Adolescents and sport

Adolescents and sport

I’ve heard that teenagers don’t get injured as badly at sport, is that true?

Adolescents experience sports injuries more frequently than adults, but they are usually less serious. Muscles tendons and ligaments are relatively stronger than in adults, and joint cartilages have some blood supply, allowing those areas to heal to some extent.

Bone injuries are most common, although bones are more pliable than in adults. Overuse injuries are relatively rare in young people but are becoming more frequent with more intensive training of young people. Fractures in young people heal more quickly with little or no resulting bone deformity.

What sort of training regime should my teenager follow?

Training in different age groups

There is an ever-increasing enthusiasm by coaches to have young people start rigorous training for a sport in the early teenage years. This has to be approached with caution. Gymnastics, tennis and even soccer are recruiting players to competition at earlier and earlier ages.

Parents should be advised that the adolescent should participate to the extent that they enjoy, as many teenagers have been turned off of all sport by over-training and/or pushy parents. It is also worth noting that it is very difficult to predict the future performance of a young adolescent — the majority of winners of junior competitions do not go on to excel in adult sport.

Hard, monotonous and regular training can make sport an agony rather than the enjoyment it should be. The aim should be to encourage a large number of adolescents to develop an interest in all sports so that they carry this enthusiasm into their adult lives.

Possible training guidelines:

  • Age 7-9 years — Stress play in a number of spans, with the all-round nature being emphasised.
  • Age 10-11 years — Technique and co-ordination exercises can be encouraged, with a focus on play rather than systematic training.
  • Age 12-14 years — Rapid changes in growth and maturity occur at this age, and training must be adjusted to the individual. Technique training, with an introduction to tactics should continue, again with an emphasis on play. Some specialisation may begin for youngsters with special talents.
  • Age 15-16 years — Fitness training can begin and should become a habit. Anaerobic exercising can begin. Strength training should be approached with care with appropriate advice about lifting techniques. Flexibility training is important at this age as growth can make the adolescent stiff and unsupple. Specialisation can begin.
  • Age 16 and older — Specialised training can begin as for adults, being aware of the differences in the rate of development between individuals. Boys may not complete growth for a few years more.

I’m a teenager and I’m very fond of many sports. Do I run a high risk of injury because of this?

Skiing

There is a strong correlation between skier age and injury. The incidence of injury in adolescents aged 11-16 years is relatively high. Young skiers of this age have sufficient skill to ski rapidly over difficult terrain but they frequently display poor judgement and recklessness. They have weaker bones than adults of similar size and often ski on old, worn or obsolete bindings that function poorly in preventing leg injuries.

Parents must realise that providing children with inexpensive hand-me-down equipment is a practice that contributes to injury risk. Children more than adults require modern, high quality bindings.

Knee injuries

Knee injuries, while more common with increasing age, are also associated with inexperienced players, particularly in rugby. In runners, youth is associated with increased risk of injury but this may be that younger, fitter runners will be able to run further and continue to do higher mileage, contributing to higher risk as a result of increased exposure.

Cessation of periods

Gender is not generally associated with increased risk of injury in sports per se, but elite women athletes often complain that their periods stop (amenorrhoea). They also run an increased risk of osteoporosis. These athletes will rarely alter their exercise regimes in spite of medical advice. There is a strong association between athletic amenorrhoea and eating disorders.

I know some form of injury is probably inevitable, but how can I protect myself from sports injury?

General advice to adolescent athletes and their parents

  • The use of protective headgear is strongly recommended for all those who participate in cycling, hurling and equestrian sports.
  • Eye protection should be considered in squash players, as the ball is small enough to actually hit the globe of the eye, resulting in a severe injury.
  • Mouth guards and gum shields should be worn in all contact sports.
  • The recent enthusiasm for inline skating has resulted in an increase in superficial abrasions to the hands, elbows and knees, as well as fractures. Protective padding should be used, as should a helmet.
  • Injuries to the ear, including those that occur during rugby, should be treated promptly by a doctor to prevent the development of ‘cauliflower ear’.
  • Adolescents who have softer bones and relatively stronger tendons than adults are more likely to get a fracture rather than a torn ligament in their leg. If medically untreated this can lead to abnormal growth.

My teenagers play many sports; how can these affect them?

Problems common in adolescents:

Osteochondritis

This describes inflammation and pain at the interior of the tendon of the knee that joins onto a bone in the leg (tibia). It is a frequent complaint in adolescents, particularly those who play sports that have a high level of knee extension, eg. volleyball. Pain and swelling over the knee may occur. Your doctor may advise rest, heat and the occasional use of strapping, and trigger exercise should be avoided. Osteochondritis heals spontaneously, although older athletes may get recurrent problems with loose bodies under the tendon of the knee.

Osteochondritis dessicans

This is the release of fragments of bone and cartilage into the knee joint. It commonly affects adolescents and it may permanently affect the joint. The condition causes cartilage and bone to disintegrate in an area that maybe as large as a penny. Loose bodies may result, causing locking of the joint.

Pain may occur during and after exercise and may be widespread in the knee. Your doctor will probably advise you to rest your limb and gradually return to activity with a slow build up of strength and mobility training.

Knee pain

This affects young people age 10 to 25 years and it caused by damage to the joint surface of the knee (patella) either by major trauma or repeated minor trauma to the knee. Pain occurs on walking, particularly downhill and on squatting. Treatment involves rest, local heat, a supportive brace and physiotherapy to build the quadriceps.

Fracture of the shoulder

Fracture of the shoulder (clavicle) is common. Treatment is conservative in a broad arm sling even if there is significant displacement. Physiotherapy may be required after a few weeks' rest so as to attain a full range of movement again.

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