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Sports Injury Prevention

A Guide to Safety for Young Athletes


Participation in youth sports is increasing. Nearly 30 million children and teenagers play sports in the United States alone.
With increased participation, there are also more sports-related injuries. More than 3.5 million kids under the age of 14 receive medical treatment for sports injuries each year. Children between the ages 5 to 14 represent nearly 40 percent of all sports-related injuries treated in hospitals. 
Overuse injuries account for nearly half of injuries in middle and high school athletes. According to the Centers for Disease Control, more than half of all sports injuries in children are preventable.
Although more than 60% of sports-related injuries occur during practice, one-third of parents do not have their children take the same game-day safety precautions at practice, such as helmet or protective equipment wear.

Differences Between Child and Adult Athletes

Unlike adults, children’s bones, muscles, tendons and ligaments are still growing. This can make them more prone to injury. Children also have different levels of mental maturity, stamina, and neuromuscular coordination than their adult counterparts.
One particular difference is the growth plate. In children, the bones are not fully formed. Most of the long bones (such as the thigh bone, leg bone, and forearm) have two “growth plates”. These areas are made of cartilage, which is weaker than bone, ligament, and tendon. This area is also where children gain bone length or height as they grow.
Injuries that may produce a sprain or strain in adults (like sliding into third base and twisting an ankle) can produce a fracture through the growth plate. These growth plate fractures or injuries can lead to growth abnormalities.
Young athletes of the same age or grade can differ greatly in size, physical maturity, and abilities. This is especially striking in middle school and high school athletes.

Injury Prevention

Have your child complete a pre-season physical examination. This is a great opportunity to find possible life threatening or disabling conditions and conditions that might make him or her prone to illness or injury.

  • “Warm-up” and “cool-down” prior to practice or play with activities like walking, cycling, or jogging.
  • Use stretches during the “warm-up” and “cool-down”. Stretching involves going just beyond the point of resistance and should not include bouncing. Stretches should be held for 10-15 seconds.
  • Stay hydrated, especially during the warm summer months. It’s important that your child not wait until they’re thirsty to drink water. Water, and non- sugar-containing sports drinks, should be the primary source of hydration for children and teenagers.
  • Avoid playing when sick, in pain, or overly tired. Teach your athlete not to over train or “play through the pain”. He or she should listen to their body and decrease training time or take a break if they have pain. 
  • Before playing, know all the rules of the game.
  • Make sure the playing surfaces are clean, dry, and safe. Wet slippery fields can lead to injuries.
  • Make sure your child has all the required protective equipment and proper footwear. It is also important to make sure the equipment fits the right way. This is especially important for helmets, mouth guards, and cleats/shoes.
  • If possible, your child should play multiple positions to learn different skills and the roles of different players, especially when first starting a sport. Play other sports or cross-train during the “off-season” and do not allow your child to play one sport year round. This will help decrease overuse injuries and develop other skills while maintaining fitness.  
  • Make sure your child is staying active during the off-season. If not, they should gradually increase their activity at the beginning of the season to minimize over-training or overuse injuries.

Tips for Specific Sports:

Football is the leading cause of sports-related injuries in children and teenagers.
Ensure your child has the appropriate protective equipment. According to the Pop Warner Football Official Rule Book, players should have: helmet, shoulder/hip/tail/knee pads, thigh guards, mouth guard, and athletic supporter.
Concussions are not uncommon. Before returning to play, the athlete must be symptom-free at rest and with vigorous exercise. The American Academy of Pediatrics and the American Academy of Neurology recommend that athletes with concussions be evaluated and cleared by a doctor trained in managing concussions before returning to play.
Make sure your child is tackling correctly. Athletes should tackle with the head up and should not lead with the helmet.
Ensure goal posts are always padded.
Knee and ankle injuries, such as sprains and strains, are the most common injuries in soccer.
Always wear shin guards.
Prior to practice or competition, ensure the field is safe and there are no “potholes” or water-logged areas.
Baseball and Softball
Helmets should always be worn when batting, waiting to bat, or running the bases.
When possible, use a field with “break-away” bases to reduce the risk of injuries from sliding. Players younger than 10 years of age should not be taught to slide.
Pitchers should follow the pitch count guidelines established by the USA Baseball Medical & Safety Advisory Committee to minimize the risk of overuse injuries. Pitchers should not be taught curveballs until age 14 and sliders until age 16.


