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The Question: High school and junior high athletes don't only face injuries on the field but often off the field as well. We sometimes hear of serious injuries and even deaths during training. This has become a major concern for parents who have kids in athletics. How can injuries in young athletes be prevented? What is the major cause for serious injuries in young athletes? Are certain people prone to serious injury during training and game play? Bonus Question: Following a serious injury or death, there is often a dispute over whom should be responsible for the situation; schools, coach, etc. What do you think? Show off your knowledge to the world! The Winners:
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High school and junior high athletes don't only face injuries on the field but often off the field as well. We sometimes hear of serious injuries and even deaths during training. This has become a major concern for parents who have kids in athletics. While the increasing popularity of youth sports has been beneficial to many, it has also resulted in higher levels of intensity and competition. Consequently, training for young athletes has the tendency to become quite fierce. The combination of inexperience and inadequate supervision can be a dangerous one in these situations. Thankfully, there are ways to prevent future incidents.
Ideally, injury prevention should begin before athletes even step onto the field or into the gym. First, the organization should ensure that there are enough coaches and assistants to provide proper supervision for the group. This way, there are enough eyes to spot potential problems and catch any that are in progress. Once this has been established, coaches should inform the players of their expectations and provide some ground rules for proper behavior. Inform the athletes that the potential for injury does exist and that training should be taken seriously. As such, horseplay will not be tolerated.
  Click To Enlarge. Coaches Should Inform The Players Of Their Expectations And Provide Ground Rules. Stress the fact that how one practices determines how one performs. In addition, training is only one or two hours per day; after the commitment is done, the players are free to do what they want, so taking a session seriously is not too much to ask. Parental involvement can also reduce the risk of injury; coaches should send athletes home with an information packet, and possibly a permission slip or waiver. Parents will then be informed of what their children will be participating in and can go over the risks with them at home. Before beginning training, coaches should assess the fitness level of the athletes to make sure they are capable of performing the required activities. Knowledge of previous experience, existing medical conditions and past injuries can help coaches plan appropriate programs.
After the initial assessments are complete, coaches should introduce the training program to the athletes and demonstrate what will be expected. Referring to the exercise database and performing example repetitions is a great way to teach the intricacies of unfamiliar exercises. Coaches should focus on proper form, breathing and adequate rest periods between sets. In addition, the myth of "no pain, no gain" should be dispelled immediately - pushing too hard is a common cause of injury. Also, make sure that all of the equipment is in proper working order. If there is to be contact, safety equipment such as helmets and pads should be worn at all times. Water or other refreshments should be close by, and common sense should prevail - if it is too hot or too rainy, practice can be moved inside or postponed. The last consideration is stretching. Stretching warms up muscles and prevents injury. However, certain types of stretching can actually increase the risk of injury, so be sure to practice dynamic stretching beforehand and static stretching afterward.
It's also helpful to have a team doctor or trainer on hand in case of emergency.
Injuries in young athletes can usually be traced back to one common culprit - inexperience. Because they are just beginning athletic training, young athletes are not familiar with many of the techniques and exercises they will be required to perform.
 Click To Enlarge. Injuries In Young Athletes Can Usually Be Traced Back To One Common Culprit...Inexperience. Ignorance of proper form and reluctance to ask for help, for fear of betraying that ignorance, can be a dangerous combination. The inexperience of young athletes also means that they have not properly developed the muscles required to perform some movements, which also leads to injury. The inexperience of young athletes also means they have no previous performances by which to judge their strength and ability. For this reason, they may push harder than their bodies can handle. Trying to lift too much weight or not giving oneself enough rest in between sets can lead to muscle strains and joint dislocations. This is a factor not just in training, but in games and other athletic events. Many young athletes don't realize their limits and may want to play every shift or play every day because they love the game. And while a track team member may want to perform in every event, it is inadvisable to do so.
Inexperience can also be reflected at home. Not knowing how much sleep or how much fuel (food) one requires can deprive a young body of what it needs to perform.
