It’s important for athletes and their parents to know what to look for with injuries, when to take a break, and how to best prepare to safely start practicing and playing again after an off-season. 

Andrew Parker, M.D., orthopedic surgeon and sports medicine physician on the medical staff at Texas Health Allen and Texas Health Orthopedic Specialists, a Texas Health Physicians Group practice, says that while some sports may seem “low impact” compared to others any sport has the potential for injuries.

“Some of the most frequently injured athletes participate in non-contact sports like gymnastics, track, and cheerleading,” Parker says. “And while all sports have the potential for concussions, fractures, or other major injuries, the real epidemic in youth sports these days lies in overuse injuries―when an athlete is asking too much of their body too often. This can be something as mild as shin splints during cross country or soccer when an athlete has not eased back into a full workload slowly enough, to more significant elbow and shoulder injuries in baseball and softball players that are the result of years of playing without adequate rest.”

“There are several studies out there supporting the benefits of playing multiple sports, or at least taking a couple months off each year, rather than playing 12 months straight. Young athletes who specialize too soon have a significantly higher rate of injury than those who do not. Sports like gymnastics and swimming have always had a difficult time with this, but over the last decade or two, baseball, soccer, and volleyball have become increasingly demanding on the athlete’s time as well,” he adds.

How to make it a safer start to play

One of the best things young athletes can do is see their primary care physician for a sports physical, which includes a medical history and a physical exam, at least six weeks before the start of a sports season. The medical history serves to give your physician an overall picture of your health and raise any red flags that might require further testing, treatment or a referral to a specialist.

In addition to getting your physical, one of the most important things you can do before returning to the field, court, course or track is to gradually work your way back into playing shape. If you show up on the first day of training without having maintained your conditioning, you could injure yourself and be stuck on the sidelines before the season even begins.

Injuries are more likely to occur when an athlete suddenly increases the frequency and amount of time spent training, as well as the intensity of workouts. The American Academy of Orthopaedic Surgeons suggests that most sports injuries can be prevented through proper conditioning, equipment and technique. A gradual return to a game-ready fitness level is the safest way to limit potential injuries, as well as knowing proper technique for a specific sport.

Parker says kids’ bodies aren’t geared to stand up to the stresses of constant conditioning and competition that have become so common. Sports injuries, such as pulled muscles and sprains, send more than 2.6 million children to emergency rooms every year, according to the Centers for Disease Control and Prevention (CDC).

“Until kids go through puberty, their bones and muscles aren’t mature,” he explains. “At that age, they need to just have fun and play, not focus on specializing in one sport because it’s really hard to know what their bodies are going to be suited for or capable of doing as they get older. Cross-training in several sports early on is really important.”

The CDC recommends ensuring that your child’s protective gear is what is needed for a specific sport and, if applicable, position. It should also address any specific physical concerns or former injuries, such as a knee brace or modified helmet. Protective and playing equipment should always be worn correctly and be inspected regularly to make sure it is still in good condition and that all items fit correctly.

Recognizing common sports injuries

According to the American Academy of Pediatrics, most young athletes experience overuse injuries rather than traumatic injuries, with the most common being sprains (injuries to ligaments), strains (injuries to muscles) and stress fractures (injuries to bones). Strengthening muscles through conditioning exercises and increasing flexibility through stretching are both ways to help reduce overuse injuries.

The American Academy of Family Physicians outlines some common youth sports injuries parents should be on the lookout for:

• Little League elbow: caused by overuse due to the repetitive throwing motion; affects the inside of the elbow and the elbow growth plate, and is common for pitchers, catchers, infielders and outfielders
• Runner’s knee: caused by repetitive motion or knee trauma; causes pain behind the kneecap, a grinding sensation and/or swelling
• Sprains: caused by falling or twisting, sprains occur when a ligament near a joint (knee, ankle or wrist) is stretched or torn; can range from mild to severe and cause pain, swelling, bruising and an inability to bear weight on the joint
• Strains: caused when a muscle is overextended and stretches or tears; mild strains may be caused by repetitive motion, while acute strains happen while running, jumping, lifting or suddenly changing direction

Chronic or overuse injuries are usually characterized by pain during play or exercise, and a dull ache during times of rest and/or swelling, as explained by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Acute injuries may include the following:

• Sudden, severe pain
• Swelling
• Inability to put weight on a leg, knee, ankle or foot
• An arm, elbow, wrist, hand or finger that is very tender
• Inability to move a joint normally
• Extreme weakness in an arm or leg
• A bone or joint that’s visibly out of place

Caring for an injured athlete

If the injury doesn’t seem severe, athletes may utilize the R.I.C.E. method, which stands for the use of rest, ice, compression and elevation for 48 hours to decrease pain and bring swelling down. Over-the-counter medications may also provide some relief. Aspirin and ibuprofen will reduce both pain and swelling, but while acetaminophen will relieve pain, it will not help with swelling.

When possible, Parker recommends an injured athlete be evaluated by an athletic trainer to assess the injury and determine whether they should see a physician. If the athlete is experiencing severe pain, swelling or numbness; can’t bear any weight on the injured area; has a joint that feels unstable or abnormal; or has re-aggravated an old injury, he or she should see a doctor as soon as possible.

While parents may be tempted to let their kids play sports year-round because it seems like everyone is doing it, Parker notes that they are really protecting their child from potential injury when they limit the child’s activity.

“We’re seeing the ‘professionalization’ of kids’ sports, where coaches are working with 10- to 14-year-olds like they are professionals. These kids may be playing on both a school team and a club team, all year long, working with various positional coaches. Because of this, we see 60 to 70 percent of kids dropping out of organized sports by the age of 13 because it’s just not fun anymore.

They should be playing multiple sports, and taking at least one day off from training each week and between two to four months off every year to let their bodies recuperate. It’s hard to make your kids take a break when you see everybody else allowing it, but they will be so much better in the long run if they’re not running their growing bodies into the ground.”