Safety in Sports
Volume 6, Number 7 - September, 2002
Editors: Carol A. Rice, Ph.D., RN, Professor and Extension Health Specialist, and Janet M. Pollard, MPH, Extension Associate-Health
Download PDF version of this Newsletter [265K]
Inside HealthHints....
- Safety in Sports
- When and What
- Preventing Injuries: Causes
- Preventing Injuries: Strategies
- Pre-participation Physical Exam (PPE)
- Heat Issues
- Equipment Essentials
- Warming Up and Working Out
- Rules, Regulations, and Proper Technique
- Common Types of Sports Injuries
- Treating Sports Injuries
- HIV and Other Blood-borne Pathogens
- Guidelines for Coaches
- Nutrition for Your Athlete
- Crash Diets, Supplements, and Steroids
- Activity Ideas for Promoting Sports Safety
- Websites with Reliable Information
- References
Safety in Sports
"Approximately 60 to 70 percent of those injured while playing sports only suffer minor injuries that could have been prevented with proper sports safety training (National Center for Sports Safety, 2001b)"
The phone rings. "Mrs. Clemment, your daughter was injured today in softball practice. Her knee may be badly injured. Could you please meet us at the hospital?" You put the phone down and fumble for your car keys. As you drive you wonder if you should have let her play sports at all, but you know she loves it. How can you ever feel secure in letting her take the field again?
According to the National Athletic Trainers Association:
- more than half of all sports injuries occur at practice.
- approximately 60 to 70% of those injured while playing sports only suffer minor injuries that could have been prevented with proper sports safety training (National Center for Sports Safety, 2001b).
According to the National SAFE KIDS Campaign:
- more than 3 million children experience sports- and recreation-related injuries each year.
- 20% of children participating in sports activities are injured and 1/4 of these injuries are considered serious.
- 21% of traumatic brain injuries in children are the result of sports or recreational activities (American Medical Association, 1998).
According to the American College of Sports Medicine:
- Each year more than 775,000 children under the age of 14 are treated in emergency rooms for sports-related injuries -- nearly half of these were preventable (National Center for Sports Safety, 2001b).
According to the U.S. Consumer Product Safety Commission:
- In 1997, sports injuries among youth under age 14 participating in 29 sports cost the U.S. public more than $49 billion (National Center for Sports Safety, 2001b).
According to Physicians and Sportsmedicine:
- From 1982 to 1996, the total number of direct and indirect fatalities among high school athletes were:
- Baseball - 13
- Basketball - 54
- Cheerleading - 21
- Cross Country - 10
- Football - 150
- Soccer - 20
- Track and Field - 35
- Wrestling - 15 (National Center for Sports Safety, Facts, 2001).
Preventing just one of these fatalities is worth the effort (National Center for Sports Safety, 2001b).
Scenarios like the one mentioned earlier are not uncommon. As we send our children back to school this Fall, we also send them back to school and community sports. It is important for parents and guardians to take an active roll in helping their children select sports activities and take safety precautions.
This issue of HealthHints will focus on organized sports -- benefits and risks, common types of sports injuries, causes, treatment, and prevention strategies.
When and What
Deciding when your child should participate in organized sports and what sport(s) would be the best choice are important facts to consider in regards to benefits and risks.
WHEN
"Participation in organized sports can have physical and social benefits. However, the younger the participant, the greater the concern about safety and benefits (American Academy of Pediatrics, 2001b)."
Participating in organized sports can have the benefits of coaching, supervision, safety rules, and proper equipment, but can also create demands and expectations that exceed the readiness and capabilities of young participants (American Academy of Pediatrics, 2001b).
"Organized sports should be tailored to match the developmental level of participants (American Academy of Pediatrics, 2001b)." To be safe, healthy, and beneficial, organized sports should have reasonable goals and appropriate strategies for attaining these goals including:
- acquisition of basic motor skills
- increasing physical activity levels
- learning social skills necessary to work as a team
- learning good sportsmanship
- having fun (American Academy of Pediatrics, 2001b).
Additionally, organized sports for children and preadolescents should complement, not replace free-play, child-organized games, recreational sports, or physical education at school. Regular physical activity is important for all children whether they participate in organized sports or not (American Academy of Pediatrics, 2001b).
WHAT
Finding the right sport to fit your young athlete is another important consideration for parents and guardians. Here are some questions to think through that may help parents in making the decision with their child:
Is my child interested?
If your child expresses interest in organized sports, then consider all of the questions below. If your child does not express interest right now, however, that is okay. Remember, organized sports are not the only way to develop athletic skills or to get physical activity. "Parents sometimes force their children into something for all the wrong reasons (Mayo Clinic, 1998b)." Involvement in bicycling, swimming (non-competitively), hiking with the family, etc. can all be avenues for physical activity and physical skill building.
Does my child have time for organized sports?