Somewhat ironically, I think it is sometimes those with the most passion that are the most prone to injuries in athletic events. These players may feel that they are invincible and capable of everything. Worse, they may expect to be able to do everything and view anything less as a failure. This often leads them to "play through the pain" and not listen to their bodies. Such an attitude can be particularly dangerous when one is coming back to a sport after suffering an injury; if the athlete tries to jump back in too quickly, the injury can be easily aggravated.
 Click To Enlarge. If An Athlete Returns Too Quickly, Their Injury Can Be Easily Aggravated. Also, an athlete who loves to play and is used to performing at a high level may ignore cautions of coaches and peers because he may feel that he "knows better." This can lead to an attitude of carelessness, which is harmful.
While society is often quick to attempt to identify a culprit, I think that such cases must be examined in full before making that determination. Ultimately, whoever caused the situation, whether by a lapse in judgment or simple carelessness, should be held responsible. If the injury was a result of poorly maintained equipment or improper supervision, then the fault lies with the organization, such as the school or team, that is charged with making sure these safety precautions were in place. If the injury was caused by a coach demanding too much out of his players or not giving them adequate breaks or nourishment, then it would be his fault. In most cases, it seems as though everyone except for the players are held responsible. While I do believe that coaches and parents should be expected to exercise more caution than players, I don't think players are always exempt from fault.
If young athletes push themselves too hard or neglect proper nutrition, stretching or rest, the injury was directly caused by their actions, or lack thereof. Even if they did not know better, the blame can't be put on a coach for what a player does at home. In addition, parents are often exempt from blame. However, they do have a vested interest in the careers of their children, so taking an active role is expected. If they allow their children to behave recklessly, some of the blame lies with them. Because of the diverse causes of injuries in young athletes, responsibility in each situation depends on the circumstances.
As a middle-school teacher and coach, my number one priority is the health and safety of all my students and athletes, and while there is no sure-fire way to guarantee that no one will ever be injured, precautions can and should be taken to limit their occurrence.
There are four primary points that should be addressed when dealing with safety in inter-scholastic athletics:
For indoor sports this is a relatively simple proposition. The gym/court should be in proper playing condition with all obstacles removed and proper padding/guards in place (i.e. pads on walls beneath basketball goals, proper wrestling mats without gaps, and pads surrounding volleyball uprights).
My particular district has decided to err on the side of caution in this regard. Given any potentially hazardous weather conditions (i.e. severe weather, high heat index, low wind chill, etc.) every coach receives a weather bulletin text message to his/her cell phone advising caution, or in some cases calling for cancellation of practice depending on the severity of the weather threat. It is my contention that most serious injuries in young athletes can be prevented on this point alone.
Again, the idea is to control those things that are within our power to control in order to prevent injury in young athletes. Providing working and safe equipment is something we can and should control to the best of our ability.
Third, every state's high school activities governing body has rules in place to provide for the safety of athletes in every sport (i.e. limits on practice time/week, length of season, conditioning vs. live, percentage of body weight that can be dropped, etc.). Every district and coach within that district should be careful to follow such limits/rules even when inconvenient. In addition, each coach's team rules and expectations should address both the on and off the field safety of all athletes. Many injuries to young athletes can be prevented simply by observing the state and team rules already in place.
 Click To Enlarge. Many Injuries Can Be Prevented Simply By Observing The State And Team Rules.
Coaches can easily modify conditioning and practice for athletes suffering from such conditions as asthma, diabetes, etc. Once again, convenience is not the priority. Winning is not even the priority. The health and safety of kids is the priority. Our approach as coaches should reflect this.
While blaming one particular sport for the majority of the high profile news reports of young athletes sustaining serious injury or even death seems a bit unfair, the data points squarely to our beloved new American past-time: Football. According to the researchers at the Center for Injury Research and Policy, "Football was associated with the highest rate of rare [serious] injuries [among high school athletes], accounting for 21 injuries per 100,000 exposures."
