Pain is not gain for adolescent athletes

Pain is not gain for adolescent athletes

You know that adolescent sports have changed when a 13-year old soccer player named Freddy Adu signs a contract with Nike. A year later, Adu becomes the highest-paid American pro soccer player, raking in a cool $500,000 a year.

But even though Adu is playing professional soccer, he’s still a growing boy. “Pediatric athletes are not little adults. They are still growing and developing, which puts them at higher risk for serious injuries,” said Mininder S. Kocher, MD, MPH, during a media briefing held yesterday.

Injury rates increasing

Serious injuries in young athletes are occurring at higher rates and younger ages than ever before. Among children age 5 to 14 years old, 40 percent of all visits to the emergency department are for sports injuries. According to Dr. Kocher, it is not uncommon to see injuries to the anterior cruciate ligament (ACL) in children as young as 9 or 10 years old. These ACL injuries can present real challenges to the orthopaedic surgeon. Surgery to repair the ACL may be needed, but surgery can “cause growth plate disturbances” as well as other problems, says Dr. Kocher. Growth plates are also particularly vulnerable to injury in contact sports like football and basketball.

Shoulder injuries are another problem for pediatric athletes. In the past, Dr. Kocher rarely saw patients entering high school who had already had shoulder injuries serious enough to require surgery. Now most of the post-middle school and junior-high school students he sees have had shoulder surgery.

In the youngest patients, “Little League elbow” is common. Several studies have found a high incidence of chronic elbow and shoulder injuries in young pitchers. Approximately 60 percent of 11-to-18-year old players have had an injury that was due to repetitive motion and overuse of the elbow and shoulder. Similar overuse injuries are also found in gymnasts.

Defining the problem

These injuries can occur if little or no attention is paid to what type of pitches a young player is being asked to make, or to the number of pitches thrown during a game or practice session.

Proper training and equipment along with an understanding of the biomechanics of young people’s bodies are critical to stemming the tide of serious injuries and surgeries.

Coaches often lack the training to understand the impact of these highly competitive sports on young bodies and to help players avoid sports injuries. In Europe, coaches receive medical training and must be certified. Coaches in the United States do not need any training or licensing. Coaches who want to win games—and parents who want successful child athletes—can put intense, unrelenting pressure on young athletes.

In part, the problem exists because parents want their children to participate in sports for different reasons than do their kids who want to play. It is important to bring those two sets of expectations into line. Dr. Kocher gives the following advice to parents of young athletes: “Understand your child’s goals when playing sports. Your child’s goals could be very different than your own.”

Young people cite wanting to have fun as the number one reason they want to play sports, followed by being with their friends. For many children, sports participation ceases to be fun when winning become the goal.

Up to 70 percent of all young athletes drop out of sports by age 14. That statistic is a real concern for doctors and parents who are worried about the growing incidence of obesity in adolescents.

Don’t ignore pain

A mentality of “no pain, no gain” among some coaches and parents also contributes to the increasing frequency of serious sports injuries. Dr. Kocher encourages adults to seek medical help when children and adolescents experience pain.

“Pain is an important signal that there could be a more serious problem. It shouldn’t be ignored,” he says. Dr. Kocher also cautions parents not to let children participate in only one sport. “I think kids are being forced to focus on a single sport at an earlier age as competitive intensity has ramped up. This may actually lead to an overuse injury.”

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