Consider all the activities in which your child is involved (e.g. music lessons, drama, clubs, etc.). Too many activities can make adding athletics frustrating or overwhelming for your child.
What are the characteristics of each sport?
With your child's interests in mind, consider how sports differ, including:
- emphasis on individual skill
- emphasis on team performance
- size of teams
- amount of physical contact
- amount of equipment needed and its cost.
All of these factors may influence your choice. For example, if your child is interested in tennis and soccer and you want them to learn teamwork, soccer is probably the better choice; while if you want them to excel in an individual skill, singles tennis might be a better choice.
How can I help my child find the sport that's best for him or her?
"The more children can try out and find something they're good at doing, the more they'll enjoy the activity (Mayo Clinic, 1998b)." When children are younger and just starting, they can benefit from exploring several options. Let them try team sports (e.g., soccer, softball, basketball, etc.) as well as individual sports (e.g., running, golf, tennis, etc.).
Observe your child's progress. Is he/she comfortable with the physical contact of the sport? Is he/she developing good hand-eye coordination (this may develop at different stages for different children)? If your child starts to show a lot of interest in one sport, consider if the sport is a good match for your child's height, weight, strength, and coordination. Also consider whether the sport is a good psychological match -- does your child enjoy being coached and going to practice, or would he/she be more comfortable with an individual training routine?
Am I ready to let my child take part in sports?
Consider your own feelings. Are you ready to relinquish your child to the coach for a few hours a week? Would you like to volunteer to help in coaching or mentoring your child's team? How well will you handle your child's victories and defeats?
If you and your child have selected a sport and you are ready to let your child get involved, consider the following questions:
What should I look for in a sports organization?
There are two important considerations in a sports organization:
- Team assignments -- Are the children assigned strictly by age, which can increase risk of injury? Or are they assigned by physical maturity and skill? Is there emphasis on warming up and cooling down to prevent injuries?
- Quality of coaching -- Get to know the coach, if possible. Consider talking with previous team members or going to a game the season prior to your child's involvement if your child has already expressed interest. If the coach consistently yells at the umpire or only allows the most skilled players into the game, your child may become discouraged.
What should I look for in a coach?
"With good coaching, your child can have a safe, rewarding sports experience (Mayo Clinic, 1998b)." It is important to look for a coach that emphasizes safety. Does the coach require players to follow the rules and use proper safety equipment? Is the playing field free of hazards? Is there a plan for handling injuries or medical emergencies? Does the coach spend enough time on fundamentals? Learning basic body movements and positioning can keep your child from slipping into bad habits, improve performance, and decrease risk for injuries.
Finally, look for emphasis on fun versus competition and winning. When children reach ages 11 or 12, they may be ready for more emphasis on competition and winning. For children under age 11, the emphasis should be on fun and skill building.
How can I best support my child?
Support from a parent can be a crucial aspect in a child's attitude about organized sports. Try to focus on fun as much as competition. After a game, steer the conversation away from the scoreboard. Focus on the benefits of the skills your child is building and the relationships he/she is developing with teammates. "Emphasize effort and improvement over winning or personal performance (Mayo Clinic, 1998b)." Don't get overly invested in whether your child wins or loses. Attend events and practices as your schedule allows -- modeling good sportsmanship. "Be positive and encouraging (Mayo Clinic, 1998b)."
How should I respond if my child wants to quit?
If your child expresses a desire to quit, ask for reasons and listen. Your child may be intimidated by older players, afraid of the coach, or setting expectations that are too high. When you understand the source of the problem you and your child can make a good decision. Be sure to look for signs of stress related to the sport. If your child is losing weight, complaining of headaches, or withdrawing from friends, quitting for now may be the wise choice. Your child can take up a sport later or get physical activity in other ways.
(This section adapted from Mayo Clinic, 1998b).
Preventing Injuries: Causes
So, you've made the decision to let your child play sports. Now the question is, how can you help your child avoid sports injuries? To help understand how to avoid sports injuries, let's first look at causes of sports injuries among youth.
Youth are susceptible to sports injuries for several reasons including the following:
- Children are less coordinated and have slower reaction times than adults because they are still growing and developing.
- Children mature at different rates. A substantial difference in height and weight may exist between kids of the same age.
- As youth grow older and bigger, the potential for severe injury increases. This increase is largely due to the amount of force involved (e.g., Two 65 to 70 pound, 8-year-old football players do not produce as much force as two 16-year-old football players who may weigh up to 200 pounds each).
"As children grow bigger and stronger, there is an increased risk of sports injuries. Children under age 10 are more likely to be injured on playgrounds or from bicycle riding while injuries due to organized sports or overexertion tend to occur more frequently in older children (American Medical Association, 1998)."
Preventing Injuries: Strategies
"Injury remains the leading cause of childhood and adolescent death and disability (American Academy of Pediatrics, 2001a)."
