To Play or Not To Play: Sports Injuries in Children

Movement is essential for the human body and the brain. Regular physical activity benefits health in many ways, including helping build and maintain healthy bones, muscles, and joints. It also helps control weight and reduces fat. Exercise is one of the least expensive ways for children, and adults, to stay healthy. Organized sports is a great way for kids to be active on a regular basis, but unfortunately, injuries do occur. This article discusses the benefits of kids being in sports, but also the main injuries that can occur.

Participation in sports develops physical fitness and general health. Sports participation exposes children to psychosocial skills such as teamwork and peer relations which promotes decision-making skills and builds confidence. Sports provide children with enjoyment and fun while learning skills and developing physically. Physical activity in general is associated with improved academic achievement, including grades and standardized test scores. Further, such activity can affect attitudes and academic behavior, including enhanced concentration, attention, and improved classroom behavior.

In the U.S., about 36 million children and teens participate in some form of organized sports, and more than 3.5 million injuries occur each year which cause some loss of participation in that sport. Unorganized sports activities have higher injury rates, but almost one-third of all injuries incurred in childhood are sports-related injuries. By far, the most common injuries are sprains and strains followed by fractures, contusions and overuse syndromes. Concussions are of special concern especially in children whose brain and nervous system have not fully matured.

The following statistics are from the National SAFE KIDS Campaign and the American Academy of Pediatrics:

Injury rates:

  • More than 3.5 million children age 14 and younger get hurt annually playing sports or participating in recreational activities.
  • Although death from a sports injury is rare, the leading cause of death from a sports-related injury is a brain injury.
  • Sports and recreational activities contribute to approximately 21 percent of all traumatic brain injuries among American children.
  • Almost 50 percent of head injuries sustained in sports or recreational activities occur during bicycling, skateboarding, or skating incidents.
  • More than 775,000 children, ages 14 and younger, are treated in hospital emergency rooms for sports-related injuries each year. Most of the injuries occurred as a result of falls, being struck by an object, collisions, and overexertion during unorganized or informal sports activities.

Sprain vs. Strain

A sprain is an injury to the ligament. Ligaments connect bones to other bones. They occur less frequently in children because of the higher degree of elasticity of ligaments in children. A child diagnosed with a ligamentous injury should also be evaluated for the possibility of a nondisplaced physeal fracture (growth plate fracture). A strain is an injury to the muscle close to the tendon (tendons attach muscles to bones) and is often the result of a forceful contraction of the muscle. These are much more common than sprains in children. Strain injuries are associated with an improper warm-up before sports, fatigue and a previous injury that was not rehabilitated properly.


Concussions are caused by direct or indirect trauma to the brain. A concussion affects how the brain functions. Concussions are not a bruised brain as they are not usually associated with structural damage to the brain. They are a subset of mild traumatic brain injury or MTBI. Concussions are on the lower end of MTBI and are generally self-limiting in duration and resolution. They are often under-reported. The CDC reports 1.6-3.8 million sports-related brain injuries each year in the US, but these numbers are thought to be low.

The majority of concussions appear to occur from impact to the side of the head and are more likely to occur in competition than in practice. Concussions occur most often with player-player contact. About 25% of high school soccer concussions occur during illegal activity. The sport with highest concussion rate is footfall followed by girls' soccer, boys' soccer, wrestling and girls' basketball.

The symptoms of a concussion may not become apparent for hours or days following an injury. The most common symptoms are a headache which lasts the longest, followed by fatigue, then, fogginess and finally sleep disturbances. If you or your child has one or more of the following symptoms following head trauma, they should be evaluated for a concussion.

  • Physical symptoms: Headache, nausea, vomiting, balance problems, dizziness, visual problems, fatigue, light sensitivity, noise sensitivity, numbness or tingling, feeling dazed or stunned
  • Cognitive symptoms: Feeling foggy or slowed down, difficulty concentrating, difficulty remembering, forgets recent information, confusion about recent events, answers questions slowly, or repeats questions
  • Sleep symptoms: Drowsiness, sleeping less than usual, difficulty falling asleep
  • Emotional Symptoms: Irritability, sadness, more emotional than usual, nervousness

Treatment of any type of sports injury depends on the type and the severity of the injury. It has been my experience over the past 23 years in practice that injuries heal faster with proper care. This includes the treatment of concussion symptoms. In 2013 Harmon, et. al. reported that: In the acute phase of a concussion manual therapy may be considered especially if there is concurrent neck pain - American Medical Society for Sports Medicine Position Statement: Concussion in Sport, the Clinical Journal of Sports Medicine; 23: 1-18.  My role as a pediatric chiropractor is to provide health services, support, instruction and rehabilitation for injuries that can occur. It is my goal to get them back to playing the sports they love as quickly as possible while providing safe alternatives during the healing process.

Dr. Wendy Henrichs has been practicing with her husband Dr. Scott Henrichs at Timber Land Chiropractic in Rhinelander since 1994. Drs. Wendy and Scott Henrichs provide comprehensive chiropractic care among other services including rehabilitation and wellness services. Dr. Wendy Henrichs specializes in pediatrics and women's health. Drs. Wendy and Scott Henrichs are board certified and licensed to practice chiropractic and nutrition counseling in Wisconsin and are committed to excellence in meeting your healthcare needs. Timber Land Chiropractic is located at 1 E. Courtney Street in Rhinelander. For a complimentary chiropractic, nutrition or lifestyle counseling consultation, call 715-362-4852 www.timberlandchiropractic.com or visit us on Facebook.