These injuries include "eye injuries, dental injuries, neck and cervical injuries and dehydration and heat illness, which may result in high morbidity, costly surgeries and treatments or life-altering consequences." Neck and Cervical injuries accounted for 8 of the 21 rare injuries per 100,000 exposures in the study and "of those neck and cervical injuries in football, 93 percent were caused by contact with another player during tackling or blocking." In addition, "football also was correlated with the majority of dehydration and heat illnesses. Sixty percent of these injuries occurred during pre-season practice after the athlete had already been participating for an hour." Given this data, it is apparent that with the violent nature of the game of football, no amount of precaution will altogether eliminate the possibility of serious neck or cervical injury in young athletes; however, dehydration and heat illness injuries can and should be eliminated with proper hydration during pre-season practice at high temperatures.
 Click To Enlarge. Dehydration And Heat Illness Injuries Can And Should Be Eliminated With Proper Hydration.
Inevitably some people are more prone to serious injury than others during training and game play. Unfortunately, identifying those that are most susceptible often is impossible until they sustain an injury. All we can do is take reasonable precautions to provide the safest environment possible for every athlete.
As with any other case of possible negligence, the evidence should do the talking. If the school district and the coach has provided the safest environment and equipment possible, they have followed state, district, and team rules regarding the functioning of their sports programs, and they have obtained current and accurate medical information and obtained medical clearance for every athlete before he/she participates in any conditioning, practice or competition, then any serious injury or death occurring in such a setting must be found as accidental with no liability on either the district or coach's part. If, however the district or coach is found to be in violation of reasonable safety guidelines, resulting in the serious injury or death of an athlete under their supervision, then the district and the coach could be found liable for the negligence displayed. References:
Injuries in young athletes are caused in a variety of ways. Identifying potential risks and taking steps to mitigate them is the best way to prevent injuries.
The first step is to make sure that all participates understand the risks. If one assumes a sport is completely safe, or believes that just because they are wearing a helmet they are invincible (as most young athletes already feel they are) they are more likely to take unnecessary risks or to perform dangerous activities. Therefore I believe the way to make the largest reduction in injuries is to ensure that the risks are made real and are deeply understood before any training or competition takes place. Understanding the risks also includes identifying medical conditions which may pose a hazard to the participant during training or competition. All people considering a new sport or exercise routine should consult their doctor to identify any potential hazardous that may be unique to their circumstances. These hazards should be discussed with the doctor and the coach prior to participation.
 Click To Enlarge. New Athletes Should Consult Their Doctor To Identify Potential Hazards. The second step is to ensure that all participates understand that rules are in place not to punish players or limit their ability to play games but to keep them safe. Rules MUST be taught as an aspect of respect. Respect is necessary in sport to ensure safety. All players should respect their opponents, teammates, and themselves. This does not mean they should not play hard, but that they should play smart, play by the rules and play respectfully. When players do this injuries will be less likely. The third step is to ensure that proper equipment is used at all times. Upkeep of equipment is paramount to this step. A helmet which has sustained a damaging blow may be more harmful than not using a helmet at all as it may give the wearer a false sense of safety.
The fourth step is to ensure that play takes place on a safe playing ground. This could mean properly maintaining and ensuring a safe playing field, or it could mean walking a cross-country running route prior to practice to make sure a recent rainstorm hasn't taken out the trail or knocked down a tree in the path. This will obviously vary in a great range of ways depending on the sport; therefore it is up to the coach to ensure that the playing ground is safe. The fifth step is to ensure that there is adequate supervision. Though the participants should be responsible for their own actions, young athletes (and even old ones) are often liable to make "dumb mistakes." A supervisor, in the form of a coach, will ensure that rules are still followed even when the players are tired or angry, will be there to stop play if playing conditions become hazardous (i.e. a lightning storm), will make sure that proper equipment is used, and will be there to perform immediate first aid or CPR in the event of an injury/medical condition. Finally the supervisor will have access to the necessary medical documentation in the event a participant requires emergency care.