Though some childhood injuries may be inevitable, you can help your child by reminding him or her of the importance of safety and appropriate physical conditioning (American Academy of Pediatrics, 2001a), and guiding your child with the following steps to minimize risk:
- Be in proper physical condition to play the sport. Develop a pre-participation fitness routine that builds overall strength, endurance, and flexibility. Include exercises designed for your child's sport.
- Know and abide by the rules of the sport. Help your child review the rules of the sport and make sure he/she understands the rules for his/her safety, sportsmanship, and effective play of the game.
- Wear appropriate protective gear for the sport (e.g., shin guards for soccer, hard-shell helmet when facing a softball or baseball pitcher, helmet with face mask and body pads for football, etc.). Make sure equipment is up-to-date and fits your child properly.
- Know how to use athletic equipment properly. This includes protective gear and work-out equipment, such as weight training equipment.
- Always warm up before playing and cool down after. Gradual, gentle stretching (not bouncing) of the arms and legs before and after the game is an essential tool for preventing injury.
- Avoid playing when very tired or in pain. Remind your child to report any pain felt during practice or competition. Close observation and quick response to pain can help your child avoid the emergency room and enjoy the sport to its fullest. Also, talk with your child about avoiding inflated expectations (and don't create expectations that are too high as a parent). When a child feels pressured by peers, coaches, or parents, he/she may try to play through the pain, promoting further injury.
- Make sure there is adequate water or other liquid for maintaining proper hydration. Peak performance requires unlimited access to water during hot weather. Dehydrated athletes can suffer severe medical complications (Clark, 1997).
- Get a preseason physical examination. The pre-participation physical (PPE) is not meant to disqualify your child from sports, but to be sure your child can safely play a sport he/she wants to play or direct your child to another type of activity that is more appropriate (Mayo Clinic, 1998a).
Pre-participation Physical Exam (PPE)
During a pre-participation physical exam, the doctor typically will do the following:
- Ask questions about the child's health and the health of his/her family
- Listen to the child's heart and lungs
- Take a blood pressure and pulse reading
- Check the eyes, ears, nose, and throat
- Examine the back, joints, and extremities
- Check the abdomen
- Assess for genital abnormalities or hernias
- Inspect the skin
- Sometimes perform vision and hearing tests (Mayo Clinic,1998a).
In performing this exam, the doctor is looking for:
- Obvious problems, such as old injuries that were not diagnosed or treated
- Less obvious problems, such as coronary artery disease (becoming more common due to less activity and more childhood obesity)
- Rare problems, such as Marfan syndrome, recognized by very long extremities, a weakened aorta, and certain heart problems
- Asthma, which may require special management due to difficulty breathing in certain conditions (e.g., in cool air and during exercise)
- Female athlete triad (FAT), which includes disordered eating, lack of periods (amenorrhea), and osteoporosis
- Signs of use of anabolic steroid or other performance-enhancing drugs/products (Mayo Clinic,1998a).
The PPE is also a good time for parents to mention any concerns about symptoms their child exhibits. These comments can be very important in helping the doctor recognize health issues early and prevent problems later on. Your doctor may also take this time to address potential risks involved in playing a sport, such as drinking enough fluids during hot weather sports to reduce risk for overheating, etc. (Mayo Clinic, 1998a).
Heat Issues
"Playing rigorous sports in the heat requires close monitoring of both body and weather conditions. Heat injuries are always dangerous and can be fatal (American Academy of Orthopaedic Surgeons, 2001)."
Heat-related illnesses include:
- Dehydration -- Dehydration is a deficit in body fluids. Young athletes should drink two 8-ounce glasses of water, juice, or sports drink 2 hours before physical activity; 4 to 8 ounces or more 5 to 10 minutes before physical activity, and 8 to 10 ounces (or more) every 15 to 20 minutes during heavy physical activity. Note: Drinks with caffeine should be avoided because they may cause cramping. Also, read labels on sports drinks to make sure they are not high in sugar content.
- Heat cramps -- Heat cramps include painful cramping and spasms of the legs, arms, and/or abdominal muscles.
- Heat exhaustion -- Heat exhaustion symptoms may include feeling tired, weak, and dizzy; headache, nausea, and possible vomiting; heavy perspiration, pale and moist skin, weak pulse, dilated pupils, normal or low body temperature, disorientation, fainting spells.
- Heat stroke -- Heat stroke is a life threatening situation -- call 911! Symptoms of heat stroke include head ache; feeling tired, weak, and dizzy; skin feels hot and dry -- even under armpits; individual appears red and flushed; individual may be delirious or unconscious. Heat stroke can potentially lead to vascular collapse, coma, and death (American Academy of Orthopaedic Surgeons, 2001; Clark, 1997).
If you or someone you know begins to exhibit any of the signs of heat-related problems or dehydration:
- Stop activity immediately.
- Move to a cool (shaded) area.
- Get some fluids (water, sports drink, IV).
