The past decade has seen a significant increase in the number of children participating in both team and solo sports. Physical activity plays an important role in the wellbeing of all children and helps them to develop physical, psychomotor and intellectual skills. It is important to remember however that sport is not just for health and personal development; it should also be enjoyable and played in the right spirit, particularly at a young age.
Maintaining this balance becomes more challenging as the level of competition increases. As a result, adolescent athletes have to train harder and longer and throughout the year as the bar is continually raised. It is therefore unsurprising that the number of sports-related injuries we typically see have increased significantly in recent years. Another notable trend is the specialisation we now see in one specific sport often at a much younger younger age than was the case a decade or so ago.
- In the UK, 79% of children aged 5-15 years take part in organised sport, 11% are involved in intensive training (Rowley, 1989)
- Approximately 3-11% of school children are injured per year while participating in sport
- Twice as many boys as girls sustain sports-related injuries (Sharma et al 2003)
- Sports involving contact and jumping have the highest injury levels, with football in particular accounting for the majority of injuries
- In general, the incidence of sports injuries seems to increase with age
- Around the period of peak linear growth, adolescents are vulnerable to injuries because of imbalance in strength and flexibility and changes in the biomechanical properties of bone
Children are not young adults. In fact their anatomy and physiology is vastly different and is becoming much more vital that coaches, parents, teachers etc. recognise this fact. Sports injuries in children can affect bone growth and soft tissue development and they therefore require careful management. During growth, there are significant changes in the biomechanical properties of bone. A child’s bone is much softer than an adult’s but, as it begins to stiffen more during teenage years, its ability to resist impact forces diminishes. Shearing and avulsion forces in particular can cause growth plate injuries and becoming more prevalent.
Anatomical differences between an adult and a child
- Shorter height
- Different segment proportions
- Biomechanical differences
- The way in which the developing skeleton responds to load
- The differing points of relative weakness
Differences in bone structure
- Higher water content and lower mineral content that adult bone
- Less brittle than adult bone (elastic properties)
- Thicker periosteum in children
- More porous than adult bones
- Richer blood supply in children’s bones
- Less efficient thermoregulation
– Body mass: surface area ratio
- Increased susceptibility to hypothermia
– Heat injury risk
- Higher threshold for sweating
- Lower sweat rate
It is also important to recognise the social and emotional changes that an adolescent typically goes through during puberty. Their metacognitive skills will either thrive or diminish dependent upon enjoyment levels of their particular sports and this will inevitably have a massive effect on performance levels and potentially injury risk.
There are of course other factors that can also contribute to higher numbers of injuries
- Insufficient rest after an injury
- Poor training or conditioning
- Over training
- Specialisation in just one sport
- Year-round participation
- External factors (pitch surfaces)
- Lack of prevention and management strategies in schools, sports clubs etc.
So what are the common signs of injury which you should look out for with your child?
- Watch for limping or swelling
- Learn to differentiate between pain around muscles, which is usually normal, and pain around joints, which can be a sign of something worse
- Watch for declines in performance, outward changes in technique or loss of enthusiasm about the sport
- Most conditions can be reversible with rest and activity modification
- If pain persists or symptoms recur after a sports activity, it’s time to seek professional help from a physiotherapist
Thankfully most of the sports injuries we see in adolescents are minor and self-limiting. Nevertheless, training programmes as well as management from parents and coaches should always take into account the biological age of each child as well as their physical and psychological immaturity. A sound understanding of the different aspects of training, including duration, intensity, frequency and recovery, are also needed to avoid causing unnecessary damage to the musculoskeletal system of a child.
Please do not hesitate to contact us at the clinic on 020 8332 1132 if you have any further questions or would like to make an appointment for your child.