Prevention helps children avoid sports injuries

Monday, Aug. 26, 2013 9:46 PM

School is back in session and children are back on the playgrounds and sports fields. They’re having fun, learning teamwork and getting exercise. And some of them will suffer injuries.

“Kids are going to get hurt, no matter what their parents tell them about safety,” said Dr. Star Schreier, an orthopedic surgeon who recently joined Dr. Doug Bagge at Cortez Orthopedics, Schreier worked as a team physician in the Denver public school system during her residency training. She also completed a one-year fellowship in pediatric orthopedics and has seen her fair share of injured children.

Prevention is obviously the first step when it comes to keeping children safe. Buckle kids up whenever they’re in an automobile, make sure they always wear helmets when riding bikes and skateboards, keep them out of streets and off roads, and oversee their activities.

“A net around a trampoline does not take the place of adult supervision,” warned Schreier. But even the most caring and careful parents, teachers and coaches will occasionally find themselves comforting an injured child.

Schreier says wrist and elbow injuries are quite common among children.

“They fall off of playground equipment or just trip and fall,” she said. When this happens, it’s important to determine if a bone is actually broken, or if the child has suffered a less severe injury, such as a sprain.

“If a bone is obviously deformed, then it’s most likely broken,” said Schreier. In this case, the child should be seen by a physician who can relocate the bone and possibly apply a cast. “Surgery is not usually required for a simple fracture.”

If the only symptoms are a small amount of swelling and pain, the injury may be just a sprain. “If they can move the wrist or elbow, it’s OK to take a ‘watch and wait’ approach,” said Schreier. If a child is too young to describe his or her symptoms, then it’s best to get an accurate diagnosis with an X-ray.

Knee injuries are also common in children, especially those who participate in sports such as football, basketball, tennis, soccer and cheerleading. Two of the most common injuries are tears of the medial collateral ligament (MCL) or anterior cruciate ligament (ACL) of the knee. These injuries vary in severity from a mild sprain to a complete tear, and often require treatment by an orthopedic surgeon.

“If the ACL tears, there is usually a sudden pop and the knee gets very swollen. The child may not be able to put any weight on that leg,” said Schreier. Depending on the severity of the injury, a knee brace or surgery may be needed.

Moving on down the body, ankle sprains and fractures can also occur in active children.

“We see this a lot in basketball, soccer and football,” said Schreier. “If a child has pain right over the bone on the inside or outside of the ankle and can’t bear weight they should be X-rayed to rule out a broken bone.”

Wrist, elbow, knee and ankle injuries while uncomfortable and inconvenient – pale in comparison to the potential seriousness of a head injury.

“A concussion can happen in many different sports,” said Schreier. “There is a misperception that a kid has to lose consciousness to have a head injury, but that’s not true.”

A concussion may occur when a children receive a direct blow to the head, when they fall on their head, or when they are shaken to the point that the head a neck is jerked around violently. The symptoms of a concussion vary from case to case, but common indications include mild confusion, memory problems, difficulty concentrating and mood changes.

“If a child has an injury that may be a concussion, they should be taken out of activity,” said Schreier. Receiving a second blow to the head while recovering from a concussion can result in permanent brain damage or even death.

“It’s not worth the risk,” said Schreier. Healing time for a mild concussion varies, but it’s usually at least a week. A physician should be involved in deciding when it’s safe for a child to return to sports or other physical activities.

Heat-related illnesses should also be taken seriously in children.

“If an athlete has nausea, vomiting, muscle cramps, or dizziness, they need to come off the field and get replenished,” said Schreier. That means getting rehydrated and cooled down. “If a kid is hot enough that they stop sweating, have mental confusion or experience a seizure that’s a medical emergency and they should be taken to the emergency room immediately,” said Schreier.

Keep your children safe at home and at school by practicing common-sense prevention and communicating with teachers and coaches on a regular basis. And remember that kids tend to think of themselves as pretty invincible, so if your child does get hurt, try not to feel guilty. It doesn’t mean you’re not a good parent, and the occasional trip to the ER is sometimes just part of growing up.

Dr. Star Schreier is a new orthopedic surgeon in practice in Cortez. Southwest Health Notes is a public service feature provided by Southwest Memorial Hospital in Cortez. The information provided herein is not intended as patient-specific medical advice or as a substitute for consultation with your personal health-care provider.