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More children suffering serious sports injuries

KEVIN CASTLE • Mar 17, 2007 at 10:42 AM

Dr. Patrick Riggins performed two surgeries on anterior cruciate ligament tears within the past two weeks. There's nothing alarming about that, except the patients were 10 and 12 years old.

Riggins' experience parallels a national trend: an increase in elementary and middle school-aged children being treated for serious bone and joint injuries.

The American Academy of Orthopaedic Surgeons (AAOS) released data last month showing 40 percent of all emergency room visits for children ages 5 to 14 are for serious sports-related injuries, which Riggins says will surely be on the increase in the next few months.

"With Little League baseball beginning to start up, I feel we are going to see our patient load begin to increase once more," said Riggins, who has already seen an increase in patients in that age group over the past three years.

Riggins has encountered many patients under the age of 15 who play two or more sports. He said because most of them play those sports at the same time, this increases the injury risk, and the body does not have the proper "downtime" to heal itself.

"Kids in that age group are not only participating in sports, but it is year round, and they're not taking any time off. That doesn't give the body time to recover," Riggins said.

"A lot of what we see are acute injuries, like a sprain or a break or ligament strain. But we also see a lot of kids overdoing it, and that's when conditions like tendon strains in the elbows or tendinitis in the knee occurs.

"I've had some kids who play basketball, soccer and baseball all at once, and they come in and they wonder why they are hurting. You just don't have the amount of time in between sports like you used to. We're not against kids being active, but some are overdoing it."

The American Academy of Pediatrics says all sports have a risk of injury, and the more contact in a sport, the greater the risk.

According to the AAP, only about 5 percent of sports injuries involve broken bones.

"Most frequent sports injuries are sprains (injuries to ligaments) and strains (injuries to muscles), caused when too much stress is placed on tendons, joints, bones and muscle," the AAP says.

The American Academy of Orthopaedic Surgeons warns of potential future damage surgery on the ACL areas could do to an adolescent's growing body because of the impact on "growth plates."

"That type of injury can be a real challenge to the orthopaedic surgeon. A child may need to have surgery, but surgery can cause growth plate disturbances as well as other problems. Growth plates are the area of developing tissues at the end of the ‘long bones' of the body. Growth plates are also particularly vulnerable to injury in contact sports like football and basketball," according to the association.

The arrival of Little League baseball and softball brings more cases of "Little League elbow" into Riggins' office every year.

Named after one of America's leading youth sport activities, AAOS chronicled the condition through a separate study last month.

"The study finds that winding up and uncurling the body too late before releasing the ball leads to increased stress on the elbows of adolescent pitchers," the study said.

"The fastball pitching motion of 27 injury-free Little League pitchers ages 10-14 was studied using motion analysis equipment. Each phase of a pitcher's windup, release and follow-through was analyzed to determine the abnormal mechanics that may lead to arm injuries. Rotating the pelvis and upper body either too early or too late before delivering the pitch caused increased stress on the elbow.

"Researchers found that pitchers who kept their pelvis' square to home plate at the point of maximum shoulder rotation and had their upper bodies square to the plate when releasing the ball had reduced elbow loads."

The number of pitches a coach lets a Little League player throw in practice and in a game also needs to be monitored on a regular basis, Riggins said, because the more throws, the more the risk intensifies.

At times, Riggins has had the unpopular job of telling the juvenile athlete and the parents that the only option, in some cases, is to cut back on the amount of sports and activities they can participate in.

"The reactions were mixed. Naturally, some of the kids were disappointed because they want to play and play constantly, but I think they don't realize the damage being done when they continue to exert themselves like this," he said.

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