October 2011

Out on a limb: Arming at-risk kids

Jordana Bieze Foster, Editor

Nothing scares parents more than knowing their child is in danger and being powerless to do anything about it. For parents whose children play sports associated with injury risks, every practice and every game might as well be Halloween.

To make matters worse, a growing body of evidence is now suggesting that kids who suffer sports-related knee and ankle injuries face a dramatically increased risk of early-onset osteoarthritis as adults (see “Future shock: Youth sports and osteoarthritis risk”). That means parents of young athletes will be feeling added pressure to keep their kids safe. And that means they’ll be coming to you for advice.

As medical professionals you know there’s no way to guarantee any athlete will be safe from injury or, later in life, from osteoarthritis. But you can still offer parents a number of ways to help minimize potential damage.

Know the risks. Statistically speaking, certain sports are more likely than others to be associated with injuries and, in particular, those injuries linked to early-onset OA. Gender can play a role, and so can genetics. Genetic screening for sports injury risk is not ready for prime time, but if anterior cruciate ligament injuries, for example, have plagued several generations of an athletic family, it might make sense for the current generation to consider track instead of basketball.

Take preventive action. Even if a child’s team doesn’t require neuromuscular training exercises, kids can still do the exercises on their own. Prophylactic bracing may help reduce risk of injury for some athletes as well.

Make the rules count. Most volleyball leagues now have rules limiting players’ feet from crossing the center line under the net, inspired by Norwegian study findings that most ankle injuries occurred when players landed on opponents’ feet. Similarly, in soccer, red cards are now issued for tackles from behind in an effort to reduce ankle injuries. But rules can only prevent injury if they are enforced. Parents can help make sure that happens.

Timing return to play. We all know that no athlete of any age likes being kept out of the game. But research is increasingly finding that when an athlete is unlucky enough to be injured, regaining normal biomechanics before returning to play—no matter how long that takes—is key to both postinjury athletic performance and long-term joint health.

Prepare for life after sports. In most sports, even the most successful athletes hang up their cleats well before their first midlife crisis. The transition away from elite-level sports comes with a number of challenges, which include finding an alternate form of exercise and adjusting eating habits to ward off extra pounds. But regular exercise and weight control are both essential for minimizing the risk of OA, particularly for anyone with a history of traumatic joint injury. Even if the transition doesn’t happen until after a kid is out of the house, parents can still establish these as important principles early on.

Parents know they can’t realistically protect their kids from everything. But they still want to know they did everything they could. You can help make that possible.

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