- Contact a health professional or your sport safety certified coach/trainer (National Center for Sports Safety, 2001a).
For more information on heat-related problems see the following handouts: "Avoiding and Treating Heat Related Problems" (http://fcs.tamu.edu/health/child_health/heat/heat_exhaustion_heat_stress.htm) and "Perform Your Best When It's Hot"
(http://fcs.tamu.edu/health/child_health/heat/fluids.pdf).
Equipment Essentials
"Did you know that playing tennis with a badly strung (too loose or too tight) racquet while wearing worn-out shoes can be just as dangerous as playing football with an out-of-place shoulder pad? Using the wrong -- or improperly fitted -- equipment is a major reason why teens are injured (Nemours Foundation, 1999b)."
Wearing the right equipment with the right fit dramatically decreases the chance of getting hurt (Nemours Foundation, 1999b). If you or your child are unsure of the proper equipment or fit, check with the coach, sports trainer, other parents, or your health care provider for information.
Some examples of protective equipment include helmets with polycarbonate shields for baseball, softball, bicycle riding, and hockey; protective eyewear (e.g., polycarbonate goggles) for basketball and racquet sports; shin guards for soccer; helmets, mouthguards, and padding for football, etc. Protective equipment should be approved by an appropriate certifying organization. Athletic equipment should also be well-maintained and safety-oriented to ensure its effectiveness (e.g., there are new "breakaway" bases that move when hit by a sliding player; these bases have shown to be effective in reducing leg injuries caused by sliding into bases (American Medical Association, 1998).
Warming Up and Working Out
Workouts and practices should always start with warming up. "Muscles that haven't been properly prepared tend to be injured more easily (Nemours Foundation, 1999b)." Start with some light cardiovascular activity, such as easy jogging, jumping jacks, or brisk walking to get the muscles warmed up. Follow this activity with stretching. Stretching after the initial warmup and for cool down periods is important because your tissue is more elastic (flexible) due to the increase in heat and blood flow to the muscles (Nemours Foundation, 1999b).
In addition to warming up, practice sessions are excellent preparation for most sports activities. Attending practices will put you in top physical condition and help your team work effectively together. Knowing how your teammates play can also help prevent injuries.
Note: Though practicing and individual workouts are very important, you should not over do it. Sudden conditioning increases may help in the short run, but can result in injury in the long run. Talk with a doctor or coach about an age- and developmentally-appropriate training and conditioning program (Nemours Foundation, 1999b).
Additionally, if you are injured, do not come back too soon. An already weakened area of the body is at increased risk for re-injury. Don't be pressured into playing before your body is fully healed. Seek medical treatment from a professional and don't use large amounts of pain relievers to mask the pain while you play. This advice also goes for playing with a cold or flu. If you are sick, you cannot concentrate on the game as well and could set yourself up for injury -- wait to play when you are feeling better (Nemours Foundation, 1999b).
Rules, Regulations and Proper Technique
Remember that rules, regulations, and proper techniques are not designed to restrict you, but protect you (Nemours Foundation, 1999b). Though you can learn the rules of the game "by the book," you should also be aware of unwritten rules. In some sports, such as running or cycling, you must also practice traffic safety rules, in addition to the rules of the competition. You should also work on good form to play well and reduce risk for injury. Rather than slamming a tennis ball into an opponent, you should learn a nicely angled volley. Finally, you should always use proper techniques. Weight lifters, for example, should take a breath between each repetition and should exhale as they push. If you hold your breath, it raises your blood pressure, and pressing a lot of weight can lead to blackout or fainting (Nemours Foundation, 1999b).
These are just some examples of rules, regulations, and proper techniques. Be in charge of learning all the proper rules, regulations, and techniques for your particular sport as well as for your training and conditioning regimen.
Common Types of Sports Injuries
There are three main types of injuries that occur in sports:
- Acute injuries
- Overuse or chronic injuries
- Re-injuries.
Acute Injuries
Acute injuries usually involve a single blow from a single application of force (Nemours Foundation, dealing with sports inj, 1999). Acute injuries occur suddenly and are usually associated with some form of trauma (American Medical Association, 1998).
Common types of acute sports injuries include:
- strains -- a stretch or tear of a muscle or tendon (the tough and narrow end of a muscle that connects it to a bone)
- sprains -- a stretch or tear of a ligament (the tissue that supports and strengthens joints by connecting bones and cartilages)
- abrasions -- scrapes.
More severe acute injuries that can occur, include:
- contusions -- a bruise caused by a direct blow, which may cause swelling or bleeding in muscles and other body tissues
- fractures -- crack, break, or shattering of a bone
- eye injuries -- including scratched corneas, detached retinas, and blood in the eye chamber
- brain injuries -- including concussions, skull fractures, brain hemorrhages, and spinal cord injuries (American Medical Association, 1998; Nemours Foundation, 1999a).
