Teen sports are great: They can promote teamwork, jump-start a lifelong exercise habit, and provide an antidote to obesity. But teen athletes can also get hurt, which means they—and their parents and coaches—should be vigilant about prevention.
Sports injuries fall into two categories. Acute injuries, like a sprained ankle or torn ACL in the knee, occur suddenly, after a missed step or a midfield collision. Overuse injuries are caused by repetitive motion that damages the body over time. Those used to be fairly rare among teens and kids. But increasingly, doctors see teens with overuse injuries that used to plague mostly collegiate or pro athletes—such as a damaged ulnar collateral ligament in the elbow (common in baseball pitchers, it can be fixed with so-called Tommy John reconstruction surgery). Or osteochondritis dissecans, an overuse problem most commonly found in the knee that can result in loose bone or cartilage fragments in the joint.
One culprit: America's crazed youth sports culture. There are high school teams, private club teams, all-star traveling teams, and sports summer camps. That means more injuries, says Mininder Kocher, the associate director of the Division of Sports Medicine at Children's Hospital Boston. Moreover, many kids now specialize early and pursue a single sport through adolescence, rather than switching sports with the season. When you do that, "you lose the benefit of cross-training," says Angela Smith, an orthopedic surgeon at the Children's Hospital of Philadelphia. Focusing on all-around athleticism keeps the body balanced and less vulnerable to injury.
There are ways to protect against both overuse and acute injuries. Proper conditioning is crucial, says Avery Faigenbaum, a pediatric exercise scientist at the College of New Jersey in Ewing. Teens new to sports should start by getting in good overall shape—including working on aerobic fitness, strength, and flexibility. "They need to be active for 30 to 60 minutes most days of the week, for at least six to eight weeks, before they get into sports. If not, it's an absolute setup for injury," says Faigenbaum. On the other hand, serious teen athletes may need to build more recovery time into their schedule, he says. Train hard on some days, but go easier and work on recovery and technique on alternate days, he recommends.
Technique is particularly important, says Kocher. Many young pitchers, for example, improperly rely on their arms for power rather than their trunk and legs. Done correctly, both strength training and working on the core muscles of the back and abdomen may prevent injury and boost performance. Sports-specific warm-up programs also can help; one such program cut the rate of ACL injuries among female soccer players, says Holly Silvers, a physical therapist and director of research at Santa Monica (Calif.) Orthopedic and Sports Medicine Group who helped develop the program. She's studying the effectiveness of another specific warm-up, to help prevent sports hernias—painful tears in the abdominal muscles—in male soccer players.
When an injury happens, its severity can be lessened by rest or prompt treatment or physical therapy. The incorrect reaction, warns Smith, would be to discourage teens from participating in sports. "The risk of injury," she says, "is far outweighed by the benefits of physical activity."