April is National Youth Sports Safety Month

There is nothing better for a child's health, social development and self-esteem than to participate in recreational activities. Although the main purpose of these sports should be fun, sports participation can lead to injury. It is estimated that approximately eleven to thirteen million youth are treated for sports injuries annually. Fortunately, most sport injuries can be prevented. For more information about sports injury prevention visit the National Youth Sports Safety Foundation, Inc. website at www.nyssf.org.

How Safe Are Sports Activities for Children in Your Community?

Take the NYSSF Safety Quiz to help you evaluate the safety conditions of sports activities in your town.

Methicillin resistant Staphylcoccus aureus (MRSA)

Staphylcoccus aureus, often referred to simply as "staph," are bacteria that are commonly carried on the skin or in the nose, without causing harm to the carrier. Occasionally staph can cause infection; staph bacteria are one of the most common causes of skin infections in the United States. Most of these infections are minor (such as pimples and boils), but some infections can be serious (such as surgical wound infections and pneumonia).

Staph bacteria have become resistant to various antibiotics, including the commonly used penicillin-related antibiotics. These resistant bacteria are called methicillin-resistant Staphylococcus aureus, or MRSA (often pronounced mer-sa). Since the MRSA infections cannot be treated with these antibiotics, treatment is often longer, more expensive, and more complicated with frequent recurrence of infections.

MRSA Infections among Athletes

Although outbreaks of MRSA usually have been associated with health-care institutions, it is becoming more common to see MRSA infections in the community. There has been an increase in MRSA infections among athletes. Most infections occur through direct physical contact of the bacteria with a break in the skin (cut or scrape). MRSA infections among athletes have been associated with skin-to-skin contact in close contact sports such as wrestling, rugby and football. Sharing equipment or personal items such as towels and clothing might also spread the bacteria.

To prevent infection, it is important to:

• Wash your hands before touching eyes, mouth, nose, cuts or scrapes.
• Do not share towels, soap, or other personal care items. This includes towels used on the sidelines at games.
• Shower with soap and water as soon as possible after direct contact sports
• Wash towels, uniforms, scrimmage shirts and any other laundry in hot water and ordinary detergent and dry on the hottest cycle.

General Safety Tips to Prevent Sports-Related Injuries

• Take your child to the doctor for a physical exam before participating in a new sport.
• Make sure your child wears all the required safety gear for their sport.
• Make sure that all athletes warm up and stretch at practice and before the game or competition.
• Teach your child not to play through pain
• Make sure first aid is available at all competitions, practices, and games.
• Avoid putting too much focus on winning, which can cause your child to push too hard and risk injury.

Specific Sports-Related Injuries

Baseball

• Baseball, softball, and tee-ball are among the most popular sports in the United States, with an estimated 19 million children, ages 5 to 14, participating.
• The healthcare system treats almost 500,000 baseball-related injuries each year.
• Common baseball-related injuries include scrapes, sprains, strains, and fractures; particularly to the ankles and knees.
• Baseball is the leading cause of sports-related eye injuries in children.
• Catastrophic injuries are rare, and occur most often if a child is struck in the head with a ball or bat.
• The U.S. Consumer Product Safety Commission found that baseball protective equipment currently on the market could prevent, reduce, or lessen the severity of more than 58,000 injuries occurring in children each year.
• Softer-than-standard balls may prevent, reduce, or lessen the severity of the 47,900 ball impact injuries to head and neck.
• Batting helmets with face guards may prevent, reduce, or lessen the severity of about 3,900 facial injuries occurring to batters in organized play.
• Safety release bases may prevent, reduce, or lessen the severity of the 6,600 base-contact sliding injuries occurring in organized play.