Overuse or Chronic Injuries
Overuse or chronic injuries are those that are sustained over a period of time or recur often. This type of injury is usually the result of repetitive training, such as running, overhand throwing, or serving a ball in tennis. Overuse or chronic injuries include:
- stress fractures -- tiny cracks in the bone's surface caused by rhythmic, repetitive overloading
- tendinitis -- small tears in the tendon fibers caused by repetitive stretching
- bursitis -- an inflammation of the bursa (a small sac in the shoulder, elbow, or knee (Nemours Foundation, 1999a)
- shin splints -- pain that occurs along the shin bone (tibia) in the lower leg (American Medical Association, 1998; Mayo Clinic, 2001b).
Remember, just because an injury doesn't occur dramatically, doesn't mean it will go away. Don't ignore overuse or chronic injuries; if left untreated they will probably get worse over time (Nemours Foundation, 1999a).
Re-injuries
Re-injury occurs when an athlete returns to a sport before an injury is sufficiently healed. Returning to a sport before sufficient healing takes place causes stress upon the injury and forces the body to compensate for the weakness in that area, putting the athlete at greater risk for further injury (American Medical Association, 1998).
Other Common Injuries
There are a few other types of injuries that are common and related to a child's age or gender.
- Growth plate injuries -- Growth plate injuries are injuries to the area of developing tissue at the end of long bones in children and adolescents (e.g., the long bones of the fingers, forearm, collarbone, hip, upper leg, lower leg, ankle, and foot). When growth is complete, sometime in adolescence, the growth plate is replaced with solid bone (American Academy of Orthopaedic Surgeons, 2001). Growth plate injuries may be acute (e.g., from a fall) or from over use. In either case, a child who has pain that persists should be examined by a doctor, and should not be allowed or expected to "work through the pain (National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse, 2001)."
- Injuries to the sex organs -- Males usually suffer more trauma to sex organs than females because the testicles and penis are unprotected in many sports. Males should wear athletic supporters, and in some sports a cup, to protect the genitals from serious injury. For females, injuries to the uterus or ovaries are rare. Breast injuries, however, are common since girls often can be sore from developing breasts -- a blow to this area can cause additional pain. Females should wear tight-fitting, supportive sports bras while playing sports (Nemours Foundation, 1999a).
Treating Sports Injuries
"The majority of sports-related injuries involve the body's soft tissue rather than the bones. About two thirds of all injuries are strains (overstretching or overextension of the muscles) and sprains (wrenching of a joint with partial tear of the ligaments) (American Academy of Pediatrics, 2000)."
If your child receives a soft tissue or bone injury, the best immediate treatment is the R.I.C.E. treatment:
- Rest -- Reduce or stop use of the injured area for 48 hours. If the injury involves the leg, the child may need to stay off of it completely.
- Ice -- Put an ice pack on the injured area for 20 minutes at a time, 4 to 8 times per day. Use a cold pack, ice bag, or plastic bag filled with ice and wrapped in a towel.
- Compression -- Compression of an injured knee, ankle, or wrist may help reduce the swelling. Tools for compression include bandages (e.g., elastic wraps), special boots, air casts, and splints. Consult a doctor about which one is best.
- Elevation -- Keep the injured area elevated above the level of the heart. Pillows can help to elevate an injured limb (American Academy of Orthopaedic Surgeons, 2001).
If an injury is severe, such as an obvious fracture, dislocation of a joint, prolonged swelling, or prolonged or severe pain, always seek professional medical treatment (American Academy of Orthopaedic Surgeons, 2001).
For acute injuries, immediate first aid attention should be administered. If the injury is severe, the athlete should be taken to the hospital emergency department (American Medical Association, 1998). If a spinal injury is suspected, however, the Emergency Medical Services System should be activated; the athlete should not be moved; the athlete's airway, breathing, and circulation should be checked; if the athlete must be moved, he/she must be in the supine position and the spine should be immobilized with appropriate equipment (National Youth Sports Safety Foundation, 2002a).
If you, your coach, or athletic trainer suspect an acute injury (e.g., the athlete's injury appears to affect function, such as limping, can't bend a finger or limb, has a change in consciousness, etc.) it is "better to be safe than sorry." Have the child be seen by his doctor, or if needed, taken to the hospital emergency department (American Medical Association, 1998).
Soreness versus Chronic Pain
An athlete should learn the difference between soreness and chronic pain. Soreness is temporary, while chronic pain continues over a longer time period. If pain persists for 2 weeks or more, an appointment should be scheduled with the child's doctor (Nemours Foundation, 1999a).
HIV and Other Blood-borne Pathogens
HIV (human immunodeficiency virus) is the virus that causes AIDS. There are also other illnesses that can be transferred by blood. Because athletes and athletic staff can be exposed to blood during activity, they have a small risk of contracting HIV, as well as hepatitis B virus and hepatitis C virus.
