Prevention of Sports Injuries

There are ∼3 million annual injuries incurred during sports participation among children and adolescents in the United States, with injury defined as one that causes time lost from sports participation. Pediatricians need to have the skills to diagnose, manage, and/or triage these injuries. Training in management of musculoskeletal injuries is not integrated into the pediatric curriculum as systematically as it should be, according to surveys of recent pediatric graduates. Injury rates have been reduced because of changes in the sport environment through increased safety regulation. The preseason examination is an opportunity to diagnose and rehabilitate old injuries and thereby prevent reinjury. However, effective prevention occurs only when the patient history is accurate and appropriate diagnoses and rehabilitation programs are initiated by the physician performing the preseason examination. For the individual patient with a musculoskeletal injury, there are four phases of rehabilitation: 1) limiting additional injury and controlling pain and swelling; 2) improving strength and flexibility of the injured structures; 3) progressive improvement in strength, flexibility, proprioception, and endurance of the injured structures until near-normal function is achieved; and 4) returning to the sport gradually through functional rehabilitation. Finally, injury in sports also includes psychological injury. Young athletes should play sports for enjoyment, to improve self-esteem, and to improve athletic skills. If these are not priorities in youth sports, then participation in sports potentially is harmful by decreasing self-esteem, diminishing athletic skills, and discouraging additional participation in sports. Pediatricians should be aware of potential psychological issues and provide guidance to address them. Pediatricians should be involved in providing medical care for children and adolescents when these patients are injured in sports participation. The overall goal of this article is to increase the competency of pediatricians in sports medicine care, specifically prevention of sports-related injuries. A framework for approaching sports injury prevention …