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Sock It to Me - But Not Too Hard

PREVENTING AND TREATING COMMON
CHILDHOOD SPORTS INJURIES

By Alexa Stanard

Sports such as football, baseball, softball, soccer and lacrosse give kids the chance to develop coordination, boost their heart rates and make new friends. They also offer lots of opportunity for injury.

Falling hard, taking a ball to the head, or smacking into another player can cause serious damage to a child’s growing body. But that doesn’t mean you need to keep your child at home. In fact, the right equipment and a fast response can minimize injury risk and long-term impact.

Amy Teddy, injury prevention program manager at the University of Michigan’s C.S. Mott Children’s Hospital, says unorganized contact sports, such as children getting together on the playground for a game of football, present the most danger. “The best thing is for parents to not negotiate safety. Safety equipment that’s required in an organized activity should apply to unorganized activities as well,” she says.

So how do you keep your children safe, whether on the field or the playground? Here are ways to protect your kids and how to respond to injuries to three of the most common sites: the head, eyes and mouth.

The head

What can happen? The biggest risk to the head is concussion, and new research indicates that if not treated properly, this injury is potentially more damaging than previously thought, says Teddy. According to the Centers for Disease Control and Prevention (CDC), a concussion is any trauma-induced brain injury resulting from the brain moving rapidly inside the skull. A concussion changes how the brain functions. About 135,000 children ages 5-18 suffer a sportsrelated concussion requiring an emergencyroom visit every year.

How can I prevent it? Concussions are more likely to occur in contact sports, such as football and hockey, but can happen in any sport.

“If there is speed combined with the ability to run into a stationary object, you need to wear a helmet,” says Teddy.

Don’t use the same helmet for all activities, because it might not protect the child adequately; a goalie shouldn’t wear a bicycle helmet in the net. If a helmet is damaged, replace it. And proper fit is more important than comfort, according to Tim Shepard, owner of TWC Surf and Sport in Sylvan Lake.

“It’s actually supposed to wrinkle your forehead when you put it on,” says Shepard. “It should be tight enough so that it won’t twist on your head, because it’s going to defeat the whole purpose if it twists.”

What can I do if an injury happens? Watch carefully for signs of a concussion in a child who has suffered a head injury, including headache, dizziness, nausea, blurred vision, insomnia, memory loss or trouble concentrating. Symptoms can appear anytime from a few minutes to a few weeks after an injury.

Seeking medical attention as soon as possible is critical when a child shows any of these warning signs, because symptoms can worsen quickly, Teddy says.

“Kids have an immature brain. When you have an interruption in development, it can have long-term effects,” she says. “This is not something to mess around with – it could be a pivotal moment in their development.”

Teddy says parents also should ask their doctors about a new test that measures brain function before the sports season begins. In the event of an injury, the test allows parents and doctors to better understand the extent of damage by providing a baseline for comparison.

Finally, Teddy says, let your child recover fully before he or she returns to any activity that poses risk of head injury.

The eyes

What can happen? Getting whacked in the eye can cause lasting damage as well. The most serious risks involve permanent vision loss along with infection, says Lori Stec, M.D., an ophthalmologist specializing in trauma at Beaumont Hospital in Royal Oak.

Stec says most eye injuries are the result of blunt trauma from a ball or other sports equipment, adding that she even had a patient who was kicked in the eye while swimming.

According to the American Academy of Ophthalmology (AAO), about 40,000 sportsrelated eye injuries occur every year. About one-third happen to children, and baseball and basketball pose the biggest risks.

How can I prevent it? The AAO recommends that kids wear protective eyewear when playing sports.“Eye protection is the absolute most important thing, [along with] wearing it all the time, even when you’re in practice,” says Stec.

Rougher sports require more resilient eyewear. The AAO provides guidelines on its Web site at www.aao.org. Choose eyewear made from non-breakable polycarbonate plastic in a sports frame, and consider having it fitted by an eye doctor. Eyeglasses are not sufficient protection and can shatter.

What can I do if an injury happens? If a child sustains a hit to the eye, symptoms of injury include bruising, a red eye, an inability to open the eyelid or to move the eye in all directions, a bulging eye and high sensitivity to light, Stec says. Long-term problems usually are preventable if a child is treated quickly.

“From my experience seeing kids who weren’t brought in right away, I would err on the side of being cautious,” Stec says. “A lot of people blow off the black eye or swollen eye, but it could be masking serious injury, and by the time the swelling goes down, it could be too late to treat vision impairment.”

The mouth

What can happen? As anyone who plays hockey can attest, the mouth is a common site for injuries, which can range from a loose or displaced tooth to total loss of a tooth. But getting knocked in the mouth can lead to more than just a gap in the smile, according to Jeffrey Zanetti, D.D.S., who has a practice in Farmington.

How can I prevent it? Using a mouth guard during sports will do more than just keep your kids’ teeth in their head – it also can help prevent serious head and jaw injuries, says Zanetti. Mouth guards cushion the teeth and prevent the lower jaw from pounding the upper jaw, which can cause a concussion, or break or dislocate the lower jaw.

“Using a mouth guard is the No. 1 thing. They should not be looked at as only for football or hockey players,” he says.

The best mouth guards are those custom- fitted by a dentist, according to Zanetti. Store-bought mouth guards, called “boil and bite” by dentistry professionals, are bulky and mostly suited for football and hockey players. Custom-fitted guards cost $20-$150, are available in several thicknesses, and will fit precisely, allowing a child to talk comfortably, says Zanetti.

What can I do if an injury happens? If a permanent tooth gets knocked out during a game, rinse the tooth with water, and put it back in the socket, then head to the dentist. The first hour is most important in seeking help, Zanetti says.

Never scrape tissue or fibers that are left on the tooth. If you’re unable to put the tooth back into place, put it under the child’s tongue so it’s in saliva (if the child is old enough not to swallow it accidentally), or put it in milk in a plastic bag, as milk has some of the same properties as saliva.

Repositioning a displaced tooth is much easier the day of the injury, Zanetti says. For a cracked tooth, save the broken piece so the dentist can bond it back into place.

A child who can’t fully open or close the mouth might have a dislocated or broken jaw. Zanetti says visit an emergency room first to determine whether serious injuries have occurred, such as concussion or broken facial bones. Treatment for such injuries can involve anything from medication to wiring the jaw shut or inserting plates. After making sure the face and jaw are OK, a follow-up trip to the dentist for X-rays is advisable.

IBUPROFEN MIGHT BE BEST FOR SOME KIDS’ INJURIES

If your child ends up in the emergency room with a musculoskeletal injury, such as a sprained ankle, you might want to request he or she receives ibuprofen for pain relief. A new Canadian study found that ibuprofen provided better pain relief after one hour than either acetaminophen or codeine in children brought to Children’s Hospital of Eastern Ontario’s emergency room with pain from a musculoskeletal injury to the extremities, neck or back occurring sometime in the prior 48 hours. The study evaluated 300 children ages 6 to 17 and was published in the March issue of Pediatrics.