How to protect your kids when they play sports, according to doctors

By Madeline Holcombe, CNN

Every time there is a head trauma, cardiac arrest, or other major injury among professional sports, parents take a deep breath.

“That athlete is someone’s child. Could that be my child?”

Cardiac events during sports are uncommon for anyone, said Dr. Stuart Berger, division head of cardiology at Northwestern University Feinberg School of Medicine. While they can also occur in kids and teens, these injuries can happen whether or not people play sports.

While many children can get injured on the field, the numbers are mostly declining — and sports are important for their physical and mental health, doctors say. They explain how to prevent and treat sports injury in kids.

How many kids get injured playing sports

Overall injuries due to youth participation in football show a dramatic decline since 2013, plateauing in 2020 and heading back up in 2021, according to the most recent figures from the US Consumer Product Safety Commission.

More than a million kids ages 5 to 14 were injured in sports and required a trip to the emergency room, according to the commission. Along with sports like basketball, soccer and football, the agency also reported significant injuries from things like playground equipment and skateboards.

Children between the ages of 5 and 14 were most likely to be injured in football in 2021: There were 110,171 reported injuries in children ages 5 to 14 in 2021, compared to 92,802 in youth and young adults aged 15 to 24.

Soccer and basketball were also high risk for kids’ injuries with 59,000 and 79,207 injuries, respectively.

The sports with the highest rates of concussion were: boys’ football, with 10.4 concussions per 10,000 athlete exposures; girls’ soccer, with 8.19 per 10,000 athlete exposures; and boys’ ice hockey, with 7.69 per 10,000 athlete exposures, according to a 2019 study.

High contact sports like hockey, football, lacrosse and martial arts might be higher risk for serious injuries such as head injury, but even seemingly safer sports like swimming and track pose some risk for overuse injuries. And they all can be made safer with the right strategy, said Dr. Erin Grieb, pediatric primary care sports medicine physician at Stanford Medicine Children’s Orthopedic and Sports Medicine Center.

Here’s what to do if your child plays sports.

What to look out for

When it comes to cardiac events, screening is crucial, Berger said.

Generally, kids are safe to play sports and exercise without concern for cardiac events, but with all types of sports, it is important to do a physical with family history to identify those who might be at risk, he added.

‘The concerns are that maybe there is somebody with an underlying cardiac abnormality,” Berger said. “The screening is designed to bring that out and that we can identify, if possible, who those kids are.”

Head injuries are another major concern to families when it comes to putting their children in sports.

The bulk of concussions in kids are related to youth sports, said Dr. Andrew Peterson, clinical professor of pediatrics and director of primary care sports medicine at the University of Iowa.

The good news is that there is not strong evidence that a handful of concussions over a childhood is associated with long term impacts as an adult, he added.

But it is really important to avoid reinjuring the head before a concussion is fully healed.

“The thing we worry about most are these second impact events where people have a concussion on top of a concussion,” Peterson said.

Coaches, referees and families should learn how to spot a concussion to make sure their young athlete is properly cared for, Grieb said.

The signs and symptoms can be physical, including headaches or sensitivity to light; mental, with confusion or difficulty paying attention; emotional, with sadness and anxiety; or sleep related, she added.

It is important to remember that concussions can present in many ways, and just because you got certain symptoms in one concussion doesn’t mean you will have the same ones in the next, Grieb said.

Prevention and response

To keep kids safe in sports, it’s important focus on both prevention and response.

Even for high contact, high-risk sports, there has been a cultural shift to focus more rules and regulations on player protection and injury prevention, Grieb said.

Learning the proper techniques and wearing well-fitting gear can help lower the risk of serious injury in sports like football, hockey and lacrosse.

In almost any sport, kids should be given ample time to rest within the week and over the course of the year to avoid injuries that can come from overuse, she added.

With head injuries, it is important that young athletes take the proper time and action to recover before getting back to their sports, Grieb said.

“You break a bone, I can put you in a cast and not let you use that arm. When you have a head injury, I can’t put your head in a cast,” she said. “You get one brain, so it’s really important that we let your brain heal.”

In response to cardiac event, every person — player, coach or onlooker — should be familiar with CPR, or cardiopulmonary resuscitation, and how to use a defibrillator, Berger said.

“Be prepared to intervene, because that’s what saves lives,” he added.

Why children should still play

The takeaway message should not be to keep your kids from sports, Berger said.

There might be a conversation with your child about what sports they want to do, along with the risks and precautions your family will take, Grieb said, but it doesn’t have to be all or nothing.

Sports and other physical activities for kids are important for building good habits to keep moving throughout their lifetime, Peterson said. And regular movement is part of growing up in a safe and healthy way, he added.

But sports also give our kids leadership skills, life lessons and fun, Grieb said.

“If you’re focused on using proper techniques, you’re focused on following the rules of the game and you have coaches and referees who are also engaged in that, then I think particularly risky sports can be safer than they have in the past,” she said.

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