Many young athletes take sports supplements such as creatine, branched-chain amino acids (BCAAs), or protein supplementation because they think it will increase strength or endurance.
Unlike prescription or over-the-counter medications, the US Food and Drug Administration (FDA) does not regulate dietary supplements. Supplements may have high rates of contamination or ingredients not listed on the label. In many cases, the label may not actually contain the exact ingredients found in the supplement.
Young athletes often consume energy drinks, which usually contain large amounts of caffeine, to improve energy or sports performance. Drinks with a large amount of caffeine may interfere with the body’s ability to cool itself, leading to the risk of over-heating or heatstroke.
The American Academy of Pediatrics reported that “energy drinks pose potential health risks primarily because of stimulant content; therefore, they are not appropriate for children and adolescents and should never be consumed.”
Always ask your child’s pediatrician or primary care provider about the safety of supplements prior to starting them.

Steroid Use

Many high school athletes consider using anabolic steroids to build muscle mass and improve strength. However, these drugs are illegal without a doctor's prescription.
Anabolic steroids have many serious side effects including aggressive behavior, elevated blood pressure and cholesterol, and liver damage. Steroids can also stop growth in children and teens that are still gaining in height.

Female Athletes

Title IX of the Education Amendments Act of 1972 is a United States federal law that states: "No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance."
This law meant that federally funded institutions, such as public schools, are legally required to provide girls and boys with equitable athletic opportunities. Before Title IX, one in 27 girls played sports. Today, two in five girls play sports and that number continues to rise.
Occasionally, female athletes may focus on being too thin or lightweight. This may lead to not eating enough or exercising excessively. This is seen most often in endurance sports such as track and field and cross-country as well as performance sports, such as ballet, gymnastics, and dance.
Girls who have unhealthy eating habits or exercise intensely are at risk for a problem called the female athlete triad. This is a combination of three conditions:

  1. Disordered eating, which can lead to eating disorders such as anorexia or bulimia
  2. Menstrual dysfunction, such as missed or abnormal periods
  3. Osteoporosis, or weakening of the bones due to the loss of bone density. This can lead to stress fractures.

It is important for parents to recognize behavior that could lead to the female athlete triad and discuss these concerns with the athlete’s doctor, athletic trainer, or a nutritionist. 

Q. Are there any specific differences between pediatric and adult athletes?

Childrens’ bones, muscles, ligaments, and tendons are still growing making them more prone to overuse injuries. Children have active growth plates which often become fractured rather than “sprained” with acute injuries. Children come in different sizes and maturity levels at similar ages, and this must be taken into account with each sport played.

 Q. Are there problems associated with supplements in pediatric patients?

Supplements are not regulated by the U.S. Food and Drug Administration and therefore may not have been tested specifically in pediatric patients, making them more risky for use in children. Energy drinks often contain a large amount of caffeine which can interfere with the body’s ability to cool itself, leading to the risk of over-heating and heatstroke. This can also lead to significant stimulation in children, and it has been recommended not appropriate for use in children and adolescents. Anabolic steroid use has significant risks associated with it, both short term and long term including aggressive behavior, elevated blood pressure and cholesterol levels, and liver damage. Anabolic steroids should never be used.

Q. What does the “female triad” refer to?

The female triad refers to a set of conditions that young female athletes are prone to developing and should be monitored for: 1) disordered eating (which can lead to eating disorders), 2) menstrual dysfunction (altered or absent periods), 3) osteoporosis (which can lead to stress fractures).

Q. What are some general safety tips for all pediatric athletes to consider?

Have your child complete a pre-season physical examination. Remember to always “warm up” and “cool down” before and after practices/games/activities which includes appropriate stretching exercises. Make sure to stay hydrated and avoid playing when sick. Check the status of the playing surface prior to participation for any areas that could lead to accidents/injuries and always make sure your child has the appropriate safety equipment required for their chosen sport. For growing athletes, expose them to many different types of sports rather than one single sport all year round to decrease the risk of overuse injuries.