Children participating in competitive athletics have grown over the past few decades, which leads to specialization and competition in early childhood years. This specialization early on, combined with decreased physical ability and preparedness, predispose these children to significant injuries that will affect them physically and mentally. The intensity of youth sports predisposes these children to overuse injuries, such as patellofemoral knee pain, and more severe disabling injuries, such as ACL tears and concussions. Unfortunately, while awareness of these injuries may not be new news, we continue to see kids at a younger age be affected by these injuries, and some sports programs do not have a injury prevention program for their participants.
In a study comparing males versus females ages 5 to 17 in regards to pediatric sports injuries(1), girls tend to experience more overuse injuries compared to traumatic injuries, while the opposite is seen in boys. Girls tend to sustain more lower extremity and spine injuries as compared to their boy counterparts, while the boys tend to sustain more upper extremity injuries. Girls are three times more likely to experience patellofemoral pain than boys, while boys are two times more likely to experience osteochondritis dissecans and fractures as compared to girls. Something interesting to note from this study is that they found that the percentage of girls and boys who suffered an ACL injury was about equal...it's not just a girl's injury after all!
In another study comparing age groups of children 5 to 12 years old versus adolescents 13 to 17 years old(2), children in general tend to experience more traumatic, bony upper extremity injuries, while adolescents suffered more overuse soft tissue injuries to the chest, hip, pelvis and spine. Children seem to be diagnosed more commonly with fractures while adolescents were diagnoses with injuries such as ACL tears, meniscal injuries, and spondylolysis. Out of the children treated for spine injuries, most of them were female and due to overuse.
I'm not saying that we should pull all of our kids out of their sports and activities. I grew up playing almost every sport in the book and I'm so thankful that I did - I would not have had any interest in physical therapy if it hadn't been for my athletic upbringing! Instead, I want to push injury prevention programming. Every sports team, club, camp, and group should have some sort of program that promotes proprioceptive and plyometrics as part of an injury prevention program. But the challenge here is, how can we make it fun, especially for our younger population? Here are some exercises(3) I've disguised as "playtime activities" you can do to prevent injury!
- "Bunny Hops" aka Double Leg Hops – This is a target jump/standing broad jump but done consecutive times forward, with the focus on soft, symmetrical landing and landing with knees bent. This can also be a race if you have multiple kids! Just make sure they know how to do it properly and with good form before they race :)
- Single Leg Forward Hop - Same as the Side Hop, but instead they are moving forward. The focus should be on minimal vertical displacement, soft landing and no collapsing of the knee in towards midline of body. If you see the knee collapsing in, do not perform this activity. This means that their hip musculature are not quite strong enough to handle the dynamic load of the single leg forward hop. To progress this exercise, increase the distance traveled.
(1) Stracciolini, A., Casciano, R., Levey Friedman, H., Stein, C. J., Meehan III, W. P., & Micheli, L. J. (2014). Pediatric sports injuries: a comparison of males versus females. The American journal of sports medicine, 42(4), 965-972.
(2) Stracciolini, A., Casciano, R., Levey Friedman, H., Meehan III, W. P., & Micheli, L. J. (2013). Pediatric sports injuries: an age comparison of children versus adolescents. The American journal of sports medicine, 41(8), 1922-1929.
(3) Irmischer, B. S., Harris, C., Pfeiffer, R. P., DeBeliso, M. A., Adams, K. J., & Shea, K. G. (2004). Effects of a knee ligament injury prevention exercise program on impact forces in women. The Journal of Strength & Conditioning Research, 18(4), 703-707.
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