As the school year begins, so do school athletic activities. Safe Kids Mid-South, led by Le Bonheur Children’s Hospital, offers three tips every parent should know about keeping young athletes safe:

Your child should have his heart checked.  An undetected heart defect can result in serious injury or even death.  That’s why a pre-sports physical is essential.  Also, check to be sure that your child’s school has automated external defibrillators -- which can save a life during cardiac arrest -- and make sure these devices are present at school practices and events.

The brain needs rest after an injury. Concussion is a serious thing and takes time to heal.  Seek medical attention right away. A health care professional will be able to decide how serious the concussion is and when it is safe for your child to return to sports. Be sure to tell your coach about any recent concussion.  Your child’s coach may not know about a concussion received in another sport of activity unless you tell the coach.

One-sport athletes should take extra precautions.  Many youth play one sport year round.  Overuse injuries, like pitcher’s elbow, have been seen by many doctors recently. To help prevent such injuries, do not increase training intensity, frequency or duration by more that 10 percent per week. Also, young athletes should take at least 10 weeks off from their sport each year.

As winter turns into spring and temperatures increase, so does the amount of time that children spend outdoors playing spring sports.  This means that the number of injuries to children can also increase. Each year, more than 38 million children participate in sports in the United States, and more than 3.5 million children ages 14 and younger are treated for sports injuries. Experts say as many as half the injuries sustained by youth while playing sports are preventable.

Safe Kids Mid-South, led by Le Bonheur Children’s Hospital, is part of a national education campaign sponsored by Safe Kids USA and supported by Johnson & Johnson.  The campaign is focusing on four areas, which are critical to keeping young athletes healthy and safe: acute and overuse injury prevention; proper hydration before, during and after play; annual pre-participation physical prior to play; and concussion awareness, prevention and screening methods.

“Children ages 5 to 14 account for nearly 40 percent of all sports-related injuries treated in hospital emergency rooms,” said Susan Helms, director of Injury Prevention and Safe Kids at Le Bonheur. “Our goal is to reach coaches and parents and equip them with the critical information and resources to keep kids out of the emergency department.”

Here are five important sports safety tips for coaches and parents from Safe Kids Mid-South:

• Pre-Season Medical Screening: These exams can detect any underlying conditions the young athlete may have and therefore prevent a potential medical emergency.
 
• Safety Gear: To prevent injuries, children playing sports should have access to and consistently use well-maintained safety equipment during both practices and games.

• Qualified Coaching: Athletic coaches should be trained in both first aid and CPR; have a plan for responding to emergencies; and have current knowledge of proper hydration methods (and establishing mandatory breaks); and concussion prevention, recognition and response. Coaches should also establish safety guidelines that athletes, parents and coaches will follow.

• Proper Conditioning: To prevent acute and overuse injuries, coaches should teach young athletes proper routines for both warm-ups and cool-downs before and after practice and play. This can help prevent sports-related injuries (such as muscle tears or sprains) by stretching and releasing any muscle tension.

• Hydration: Athletes should be encouraged to drink fluids (water or sports drink) 30 minutes before the activity begins and every 15-20 minutes during activity. Coaches should establish mandatory water breaks during practice and games. Don't wait for the child to tell you he/she is thirsty.
 
• Rest: If young athletes are very tired or in pain, coaches and parents should encourage them to rest as this valuable recovery time can help prevent overuse injuries.

For more information on Safe Kids Mid-South or on sports injury prevention in general, please visit www.safekids.org/sports. Safe Kids Mid-South works to prevent unintentional childhood injury, the leading cause of death and disability to children ages 1 to 14.

With nice weather fast approaching, your kiddos will likely be spending more time outside.  Organized sporting events or simple backyard play can increase the risk for bone and joint injuries. Parents are often confused as to what injuries need to go to the emergency room right away and which can wait for the pediatrician or orthopaedist during regular office hours. Dr. Derek Kelly, an orthopaedic surgeon with Campbell Clinic and Le Bonheur Children's Hospital, gives expert insight into children’s bone injuries.

WHAT TO DO
• Keep them still and help them support the injured area.  Most kids will instinctively hold their arm or leg in the safest and most comfortable position after an injury.
• Make sure they are breathing normally (crying is a good sign that they are getting plenty of oxygen).
• Try to calm his or her fears.
• Check to see if the injured area looks normal.  Severe fractures (those that need to go to the emergency room) often look strange. The arm or leg may be bent or badly swollen.
• Check to see if there is any bleeding near the injured area. Bleeding could indicate that the bone is broken and has come through the skin. This requires an immediate trip to the emergency room.
• Check to see if the fingers and toes are pink.  This means that there is good blood flow and the injury has not damaged any blood vessels. If the fingers and toes are not pink a trip to the emergency room is required.
• Finally, if the injured area looks normal, there is no bleeding and if the fingers and toes are pink, then you would need to ask your child to gently move the joints (elbow, wrist, ankle) near the injured area.  This might be a bit painful in a sprain or strain.  But if the child isn’t able to move the joints due to pain, it could be a badly broken bone and you need to go to the emergency room. 