Though the risk of becoming infected with any of these viruses through blood contact is very low, it is still important to take some precautions:
"Athletes must cover existing cuts, abrasions, wounds, or other areas of broken skin with an occlusive dressing before and during participation. Caregivers should cover their own damaged skin to prevent transmission of infection to or from an injured athlete.
Disposable, water-impervious vinyl or latex gloves should be worn to avoid contact with blood or other bodily fluids visibly tinged with blood and any object such as equipment, bandages, or uniforms contaminated with these fluids. Hands should be cleaned with soap and water or an alcohol-based antiseptic handwash as soon as possible after gloves are removed.
Athletes with active bleeding should be removed from competition as soon as possible and the bleeding stopped. Wounds should be cleaned with soap and water. Skin antiseptics may be used if soap and water are not available. Wounds must be covered with an occlusive dressing that remains intact during further play before athletes return to competition.
Athletes should be advised to report injuries and wounds in a timely fashion before or during competition.
Minor cuts or abrasions that are not bleeding do not require interruption of play but can be cleaned and covered during scheduled breaks. During these breaks, if an athlete's equipment or uniform fabric is wet with blood, the equipment should be cleaned and disinfected (see below), or the uniform should be replaced.
Equipment and playing areas contaminated with blood must be cleaned until all visible blood is gone and then disinfected with an appropriate germicide such as a freshly-made bleach solution containing 1 part bleach in 10 parts of water. The decontaminated equipment or area should be in contact with the bleach solution for at least 30 seconds. The area may be wiped with a disposable cloth after the minimum contact time or be allowed to air dry.
Emergency care must not be delayed because gloves or other protective equipment is not available. If the caregiver does not have the appropriate protective equipment, a towel may be used to cover the wound until an off-the-field location is reached where gloves can be used during more definitive treatment.
Breathing (Ambu) bags and oral airways should be available for giving resuscitation. Mouth-to-mouth resuscitation is recommended only if this equipment is not available.
Equipment handlers, laundry personnel, and janitorial staff must be trained in proper procedures for handling washable or disposable materials contaminated with blood (American Academy of Pediatrics, 1999a)."
Guidelines for Coaches
Coaches play one of the most vital roles in keeping their players safe. Here are some guidelines from the National Center for Sports Safety to help assure that your athletes have a safe playing environment:
- Develop an emergency action plan and make sure all of your assisting coaches are familiar with the emergency procedures.
- Always have an accessible, working phone at practice and at games to ensure that emergency personnel can be contacted quickly in case of an emergency.
- Make sure that your first aid kit is with you at all practices and games.
- Always have water or sports drinks available for your athletes, giving them numerous breaks to prevent dehydration.
- Examine your playing fields, courts and other surfaces before practice and games for potentially dangerous obstacles such as holes, loose tiles, buckled wood, wet spots and sharp objects.
- Regularly check the players safety equipment before practice to make sure it is put on correctly and that nothing is cracked or missing pieces. If equipment is damaged, do not let the athlete use it.
- Make sure to store unused equipment away from the playing field so that no one trips over it while playing.
- Encourage your athletes to be aware of any unsafe playing conditions and report them to you (National Center for Sports Safety, 2001a).
Parental Code of Conduct
Parents are an essential component of young athletes learning good sportsmanship. Parents are the best model for their children as they form attitudes about sports. For a "Sport Parent Code of Conduct" to present to parents go to http://www.nyssf.org/sportparentcodeofconduct.html.
Nutrition for Your Athlete
"There is no magical food or supplement that can transform an average athlete into a superstar. No matter what the age of your youngster, optimal performance depends more on a balanced diet, sufficient nutrients to meet the demands of physical activity and adequate rest (American Academy of Pediatrics, 1999a)."
Some youth participating in competitive sports, however, may be looking for a way to get a competitive edge -- nutrition is one place they often turn for help. Sports activities may require increases in the following areas:
- Caloric (energy) intake: A young athlete needs adequate calories, otherwise he/she may feel weak and fatigued. To raise caloric intake, rely primarily on carbohydrates (e.g., potatoes, rice, pasta, beans, bread), which are a good source of energy during physical activity.
- Protein intake: For the most part, Americans take in a lot of protein. The protein needs of your young athlete may only be little more than that of a sedentary individual. Some evidence suggests, however, that a small increase in protein along with physical activity, may be important when trying to increase muscle mass and lean tissue. "Often, simply by increasing caloric intake in a well-balanced diet, a child will obtain any additional protein she may require (American Academy of Pediatrics, 1999a)."
- Fluid intake: As discussed earlier, fluid intake is essential to avoid dehydration and overheating. Youth should drink fluid before and during physical activity. It is also important to note that although sports drinks do provide some replacement of salts and sugars lost during vigorous activity, they also may be high in sugar, which can sometimes cause cramps, nausea, and diarrhea. Water is usually the best choice for fluid intake.