Basketball

• Physical contact between players is the most frequent cause of injuries.
• Ballistic movements such as sharp cutting, pivoting, and abrupt changes of direction also cause many injuries.
• The majority of injuries are in the lower extremities; ankle sprains are the most common injury; knee injuries are also common, especially in females.
• Appropriate physical conditioning is the most important step your child can take to prevent injury.
• Protective equipment includes shoes specifically designed for basketball (e.g. medium-tops for ankle support) and mouthguards; athletes with a history of ankle injuries should wear some form of external ankle support (e.g. taping/braces)

Football

• Studies have shown that 15-20% of players age 8-14 are injured during football season.
• More than 150,000 players under age 15 seek treatment in emergency rooms each year.
• The most common football-related injuries are sprains and strains. For young children, injuries usually occur in the upper body; older players often have lower extremity injuries.
• Concussions make up about 5% of reported football injuries.
• To prevent injury all players must wear: a helmet; pads for the shoulders, hips, tailbone, and knees; thigh guards, and a mouth guard with a keeper strap.
• Mouth guards need to fit properly to provide the utmost protection. The better the fit, the more comfortable it will be for the player, and the more likely they are to wear it. The best fitting devices are those that are custom made by a dentist. Many dentists donate mouth guards or offer reduced pricing for teams. At the very least, the dentist can check for proper fit.

Gymnastics

• Gymnastics, an intense, repetitive, high impact sport, has been associated with a great many injuries in young children.
• Hospital emergency departments treat more than 25,000 injured gymnasts under age 15 annually.
• A new study has revealed wrist pain in 73% of young, non-elite club gymnasts, and many gymnasts have reported being in pain for more than six months.
• The most common injuries are sprains, strains, and stress fractures; most often in the ankles, knees, or lower back.
• Protective equipment may include wrist guards, hand grips, special footwear and pads.
• Make sure that equipment at the gym is in good condition and spaced far enough apart to avoid collisions; floors should be padded and mats secured.
• Insist that your child have spotter when learning new skills.
• Don't let the coach push your child to moves that they do not feel comfortable performing.

In-Line Skating

• As many as one-third of in-line skating emergency-room treated injuries could be prevented or lessened in severity by the use of protective equipment.
• Protective gear includes elbow and kneepads, gloves, helmets, and wrist guards.
• Look for uneven pavement or other surface problems.
• Check your skates regularly for wear and tear. Make sure the wheels are tightened.

Skateboarding

• When losing your balance, crouch down of the skateboard so your fall is short.
• Try to land on fleshy parts of your body when falling.
• Try to roll as you fall, which prevents your arms from absorbing all the force.
• Try to relax, rather than remaining stiff when falling.
• Protective gear includes helmets, padding and closed-toe, slip-resistant shoes.

Soccer

• More than 200,000 youths are treated for soccer injuries each year.
• The injury rate in soccer is very low - less than 1% - in players under the age of 12, but the injury rate rises with age.
• Most injuries are cause by illegal plays, poor field conditions, or heading the ball incorrectly.
• Common injuries include sprains, strains, and bruises of the leg; the most common site of injury is the ankle, followed closely by the knee.
• Acute head injures are rare, accounting for about 5% of injuries.
• Many of the most severe injuries are related to soccer goal posts. If the goal posts on your field don't have padding, talk to school or park authorities about adding pads to reduce injury caused by a player's head hitting the post.
• Protective equipment includes shin guards and shoes with molded cleats or ribbed soles.
• Ask your child's doctor and coach whether it's safe for your child to "head" the ball and, if so, make sure your child knows how to head the ball correctly to avoid head and neck injury

Volleyball

• Each year, more than 187,000 volleyball-related injuries are treated in hospitals, doctors' offices, clinics, ambulatory surgery centers, and hospital emergency rooms.
• Common injuries include concussions, dislocations, elbow contusions, wrist or finger sprains, and fractures.
• Protective equipment includes kneepads, defensive pants, and lightweight shoes with ankle and arch support.
• Volleyball courts should have at least 23 feet of overhead clearance.
• "Call" the ball to reduce the chance of colliding with another player.

Current information on injuries related to specific sports and recommendations for safety are included in a fact sheets published by the National Youth Sports Safety Foundation, Inc. (NYSSF), which provide current information on: statistics, risks of participation, most common injuries, and training. The information has been compiled from journal articles, national medical organizations, books, newsletters and experts in the field. The publications are written especially for parents, health professionals, program administrators and coaches to serve as a guideline on current recommendations.

Copies of the publication are available from the Foundation for $2.00 each. Write NYSSF, Dept. G, 333 Longwood Avenue, Suite 202, Boston, MA 02115-5711 or visit www.nyssf.org.