If everything appears normal according to the checklist above, it is probably safe to wait and make an appointment with your child’s pediatrician or orthopedic surgeon during regular office hours. If you feel you need to go the emergency room, then it is important to support the arm or leg with a large pillow, stack of towels or rolled up newspapers.  This will provide some comfort and support while on the way to the emergency room.

WHAT NOT TO DO
• Don’t apply a tight wrap or constricting bandage.  Broken bones cause swelling that could be made worse by tight bandages.
• Don’t try to set or realign the arm or leg.  Doing so could cause further damage and pain.
• Don’t give your child anything to eat or drink before a nurse or doctor in the emergency room has seen the injury.  Feeding your child or allowing them to drink could delay the use of certain medications to help control the pain and repair the broken bone.

It’s the height of football season when injuries among students and young players are quite common. We took some time to speak to Dr. Derek Kelly, orthopedic surgeon with Campbell Clinic, regarding what parents should know about neck injuries and what to do if their child experiences one. Here’s what he had to say.

What type of sport presents the highest rate of neck injuries to kids and young adults?

High energy sports place children and adolescents at the highest risk of neck injuries.  By far the most common sport in our area related to these injuries is football. But neck and spine injuries do occasionally occur in other sports like gymnastics, cheerleading and hockey.  In addition motor-powered sports like dirt bike and ATV racing place kids at a high risk for these injuries, but the number of spine and neck injuries we see each year from racing sports are lower due to the lower number of participants in these activities.

What do parents need to know about preventing neck and back injuries?

The only sure way to prevent neck and spine injuries related to high energy sports is to avoid the sport all together.  However, sports provide many positive benefits for children and adolescents including physical fitness, team participation, leadership skills, sportsmanship and discipline.  Therefore, care should be taken to ensure proper safety.  First, participants in these activities should take all precautions allowed by the sport including use of the proper safety equipment. 

Specifically, football players should wear helmets with face shields and pads.  Also, football players should be taught; and should practice, proper and safe tackling techniques.  Many neck injuries in junior high and high school football occur as the result of improper spear tackling. This occurs when the player lowers his head just before tackling another player and drives his flexed head and neck into the body of another player. This type of tackle places extreme stress on the structures of the neck and places the spinal cord at risk for injuries.  A tackler should always “see what you hit."  This means, the tackling player should keep his head up throughout the entire tackle to ensure no force is placed on a flexed neck.

What's the first thing a parent/spectator should look for in a child that might have been injured on the field during a contact sport?  How should the child be handled/moved if injured?

An injured player should not be moved until they are assessed by a trainer or medical staff member.  Most football injuries are minor sprains or strains of the joints or muscles and are considered routine aspects of the sport.  However, some injuries are quite severe and should be handled carefully.  An injured player should first be assessed for the ability to breathe.  If a player is not breathing, or is unresponsive, the medical staff should be alerted immediately to begin life saving measures and arrange for rapid transportation to the nearest emergency facility.  Any player with altered mental status (confusion, amnesia, dizziness) should be evaluated by medical personnel.  These symptoms could be a concussion or mild brain injury. In most instances, players with these symptoms should not return to play during the same game in which the injury occurred.

Any player with inability to move the arms or legs, even if complete function returns in a short time, should not return to that game and should not return to play until evaluated by trained medical personnel.  If the player is unable to move the arms or legs or is unable to feel sensations in the arms or legs, they should not be moved until evaluated and stabilized by medical personnel. This typically involves neck bracing and securing the injured player to a spine board for transportation to the hospital.  The helmet and pads should not be removed on the field and should remain in place until the injured player arrives at the hospital.  The face shield can be removed if there is a concern over the player’s ability to breathe or if oxygen has to be given.  Many neck  and spinal cord injuries can be successfully treated, often with partial or complete recovery of function, if the injured player is managed correctly at the time if injury.

If there is any concern about the severity of an injury, always assume it is worse than it might appear.  There is always a strong desire from the player, teammates, coaches and fans to have the player return to play as soon as possible. Paying careful attention to symptoms like altered mental status and temporary burning, numbness or weakness in the arms and legs and seeking appropriate medical care can prevent season-ending, career-ending and even life-ending injuries.

Tennessee high schools have a new policy for sports-related concussions, which requires that players who show signs of a concussion be removed from the game and not allowed to resume play until given the clear by a medical professional.

A concussion is a brain injury and all are serious. The majority of concussions do not involve loss of consciousness. Recognition of and proper response to concussions when they first occur can help prevent further injury or even death.

Although symptoms may not occur immediately, common signs include:

• Headache
• Dizziness or vertigo
• Lack of awareness
• Nausea and vomiting
• Poor attention and concentration
• Fatigue
• Double or blurred vision
• Irritability and/or bothered by light or noise
• Memory problems

The Tennessee Secondary School Athletic Association  is following the lead of the National Federation of State High School Associations, which includes the following in every sport rule book publication: Any player who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the game and shall not return to play until cleared by an appropriate health-care professional.

For more information, visit the Centers for Disease Control and Prevention’s Concussion in Sports site.