroke. Any athlete suspected of having heat illness should immediately be removed from play, cooled by any means available, and transported by emergency medical services (call 911).

Heat-related illnesses can be prevented when athletes are given adequate time to get used to exercising in the heat (usually takes 1 to 2 weeks). Drinking water or a sports drink before, during, and after training, as well as avoiding stimulants includingcaffeine, can also help.

Commotio Cordis

Sudden death as a result of a significant impact to the chest is known as commotio cordis. The usual cause is impact from a baseball, lacrosse ball, or puck, or a direct blow in football or hockey. Recognition and resuscitation alone are rarely successful; however, if available an automated external defibrillator can successfully resuscitate athletes with this condition.