Football has the highest frequency of injury for high school sports. Head and neck injuries, heatstroke and musculoskeletal injuries are very common. The risk of repetitive minor brain injuries is also a major risk. Sport related head injuries make up over 20% of all traumatic brain injuries in children and adolescents. Although there are education and safety programs concerning sport injuries the risk of injury and death has not decreased. Between 10 and 15 children die each year from sports related injuries.
40,000 high school players suffer concussion each year. A concussion is a traumatic injury to the brain where a mechanical force causes direct disruption of brain function. It is associated with changes in metal status and does not need to be associated with loss of consciousness. If a child has a concussion a CT scan of his or her brain is normal. Only in cases where there has been bleeding within or around the brain or swelling of the brain would the CT scan be abnormal. This can be seen in cases of subdural or epidural hematomas. These events are frequently life threatening and require immediate intervention.
Long-term effects of repetitive brain injuries have been identified. These include an increase frequency of memory related diseases such as Alzheimer disease, depression and even brain atrophy. Studies of professional football players have strongly supported this link between repetitive minor brain trauma and long-term health problems. The risk of Alzheimer disease in professional football players aged 30-49 is almost 20 times higher than the general population.
Up to 15% of football payers each year receive neck and spine injuries. These injuries are the result of excessive flexion or extension of intervertebral joints. This leads to secondary injury to muscles, ligaments, discs and nerve roots. Pain can range from mild numbness or stinging to severe radiating pain. The pain may be at the site of the injury such as the back or shoulder or it may extend down an arm or a leg. Often the pain is not associated with muscle weakness and is related to muscle spasm. Gait changes and joint movement limitation are often seen and are usually due to pain or discomfort. Pain or weakness symptoms may begin immediately or may be delayed due to secondary problems due to swelling and inflammation.
Neck injuries can involve direct damage to the cervical spine or alignment of the spine. These injuries are often due to a force being directed to the top of the head and transmitted down to the neck during a tackle. Such a tackle is called “spearing” and can lead to permanent paralysis. If such an injury occurs during a game or in practice then extreme precautions are taken to immobilize the head and neck until appropriate radiographic and physical examinations have been performed.
Another type of neck injury is damage to the disks between individual vertebras. Chronic injury to the neck often leads to degenerative disc changes and long-term problems with pain, muscle function and gait.
Musculoskeletal injuries involving the extremities are common. About one-third of all limb injuries in childhood are sports related. The most common knee injuries include damage to one or more of the four ligaments that stabilize the knee. These are the medial collateral ligament (MCL) that stabilizes the inside of the knee; the lateral collateral ligament (LCL) that stabilizes the outer knee; the anterior cruciate ligament (ACL) the stabilizes the knee from rotating and slipping forward and the posterior cruciate ligament (PCL) that stabilizes the knee from rotating and slipping backwards. Often ligament injuries occur together. It is common for the ACL and MCL to be torn as well as the meniscus. When the meniscus is damaged this is called a tear. The knee meniscus is a C shaped cushion that the knee bones rest upon. A PCL injury is usually due to hyperextension of the knee or results from a flexed knee being forced backward causing direct damage to the PCL.
Traumatic injuries to hands, wrists, fingers, hamstrings, toes and shoulders are common as are overuse injuries to the iliotibial (IT) band. The IT band extends from your hip down across your knee on the outside of your leg. It stabilizes your knee and hip during running and can become irritated from rubbing on the bones on the outside of your knee. Pain is common on the outside of your knee and can run up the outside of your knee extending to your hip. Muscle strengthening exercises and stretching are often prescribed as are cold and rest.
When your child engages in any sport the best way to prevent injury is with proper preparation, proper guidance and the proper use of appropriate equipment. Injuries can and do happen even with the best preparation. Exercise and movement are needed for your child to grow into a healthy adult. At the same time you must make sure your child avoids and recognizes injuries and obtains proper treatment when injured.