Several recent studies, including this one from Philadelphia, have shown a significant rise in children’s sporting injuries over the past 10-15 years. A large percentage of these are knee injuries such as ACL or meniscus tears, which can have ramifications on knee health as an adult if not treated adequately during childhood. Throwing injuries of the shoulder and elbow, such as “Little League Elbow” are also increasing. Treatment of these injuries in growing children can be more complex than the corresponding injuries in an adult and often need referral to an orthopedic sports medicine specialist.
What are the reasons for this trend in increasing youth sports injuries? I believe the answer is multi-factorial. As is often the case, when an injury or condition shows an increase in incidence, some of the rise may be due to an increase in diagnosis. Physicians may begin to pay more attention to certain problems because of attention in the medical literature or in the media, leading to fewer missed injuries and a higher reported rate of the specific condition. An excellent example of this is the rise in reported concussions due to much recent attention.
Another reason is that children and teens are playing in more competitive sports at younger ages. Little league sports are much more competitive and played at a higher level than they were when I was a child. After the league season is over, many children continue to participate in their sport on a club team or in another league. I see many adolescents in my office who play one sport basically year-round. I see this trend most commonly in sports such as soccer, softball, basketball, baseball, cheerleading, and gymnastics. This leads to not only an increased risk of an acute injury, like an ACL tear, but also to overuse injuries because there is no real rest period during the year. It is important to make sure there is some time off and to vary sports participation to avoid overuse injuries, especially if the child begins to experience consistent muscle or joint pain.
The organization of youth sports by chronological age is another factor, especially in direct contact injuries. Young athletes are not merely small adults; their bones, muscles, tendons, and ligaments are still growing, making them more susceptible to contact injuries, especially in the weaker areas around growth plates. Young athletes of the same age can differ greatly in size and physical maturity, which is why I would prefer parents and coaches try to group kids according to skill level and size rather than age, particularly during contact sports.
I am not saying children’s playing more sports is a bad trend. With the epidemic of childhood obesity in America today, encouraging kids to play sports is a good thing. Still, parents, coaches, and we in the sports medicine community can work together to ensure effective injury prevention programs will keep young athletes healthy and in the game.