Nutritional Supplements/Drugs

Creatine

• There is yet no long-term data on the safety of creatine ingested in the high doses many athletes use--10 to 30 times recommended levels. Source: Sports Medicine Digest, August 1998, Volume 20 No. 8.
• The American College of Sports Medicine has issued an official statement on creatine supplementation which was released June, 1988. It calls for more research.
• For more information, visit the Creatine Side Effects, Interactions and Warnings webpage.
  
• Gamma hydroxybutyric acid (GHB), gamma butyrolactone (GBL), and 1,4 butanediol (BD)
• Dangerous products sold as dietary supplements for bodybuilding, weight loss, and sleep aids have been linked to deaths and severe sickness requiring hospitalization.
• In 1990, FDA banned the use of GHB, but some companies switched ingredients to GBL and after warnings about GBL, switched to BD. These are all very similar chemicals, which the body converts to GHB with the same dangerous effects.
• GBL-related products have been linked to at least 122 serious illnesses reported to FDA--including three deaths.
• Some GBL- and GHB- related products have been used as "date rape drugs"
• For additional information view the GHB Abuse in the United States information page.

Steroids

• Anabolic steroid use has been implicated in early heart disease, including sudden death, the increase of bad cholesterol profiles (increased LDL, lower HDL), an increase in tendon injuries, liver tumors, testicular atrophy, gynecomastia (abnormal enlargement of breasts in males), male pattern baldness, severe acne, premature closure of growth plates in adolescents, emotional disturbances and other significant health risks.
• Visit the Steroids: Play Safe, Play Fair webpage for more information.

Stimulants

• Often used by athletes to lose weight and increase muscle mass
• Products range from illegal drugs such as methamphetamines and cocaine to supplements that can be found in drug stores containing stimulants such as synephrine, yohimbine, caffeine, guarana, kola nut, ephedrine and ephedra.
• The long-term effects of such supplements have not been sufficiently studied in younger athletes.
• Side effects of these drugs and supplements include heart palpitations, psychiatric and upper gastrointestinal effects, and symptoms of autonomic hyperactivity such as tremor and insomnia.

Tetrahydrogestrinone (THG)

• Steroid-like chemical developed and cloaked to avoid detection by doping tests; often classified as a "designer" steroid.
• "If there is one great concern that THG has exposed, it's the potential that other non-detectable anabolic steroids may be in the pipeline." Gary I. Wadler, M.D., FACSM
• The health risks of designer steroids compared to or beyond symptoms of anabolic steroid use are currently unknown.
• Refer to the article FDA Bans Designer Steroid THG for more information.

Eating Disorders

• Athletes in all sports are susceptible to eating disorders, and as many as one-third of all female athletes suffer from them.
• "Athletes are more at risk of eating disorders than non-athletes, but they are also under-identified." Ron Thompson, PhD, cofounder of Bloomington Hospital's Eating Disorders Program
• Athletes may feel that reducing their body fat will increase their performance, which is not necessarily true.
• Anorexic athletes have 7 times the risk of bone fractures than people without eating disorders.
• Athletes competing in sports with revealing uniforms, such as track, swimming, volleyball and gymnastics, are at an increased risk for eating disorders.
• Athletes may compare how they look in the uniform compared to teammates resulting in competitive thinness.
• Many athletes look up to their coaches, so coaches have to be very careful about what they say. This is especially important for male coaches working with female athletes.

Eye Protection

The American Academy of Ophthalmology has launched a campaign for mandatory protective eyewear for children participating in school-related or community-sponsored athletic events. Eye injuries are the leading cause of blindness in children, and sports are the major cause of eye injuries in school-age children.

Pre-participation Exams

• Before your child begins participation in a sport, take him or her to the doctor for a physical exam. The doctor can help assess any special injury risks your child may have.

Sport Parent Code of Conduct

Being active in sports should be fun for our children. Good sportsmanship should be taught during sport activities, but parents need to recognize their responsibility as a role model to their children. In response to the rise of un-sportsmanlike conduct occurring on the sidelines, more than thirty heads of Massachusetts' chapters of national sports and medical associations, educational organizations, and professional associations met to develop a sport code of conduct for their state. Use this as a reference to review your own conduct and shift the focus of sports activities back to the children.