Your Interview

What are the precautions parents should take for injuries.

Dr. Purcell: Injury is always a risk when kids are participating in sports and recreational activities.

There are ways to help reduce risk, including ensuring children are wearing the appropriate protective equipment for the sport or activity that they are doing. For instance, wearing proper shoes and a helmet when riding a bike; wearing proper shoes when playing soccer, even just a pick up game; wearing wrist guards, helmets and knee pads when skateboarding or snowboarding.

Ensuring that children have the necessary skills to play a sport is also important to help prevent injury. Proper coaching and training is essential to help reduce the risk of injury.

Making sure that children have appropriate rest and time to recover is also very important. If a child is playing the same sport on three different teams and is playing almost every day of the week, they are at high risk for injury, particularly overuse injuries.

Playing for one team at a time and playing different sports that require different sets of muscles and different skills helps prevent overuse injuries.

My nine-year-old son got hit in the face by a baseball last week. He was wearing all the proper baseball gear at the time (including helmet). He has 2 black eyes and a broken nose. How can this be prevented?

Dr. Purcell: Unfortunately there are some injuries which cannot be prevented. Helmets do not prevent facial injuries. Without knowing more of the circumstances of how your son was hurt it is difficult to say what could have helped prevent his injury.

Knee pain for some quickly growing 8 to 13 year olds involved in sports of sudden accelerations, twists and turns worries parents and coaches. What advice in additon to rest, cycling, swimming, investigating knee braces and possibly orthotics would you offer please?

Dr. Purcell: Knee pain that persists for more than a couple of weeks or that interferes with activities should be evaluated by a doctor. The exact cause of the pain needs to be determined before any advice can be given regarding the use of knee braces or orthotics.

Depending on what is causing the pain, physiotherapy may also be beneficial to help reduce symptoms.

I have a nine-year-old boy playing soccer. He seems to get a lot of turned knees and ankles that keep him out for a game or two. Are there strengthening exercises he can do to prevent this?

Dr. Purcell: Soccer results in many injuries to the ankles and knees. Part of the problem may be your son's level of motor development. Not every nine-year-old has the same motor skills and some children are more prone to injury when they are not as advanced in their motor skills.

Overall conditioning is important to help prevent injuries, including appropriate stretches prior to playing soccer. During the warm up prior to games, kids should be stretching the quads, hamstrings, calf muscles, and hip muscles to get them ready to play.

Strengthening exercises that can help include jumping in place on one leg (alternate legs), doing toe raises on a stair (stand with the toes at the edge of a stair and push up onto your toes, then lower the heels below the level of the stair), jumping with both legs in different patterns in a grid of four squares (this can be done one leg at a time as well).

Is there a point when children are doing too much sports activites that puts them at a greater risk to injure themselves at a young age? If so, how do we know what too much is?

Dr. Purcell: Yes there is always the danger of too much sports. Children need adequate rest to avoid injury and to recover from sporting activity. Generally speaking, children should do no more than 5 days a week of activity. Taking a couple of days a week off will help their bodies recover.
The volume and intensity of activity needs to be monitored as well. More than a couple of hours of activity at a time puts children at risk of injuries, particularly when they get tired. If children are complaining of pain during or after activity that is an indication that they are doing too much.
It is also important to realize that children who play only one sport all year round are at risk of overuse injuries. Children should play different sports to develop different sports skills and to use different muscles. They should have time off (couple of months) from a sport to allow for recovery. Playing on multiple teams and playing multiple sports at the same time put children at risk of injury as well.

I coach and for years when I played, coaches always told me that throwing a curveball as a pitcher could hurt them at a young age? Is that true?

Dr. Purcell: Yes. The forces generated across the elbow joint by throwing curve balls when a child is still growing can cause injury to the growth plates and bones in the elbow. Throwing too many pitches at a young age can also cause injury. That's why junior leagues limit the number of pitches a young athlete can throw in any game or week.

What are safe distances for kids to run/race in elementary school and high school without risking injury?

Dr. Purcell: Generally, the younger the child, the shorter the distance that is safe to run. Sprints are generally safe for any age but distance running can be more problematic. Young children may be able to run distances up to 2 km; older children may be able to run up to 5km; adolescents may be able to run up to 10 km or possibly more.

The key to preventing injury is to ensure that children are training properly, with gradual increases in the frequency, volume and intensity of exercise. Adequate rest and recovery is necessary to allow the body to recover. If the activity is causing pain, it is an indication they are doing too much and need to cut back.