1. Rodts, Mary Faut Editor, DNP, CNP, ONC, FAAN

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We have all seen them-adolescents and young adults who are undergoing yet another surgery in a series of procedures that have occurred secondary to athletic injuries. From shoulder repairs to knee reconstructions, the precipitating factor is the same-participation in some form of competitive athletic activity. What constitutes a program that would help prevent injuries in this patient population?

FIGURE. Mary Faut Ro... - Click to enlarge in new windowFIGURE. Mary Faut Rodts, Editor, DNP, CNP, ONC, FAAN

The American Academy of Orthopaedic Surgeons (AAOS) has been delivering the message that athletic training and prevention of injuries in children is something that needs to be a primary concern of those responsible for athletic activities for children. In 1995, the AAOS developed a program called Play It Safe, which identified what parents and coaches needed to know about safe sports. In 2005, the AAOS and The National Athletic Trainers' Association (NATA) launched a very public campaign of advertisements drawing attention to youth sports. This awareness of the increase in sports-related injuries has resulted in helpful tools for parents and athletes to help understand and identify sports-related risks. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2006). Numerous NAON programs have focused on topics of safe athletic activities. Research to confirm what types of injuries and what modifications should be made to sports programs is being carried out (Radelet, Lephart, Rubinstein, & Myer, 2002).


Several things are necessary to reduce the risk of athletic injury in children and adolescents. First, proper training for competitive sports is essential to prevent injuries. While injuries may still occur even in an athlete who has participated in a guided program that has been structured to meet the demands of a particular sport, accidents are still possible. A specific program that targets the muscle strength as well as the flexibility that is required for a particular sport can best be established by an athletic trainer or physical therapist who understands the rigors of the sport. It is not logical to expect high performance with low performance training.


Supervision of all aspects of athletic activities is very important. Athletic trainers and coaches need to participate in the development and implementation of a comprehensive plan to ensure that athletes are monitored during training and sports events. The consistent use of proper protective equipment must be mandated by those in charge of sports activities involving children.


Second, those involved need to accept that if an injury occurs the appropriate rehabilitation program should be developed and adhered to prior to returning to sports activities. On more than one occasion I have had the opportunity to assess a teenage boy who had sustained a L5 pars fracture while engaging in high school football. The discussions were almost always the same. The young athlete was accompanied by his parents who showed concern over the diagnosis and equal concern about the need to have him return to football immediately so that college scholarships would not be affected. These consultations were always long and difficult because what was best for the child was not an immediate return to the playing field but rather a period of immobilization and rest in an effort to achieve healing of the pars fracture without surgical intervention.


Finally, appropriate expectations by the athlete, parents, and coaches are an area that requires discussion. There are many reasons that drive children to become competitive athletes. In many cases it starts off with the simple concept of having fun with a sport. Success in a sport provides the springboard into pursuing higher levels of competitive activities. In other cases, it is the strong desire of one or both parents to see their child succeed in a particular sport. It might be a sport that one of the parents had been successful at and the idea of continuing the legacy is a strong motivator for the son or daughter. In theory there is nothing wrong with this concept unless it is obvious that the child is not interested in the sport, does not have the necessary capabilities to perform the sport, or if the parent becomes overbearing. This parental behavior not only occurs in childhood athletics but is also seen in other children's activities such as beauty pageants and television/ movies. Being realistic about the child's capabilities and acknowledging/accepting the child's decision not to participate in a competitive sports activity is important. Those children that have no desire to participate in a sport will be less likely to fully participate in the training program that is necessary to prepare them for competitive sports-resulting in a possible injury.


Encouraging an active, healthy lifestyle for children is known to prevent childhood obesity and diabetes. Youth participation in sports activities should be encouraged. However, the appropriate emphasis of just how much is reasonable for each child needs to be continually monitored and should not be underestimated. Proper training, participation, and rehabilitation (when it becomes necessary) should to occur. Remembering that not every child has the physical capabilities or desire to compete at a high level should also be considered by parents, peers, and coaches.




American Academy of Orthopaedic Surgeons. (2007). A guide to safety for young athletes. Retrieved April 1, 2008 from


National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2006). Childhood sports injuries and their prevention: A guide for parents with ideas for kids. Retrieved April 1, 2008 from [Context Link]


Radelet, M. A., Lephart, S. M., Rubinstein, E. N. and Myers, J. B. (2002). Survey of the injury rate for children in community sports. Pediatrics, 110(3), e28. [Context Link]