Doc, When Can I Play Again?

Young Athletes and Sports Related Injuries

BY ANDREW PATTON, MD

KIDS PLAYING SPORTS IS GREAT. ACCORDING TO DR. Cynthia Bella, pediatric orthopedist at Northwestern University’s Feinberg School of Medicine, the benefits of sports participation include:

• Increased socialization with their peers

• Enhanced self-esteem

• Fosters a child’s overall health and bone density

• Reduces the risk of being overweight, diabetes, cardiovascular disease, depression and risk-taking behavior

My wife and I have three young boys all playing sports and it is a huge part of our family dynamic. Yet, children often do get hurt, and sometimes those injuries can sideline young athletes for months or an entire season and may sour them on participating in the future. The effects of sports injuries may even linger into adulthood. We hear a lot about young athletes having serious sports related injuries. Youth related sports injuries typically fall into two categories:

• Acute traumatic injuries. These injuries include things like: fractures, sprains, concussions, and cuts and they typically result from a sudden blow or force.

• Overuse injuries. These injuries are also called chronic injuries because they typically occur over time and are the result repetitive training and fatigue.

Overuse injuries in young athletes can be just as damaging as acute injuries, especially if ignored or left untreated and we are seeing a lot of overuse injuries in young athletes. This in part stems from young athletes electing to drop seasonal sports and focus their energies on one sport year round. Using the same muscles over and over again results in forming muscle memory and when the body is called to react differently, the muscles don’t know how to react and this often results in injury. In addition, younger athlete’s muscles are still developing and this also puts them at greater risk for injury.

Prevention of injuries in young athletes is a big issue among all youth sports organizations and a big concern for the American Orthopaedic Society of Sports Medicine (AOSSM). Several years ago, AOSSM initiated the STOP Sports Injury Program. STOP is an acronym for SPORTS TRAUMA AND OVERUSE PREVENTION in youth sport. The goal of AOSSM is to keep these young athletes out of the operating room and on the playing field.

Accurate diagnosis of a young athlete’s pain may require orthopedic expertise because pain from a repetitive motion injury may develop somewhere in the body other than the site of the injury. Knee pain, for example, could result from injury to the hip.

When assessing a new patient following an injury, one of the most important things I can do is have a pretty detailed conversation with the young athlete and their parent(s) to help identify why they may be seeing me. I often ask them about what awards they have won, what championships, the best game, etc. We also talk about training, the hours, the time put into play. Once we review the information, it is often a wakeup call to the player and their family of how the injury could have occurred due to overuse and ultimately fatigue. Combine the personal history with a physical examination, and we are on the path to an accurate diagnosis and ready to discuss options. Although, surgery is sometimes the only option, operating on young athlete has special considerations. According to The American Academy of Orthopedic Surgeons, “children’s bones, muscles, tendons and ligaments are still growing,” which makes them more susceptible to injury. Growth plates, the cartilage at the end of long bones where bone growth occurs, are especially susceptible to injury that could disrupt normal growth. “A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete,” the organization emphasized.

When I young athlete comes to see me in clinic following a sports related injury, inevitably, the first question they will ask is, “Dr. Patton, when do you think I can play again?” Unfortunately, the answer to that question is rarely quick or simple. Return-to-play answers can be controversial and confusing and often involve a lot people including parents, grandparents, coaches, trainers, and health care providers. It’s really important to keep an open mind, a well-rounded perspective and make sure that young athlete understands his/her injury and what the safest and healthiest options (surgical and non-surgical) to insure a healthy outcome. Let’s keep our young players healthy and injury free and remember, kids should not play through the pain… keep them safe and if you suspect a sports related injury, see your family doctor and/or orthopedic sports medicine doctor.

For more information about youth sports injury prevention, please visit: https://www.stopsportsinjuries.org/

Andrew Patton, MD is a fellowship trained orthopedic surgeon specializing in sports medicine. He sees patients of all ages and all activity levels. To schedule and evaluation with Dr. Patton, please call or visit Orthopedic Specialists of Louisiana: 318.543-BONE(2663) or visit: orthopedicspecialistsla.com