Simple precautions can protect children from sports injuries

Children’s knees, along with shoulders, elbows and ankles, are most at risk for repetitive motion problems. - Photo courtesy Jennifer Aalgaard, Good Samaritan
Children’s knees, along with shoulders, elbows and ankles, are most at risk for repetitive motion problems.
— image credit: Photo courtesy Jennifer Aalgaard, Good Samaritan

Spring has finally arrived in western Washington and that means more time spent outdoors. Dr. Jason Brayley, a sports medicine physician with MultiCare Health System, wants to help parents prevent injuries to their children with a few simple precautions.

Make sure your child uses the proper protective sports gear, such as mouth guards or eye protection for a particular sport.

Warm up before exercise. This can help minimize the chance of muscle strain or other soft tissue injury during activity. Warm up exercises make the body’s tissues more flexible.

Wear sunscreen and a hat (where possible) to reduce the chance of sunburn, which is actually an injury to the skin.

Stay properly hydrated while playing.

Know the warning signs of a serious injury (see below)

Treat Injuries with RICE

• Rest. Reduce or stop using the injured area for 48 hours. If you have a leg injury, you may need to stay off of it completely.

• Ice. Put an ice pack on the injured area for 20 minutes at a time, four to eight times per day. Use a cold pack, ice bag or a plastic bag filled with crushed ice that has been wrapped in a towel.

• Compression. Compression of an injured ankle, knee or wrist may help reduce the swelling. These include bandages such as elastic wraps, special boots, air casts and splints. Ask your doctor which one is best.

• Elevation. Keep the injured area elevated above the level of the heart. Use a pillow to help elevate an injured limb.

Injuries are common while playing sports. Below are some common childhood sports injuries.

Sprains and Strains: these injuries are very common in active children and adolescents. A sprain is an injury to a ligament, a tough and fibrous connection between two bones. Sprain injuries typically involve stretching or tearing of the ligament. A strain is an injury that occurs to a tendon, another type of connective tissue that connects muscle to bone. Sprains and strains are best treated with rest, icing, compression and elevation of the affected area. While these injuries are typically minor and resolve quickly without seeking medical attention, there are several key factors that should be kept in mind when deciding if your child needs to see a physician. If your child experiences any of the following, see a physician as soon as possible: severe pain, inability to move or put weight on the injured area; you cannot touch the injured area without severe pain; any lumps or bumps that look different than the uninjured side; buckling occurs when attempting to use an injured joint; numbness around the injured area; red color surrounding or streaking from the injured joint or foot; multiple injuries to the same area or joint.

Growth Plate Injuries

All growing bones have an area called the physes or “growth plate,” where special cells cause lengthening of bone in children and adolescents. These areas are very susceptible to injury and can often mimic a simple sprain or strain. If a suspected sprain or strain is not improving within 48 hours, it could potentially be a more serious growth plate injury. All injuries to the growth plate may cause a problem with bone growth, therefore it is important to have these injuries identified and treated early. The specific amount of injury to a growth plate can be determined with a basic X-ray. Most growth plate injuries that do not require surgery and do well with immobilization of the area and appropriate time off before returning to active play. Girls may continue to grow late into their teens and boys through the early 20s, so it is always important to keep these potentially serious injuries in mind if your child is hurt while playing.

Repetitive Motion Injuries

Active children can be at risk for repetitive motion or “overuse injuries,” the same as adults. All major joints of the body are at risk for developing repetitive motion injuries, although in children the shoulders, elbows, knees and ankles are most at risk. Overuse injuries may occur if your child participates in a specific sport or activity on a very regular basis. Pain will typically develop slowly over time, often getting to the point where playing is no longer possible. It is very important that children in organized sports learn proper techniques related to their sport in order to protect their growing bodies and avoid injuries that may prevent them from having fun and living a healthy lifestyle.

Heat Injuries

Heat tolerance is much lower in children than adults. Children have a reduced sweating capacity and greater body surface area to weight ratio as compared to adults, which places children at a much higher risk of overheating when exercising and playing vigorously. When children become dehydrated, their core body temperature rises significantly faster than an adult, leading to potentially deadly consequences within 20 minutes if overheating develops and is not recognized. Symptoms such as muscle cramps, rapid heart rate, nausea, vomiting, headache, poor coordination, confusion and irritability may be signs that your child is suffering a heat-related illness. If there is any suspicion that this may be an issue for your child, evaluation at an emergency department is the best plan.

Follow these tips for exercising safely in hot weather: respond quickly if heat-related injuries occur; schedule regular fluid breaks during practice and games; drinking water is the best choice, other suitable liquids include fruit juices and sports drinks; kids need to drink 8 ounces of fluid every 20 minutes while playing an active sport, plus more after playing; wear light-colored, “breathable” clothing and wide-brimmed hats; and use misting water sprays on the body to keep cool.

Now that good weather is right around the corner, I hope you and your children enjoy a safe season.

Dr. Jason D. Brayley practices at MultiCare Orthopedics and Sports Medicine in Puyallup. He attended professional school at Loma Linda University, completed his internship and residency at Naval Hospital Camp Pendleton and his fellowship at the Cleveland Clinic Foundation. He is a member of the American Medical Society for Sports Medicine, American College of Sports Medicine, American Association of Cycling Team Doctors and the American Board of Family Medicine.

To contact Dr. Brayley, visit

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