Recognizing Movement Injuries in Children
Williams, Biff, Marston, Rip, JOPERD--The Journal of Physical Education, Recreation & Dance
Most children seem to have a natural desire to be active and to explore new experiences. Their rapidly developing bodies provide ever-increasing opportunities to challenge the limits of their motor abilities. In addition to their physical education classes, more and more children are participating in extra-scholastic activity programs such as youth sport clubs and community recreation programs. Unfortunately, with the increased opportunity to participate in such activities comes an increased risk of injury. Children in the elementary grades are particularly prone to injury because they are not as coordinated as adults and react more slowly to movement hazards in the environment (e.g., they have trouble getting out of the way of a running teammate or thrown object). They may not be able to assess the risks involved or consequences connected to specific movements (e.g., a dive-forward roll; throwing the bat after hitting the ball). In addition, children of the same age can vary greatly in size and weight. All o f these factors contribute to an environment that may be more conducive to injury than to learning.
Sport injury hazards are drawing increased national attention, and for good reason. According to a national survey, an average of 775,000 children under age 14 are treated in hospital emergency rooms each year for sport-related injuries, and "21 percent of traumatic brain injuries in children are the result of sports or recreational activities" (KidsHealth, 2001). Another two million children per year receive a sport-related injury that does not require a visit to the emergency room (KidsHealth). Such statistics have prompted the National Athletic Trainers' Association Research and Education Foundation to form an alliance with the American College of Sports Medicine in order to study injury patterns in youth sports. As the chair of the foundation's research committee stated, "Youth make up the largest group of participants in organized sports, and yet we know relatively little about how and why they are injured" (National Athletic Trainers' Association, 1998).
Most injuries to children can be classified as either acute injuries or overuse injuries. Acute injuries usually occur suddenly (e.g., bruises, strains, sprains, eye injuries, broken bones), while overuse injuries tend to result from practicing a specific movement too often or from improperly executing a repetitive movement (e.g., Little League elbow, swimmer's shoulder, shin splints) (KidsHealth, 2001). Recent data indicate that 30 to 50 percent of all pediatric sports injuries are due to overuse (DiFiori, 1999).
Although conscientious teachers and scholastic coaches may strive to provide safe, developmentally appropriate activities for their students, many children are engaging in additional movement activities over which qualified professionals have little, if any, control. For example, teacher associates, whose major objective is to maintain a minimum level of social accountability (translated: "no fights"), supervise most school recesses in a chaotic setting wherein little regard is given to factors related to injury. Similarly, many community recreation organizations rely on volunteer personnel for the core of their programs. These volunteers usually have good intentions but may lack the background to create physically or emotionally safe activity environments. Untrained personnel sometimes view children as miniature adults. Yet, children differ physiologically, cognitively, and emotionally from teenagers and adults. They should not be told to "play through" injuries such as tendonitis, stress fractures, and shi n splints (American Academy of Pediatrics, 2000). The "no pain, no gain" philosophy is not appropriate for children's practices or games.
Parents may likewise lack knowledge about appropriate levels of participation for their children or their own role in preventing youth sport injuries. For example, the results of the National SAFE KIDS Campaign survey (2000) indicate that many parents are not very concerned about injuries in youth sports:
More than half of parents. …