(This section adapted from American Academy of Pediatrics, 1999a).
Crash Diets, Supplements and Steroids
With much hype surrounding the homeruns knocked out by Mark McGwire (who has used androstenedione and creatine) and Sammy Sosa (who has used creatine), many kids are turning to these supposed muscle building substances for a competitive edge. Unfortunately, these substances are not regulated by the U.S. Food and Drug Administration (FDA), and therefore do not fall under the same scientific scrutiny as regulated drugs for purity, benefit, or harmfulness. If your child is involved in sports, he/she might be drawn to supposed power/muscle-building substances, or unhealthy weight-management strategies (e.g., crash diets, taking laxatives or consuming special supplements) -- all of which can be potentially dangerous (American Academy of pediatrics, 1999a; Mayo Clinic, 2001a).
"Some athletes may engage in unhealthy weight-control practices, particularly in sports in which thinness or 'making weight' is judged important to success... (American Academy of Pediatrics, 1996)." Extreme weight-loss practices that may be used by young athletes include overexercising, prolonged fasting, vomiting, using laxatives, diuretics, diet pills, or other licit or illicit drugs and/or nicotine, as well as use of rubber suits, steam baths, or saunas (American Academy of Pediatrics, 1996).
Other athletes may try supposed power/muscle-building substances. Unfortunately, there have been few scientific studies on the popular substance androstenedione or andro, as it is often called. In fact there is no real answer to what andro actually does, though we know it is a precursor hormone in the production of testosterone. Additionally, some health risks have been identified, including acne, breast enlargement, liver and heart problems, and personality disorders resulting from its use (Mayo Clinic, 2001a).
Creatine, which has been better studied, proclaims to help release energy in muscles for short-term boosts of power. There are, however, serious questions about its long-term use, such as whether the kidneys can process that much creatine for a number of years. Additionally, creatine tends to draw water away from the body into muscle cells, which can lead to serious dehydration (Mayo Clinic, 2001a).
"Despite the testimonials to muscle size and strength, there is no scientific evidence that andro, creatine or any other substance enhances athletic performances over what could be attained by practice, training, and proper nutrition, Dr. (Todd B.) Nippoldt, (M.D.) says (Mayo Clinic, 2001a)."
"It's easy to get tempted by the hundreds of sports bars, gels, supplements, protein powders, amino acid powders, and other products out there. Their commercials and packages make promises about building athletes up, increasing their power and strength, and making them healthy, but the truth is that these products just aren't necessary, and usually aren't suitable for teens (Nemours Foundation, 2001).
Activity Ideas for Promoting Sports Safety
The following is a list of program activities adapted from suggestions by the National Youth Sports Safety Foundation (NYSSF):
- Safety Equipment Checks: Organize a safety equipment check with a certified athletic trainer. Invite local youth sports teams to have the trainer check their equipment to make sure it fits properly and is in good condition.
- Sports Medicine Lectures for youth, parents, and coaches: Invite local sports medicine professionals to give presentations. (A sports medicine professional is defined as a health care professional with additional training in sports medicine. These would include orthopedics, pediatricians, general practitioners, family physicians, osteopathic physicians, physiatrists, sports psychologists, podiatrists, nutritionists, and athletic trainers.) Suggestions for topics include: Emergency Plans and Protocols, Recognition of Injuries, Sports Safety, Overuse Injuries, How to be a Supportive Parent, Conditioning, Steroids, Drug and Alcohol Abuse, A Healthy Approach to Sports Participation, Safety Equipment, Nutrition for Sports, How Coaches Can Be A Positive Role Model, How to Evaluate a Sports Program for your Child, Keeping Sports Fun, and the Sports Medicine Team.
- Media Events: Encourage local talk shows and newspapers to do stories on sports safety. Invite them to cover your special event for National Youth Sports Safety Month.
- Pre-participation Physical Exam Clinics: Organize a clinic with sportsmedicine professionals to screen youngsters for physical disabilities and limitations that would increase their potential for injury before starting a sports program.
- Injury Screening Clinics: Organize a clinic with sportsmedicine professionals to screen youngsters for pre-existing injuries that have not healed properly or have not been adequately rehabilitated.
- Coaching Certification Workshops: Hold First Aid/CPR certifications and coaching education workshops for recreational and interscholastic coaches. Suggested national coaching education programs include: American Red Cross/USOC Sports Safety Training, American Sport Education Program (ASEP), Program for Athletic Coaches Education (PACE), National Youth Sports Coaches Association (NYSCA), Basic Amateur Sports Injury Care (BASIC). For more information regarding coaching education programs, contact the National Youth Sports Safety Foundation office.
- Special Events: Create a sporting event such as a walk, bicycle outing, or competition. Hold pre-event and post-event clinics teaching youngsters how to warm-up, stretch, cool down, and participate safely. (This would be a great activity before or during Walk Across Texas.)