 Click To Enlarge. A Coach Will Ensure That Rules Are Followed. The final step to help prevent injuries is to ensure that participants are properly prepared for the physical and mental stresses of whatever activity it is they are undertaking. This includes such things as insuring proper nutrition (especially hydration), proper training on equipment use and rules, and proper warm-up.
To understand the cause one must understand which injuries are most common and which are most serious. The most common injuries for athletes are soft tissue injuries (the most common being bruises and sprains); however, the most serious injuries that face young athletes are brain injuries (http://www.myoptumhealth.com/portal/DiseasesandConditions). These are the main cause for sports-related deaths. The most common is a concussion. A concussion is defined as "a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces." (http://thejns.org/doi/pdf/10.3171/foc.2006.21.4.4)
A concussion can occur from impacts between the head and just about anything else, the ground, another player, equipment on the field (goal posts). Concussions can occur even if the head does not directly hit anything but rather the player is running in a direction and has that direction rapidly reversed (by another player or an object). The best ways to mitigate this risk is to ensure that properly maintained equipment is used and that rules are followed. Another very serious injury that is specific to school-aged athletes is that of sports related blindness. Sports related injuries are the LEADING cause of blindness in youths. (http://health.usnews.com/) According to this report the most common causes of sports-related blindness are injuries sustained in baseball and basketball. Prevent Blindness America states that 90% of these injuries are preventable and recommends safety goggles for basketball, and batting helmets with polycarbonate face shields for baseball. While these may not be deemed fashionable initially, with proper education young-athletes should be able to recognize that safety is most important.
Yes. Those who have already sustained a serious injury are at increased risk of re-injury. Special attention and care should be taken after an athlete is injured to ensure that proper recovery takes place. No athlete wants to miss out on the sport they spent so much time training for; however, this may be the only way to prevent re-injury. An injured athlete should be encouraged to continue to support the team and train to whatever extent is deemed safe by their doctor and coaches.
Besides those that are at risk for re-injury, those with pre-existing medical conditions may be at increased risk of serious injury. This should be considered prior to their participation. Finally, anyone not following the steps outlined in the answer to number one are at a much higher risk of injury.
Each case will have to be evaluated based on its specific circumstances. However, responsibility lies with every part of the chain. Failure at any level can lead to a breakdown of safety mechanisms. Ultimate responsibility for the team lies with the coach (and with how the coach follows rules set up by the school/district/state). In the cases of death which I have read about the cause of death has been an unknown congenital heart defect. In those cases there was no way of foreseeing the death or preventing it.
There are several different practices that young individuals can follow to decrease the risk of injury, but all of them amount to the same thing: LISTEN TO YOUR BODY! If you feel pain in your muscles, joints, or tendons (other than the normal "burn"), then you must immediately stop and re-assess both your form and your bodies energy levels.
Here are some basic practices you should implement to keep risk of injury low:
Exercising with all these systems running at optimal speed heightens the training experience and lowers the chance of injury. A good warm up would be a light jog on the treadmill for 10 minutes, and then one or two sets of 15-20 (not to failure) on your first exercise.
 Click To Enlarge. A Good Warm Up Would Be A Light Jog On The Treadmill.
Stretch after your weight training session to crank up blood flow to your tired muscles while avoiding the negatives of stretching before exercise.
Young trainees can suffer an injury for a variety of different causes:
 Click To Enlarge. If You're Exhausted, Your Body Is Telling You It Needs More Recovery Time.
There are a few different types of people in whom the risk of injury during training is greatly increased:
Deciding the blame for an injury should definitely be on a case-by-case basis. That being said, I do have some opinions for some broad instances:
Please train safe, so you can continue to enjoy your exercise. Good luck, and happy training! ~TwinIam Citations:
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