Medical: As kids get bigger, youth sports injuries mount

BY LEE BOWMAN

Bigger, stronger, faster. If you don't happen to be the parent of a kid engaged in a competitive sport, this trend among youthful athletes of all ages may have gone unnoticed.

Pewee football teams often have kids who 20 or 30 years ago could have passed for high-school freshmen. Many youth-soccer squads have at least a couple of preteen players about as tall as their parents. It's a rare upper-division high-school girls' basketball or volleyball team that doesn't have several 6-foot-plus members.

All this is a more-or-less natural result of American nutrition and health care, genetics, and training and conditioning for one or more sports that often start at the preschool level.

Still, it's a fine line for pediatricians and youth-development experts who, on one hand, worry that the littlest and not-so-little athletes are overdoing the workouts, but at the same time espouse a "get a move on" message to encourage physical fitness and battle obesity.

Researchers are finding that fewer kids are taking part in organized sports beyond grade school, largely because of the emphasis on competition over participation. By some estimates, 70 percent of participating kids leave organized sports before age 13.

One side effect of the sizing-up trend, though, may be more frequent and more severe injuries among participants in youth sports.

A study published last month in the journal Pediatrics tracked concussions among athletes in organized youth sports between 1997 and 2007, using a national surveillance network of hospital emergency rooms.

Researchers from Brown University found that the pace of ER visits for concussions had nearly doubled among 8- to 13-year-olds, and more than tripled among players 14 through 19.

The lead researcher, Dr. Lisa Bakhos, said she's not sure if the increases reflect a real increase in the incidence of injury rather than a greater awareness of the danger of the brain injury among parents and coaches.

"But we do speculate that youth sports are getting extremely competitive, and kids, in general, are getting bigger; so you end up with 8-year-olds with 13-year-old bodies but the maturity still of 8-year-olds."

The study used data on sports participation in an attempt to quantify the concussion exposure for various games, and the researchers noted that about 9 percent fewer 7- to 17-year-olds were taking part in the top five sports in 2007 than in 1997.

That's bad news for recreational leagues and kids in general, but also for those still playing.

Michael McCrea, head of the ProHealth Care Neuroscience Center and Research Institute in Waukesha, Wis., an expert on sports concussions and ways to measure their impact, noted that participation in many sports has become year-round. "So maybe participation is down, but for those playing, say football, the number of exposures (to a certain type of injury) seems to be certainly higher than a decade ago."

Many sports-medicine doctors report that up to 75 percent of the injuries they treat in those under 18 result from overuse and overtraining.

For concussions, there's growing evidence that major knockout blows may not be the only type of injury to fear. Several recent studies suggest that multiple minor blows to the forehead — like those experienced by, say, football linemen or any soccer player who does a lot of heading — can also traumatize key learning and memory regions of the brain, particularly in younger brains.

On the plus side, there is growing awareness about the dangers of youth-sports injury in general and concussions particularly. Both the American Academy of Pediatrics and the American Academy of Neurology have issued new guidelines and recommendations on sports concussions.

The pediatricians note that neither protective gear nor any therapy other than mental and physical rest are effective in preventing or treating a concussion, and suggest that return to play must be a gradual resumption of activity accompanied by monitoring of symptoms by a health-care professional.

The neurologists call for removing any athlete suspected of having a concussion from play and not returning him or her until cleared by a neurologist or other physician with experience in concussions. They also urged that "a certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk of concussion."

A recent review of high-school sports medicine by Scripps Howard News Service found that only about a third of the nation's high schools with a sports program have a full-time athletic trainer — mainly due to cost concerns — and that professional medical help for youth sports in a community often follows the availability of certified trainers in the local schools.

Contact Lee Bowman at BowmanL@shns.com