- Sports Clinics: Have professional sports teams and coaching groups host clinics for youngsters covering: the inherent risks of sports participation, proper technique, rules, safety equipment, nutrition, drug and alcohol abuse, sportsmanship and having fun.
- Safety Equipment Fair: Invite sporting goods manufacturers to exhibit the latest safety equipment and demonstrate its proper use.
- Conditioning Workshops: Have certified weight training instructors and athletic trainers hold workshops for athletes to teach them how to get in shape safely.
- Book Fair on Sports Related Resources: Invite publishing companies to showcase their materials on sports for coaches and parents at a school, library, or community center (National Youth Sports Safety Foundation, 2002b).
Websites with Reliable Information
- A Guide to Eating for Sports (Nemours)
http://www.kidshealth.org/teen/food_fitness/nutrition/eatnrun.html. - Childhood Sports Injuries (AAOS)
http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZHT0BNGDC.html&soc=NIH&srch_typ=NAV_SERCH - Preventing Children's Sports Injuries (AMA)
http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZY7SDLK9C.html&soc=AMA&srch_typ=NAV_SERCH
References
- American Academy of Orthopaedic Surgeons (2001). Childhood sports injuries [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZHT0BNGDC.html&soc=NIH&srch_typ=NAV_SERCH. - American Academy of Pediatrics (1999a). Human Immunodeficiency Virus and other blood-borne viral pathogens in the athletic setting [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZIEC43KAC.html&soc=AAP&srch_typ=NAV_SERCH. - American Academy of Pediatrics (1999b). Nutrition and sports [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZVGSO8W7C.html&soc=AAP&srch_typ=NAV_SERCH. - American Academy of Pediatric (2001a). Office-based counseling for injury prevention [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZJQIXS19C.html&soc=AAP&srch_typ=NAV_SERCH. - American Academy of Pediatrics (2001b). Organized sports for children and preadolescents: Policy statement [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZAYHQA79C.html&soc=AAP&srch_typ=NAV_SERCH. - American Academy of Pediatrics (1996). Promotion of healthy weight-control practices in young athletes [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZ8PAS0NAC.html&soc=AAP&srch_typ=NAV_SERCH. - American Academy of Pediatrics (2000). Sports injuries [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZ9XPK8W7C.html&soc=AAP&srch_typ=NAV_SERCH. - American Medical Association (1998). Preventing children's sports injuries [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZY7SDLK9C.html&soc=AMA&srch_typ=NAV_SERCH. - Clark, N. (1997). Nancy Clark's Sports Nutrition Guidebook, (2nd edition). Brookline, MA: Human Kinetics.
- Mayo Clinic (1998a). Pre-participation physicals: Making sure a young athlete can play safely [on-line]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/
invoke.cfm?objectid=2237B71A-8AA6-4132-BC97F02D6982CE1D. - Mayo Clinic (2001a). Muscle-building supplements: Are they safe? [on-line]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/
invoke.cfm?objectid=7C05F9A5-A456-4391-AE4457129F6337A1. - Mayo Clinic (2001b). What are shin splints? [on-line]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/
invoke.cfm?objectid=B20183E5-54C3-4999-A35A632EE5BD31D0. - Mayo Clinic (1998b). Youth athletics: Finding the right sport [on-line]. Available: http://www.mayoclinic.com/findinformation/conditioncenters/
invoke.cfm?objectid=3172E59F-EA19-4619-ADFDC0FC3DF703BC. - National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse (2001). Growth plate injuries [on-line]. Available: http://medem.com/search/article_display.cfm?path=
n:&mstr=/ZZZNJ4R5FDC.html&soc=NIH&srch_typ=NAV_SERCH. - National Center for Sports Safety (2001a). For the coach [on-line]. Available: http://www.sportssafety.net/home.cfm?action=for_coaches.
- National Center for Sports Safety (2001b). Injury facts [on-line]. Available: http://www.sportssafety.net/home.cfm?action=injury_facts.
- National Youth Sports Safety Foundation (2002a). Inter-association task force for appropriate care of the spine-injured athlete [on-line]. Available: http://www.nyssf.org/spine%20injured%20athlete.html.
- National Youth Sports Safety Foundation (2002b). National campaign: Suggested events [on-line]. Available: http://www.nyssf.org/sports%20safety%20month%20events.html.
- Nemours Foundation (2001). A guide to eating for sports [on-line]. Available: http://www.kidshealth.org/teen/food_fitness/nutrition/eatnrun.html.
- Nemours Foundation (1999a). Dealing with sports injuries [on-line]. Available: http://www.kidshealth.org/teen/safety/first_aid/sports_injuries.html.
- Nemours Foundation (1999b). Sports and exercise safety [on-line]. Available: http://www.kidshealth.org/teen/safety/safebasics/sport_safety.html.
