Ped Med: Preventing injuries in children

Warning: Sports fields, roadways and bathtubs may be injurious to your child's health.

Each year, in those three settings, thousands of children suffer injuries, most of which could be averted with some precautionary steps.

"Sports injuries are becoming the most common reason young people are going to the emergency room," says Dr. Jordan Metzl, medical director of the Sports Medicine Institute for Young Athletes at the Hospital for Special Surgery in New York City.

He urges coaches and parents to look out for such common and potentially problematic conditions as:

-- Little League shoulder, a pitching overuse injury that can affect the growth plates;

-- Runner's shin pain, which can diminish performance and requires rest and strengthening;

-- Wrist pain after a fall that continues due to a hairline fracture that may be overlooked.

Metzl also advises keeping an eye out for signs a young player has too much on his or her plate, such as:

-- Being tense, moody, irritable, especially at practice and game times;

-- Performing poorly in school;

-- Pursuing few non-sports activities;

-- Spending little time relaxing or seeing friends;

-- Focusing solely on athletics;

-- Treating games more as an obligation than fun;

-- Showing reluctance to attend games or practice;

-- Feeling exhausted.

Metzl recommends caregivers help young athletes:

-- Plan ahead;

-- Start early on big projects;

-- Break up large tasks;

-- Economize their energy;

-- Limit TV viewing and phone and online conversations during the sports season;

-- Nap;

-- Keep sight of long-term goals.

Dr. Robert Marx, orthopedic director of HSS Sports Medicine Institute for Young Athletes, says it's important to know what injuries require immediate medical attention.

"If the kid hears a pop in his or her knee, and it swells, that's bad," he says. "If they can't bear weight right away or if they have trouble coming off the field on their own, that's also a sign a specialist is needed."

Lauren Antonucci, director of Nutrition Energy, says athletes should also be informed about good nutrition, encouraged to down sports drinks and water, eat sufficient amounts of calories and carbohydrates and have healthy attitudes about body weight and image.

"Sports will always be injury-laden, but statistically it is safer to play sports than to travel to a game by car," Metzl notes.

Indeed, a study published in the American Journal of Preventive Medicine shows motor-vehicle accidents are the leading cause of death in the United States for people between the ages of 1 and 34.

Many of those accidents are caused by drunk drivers, the authors say, noting 30 percent of Americans will be involved in an alcohol-related crash in their lifetime.

Discouragingly, the national survey shows a resurgence in alcohol-impaired driving, which decreased by about 1 percent from 1993 to 1997 -- from 123 million to 116 million annual episodes -- but then jumped to 159 million by 2002.

Dr. Kyran Quinlan, clinical associate in pediatrics at the University of Chicago, says there is an urgent need to make the roads safer by developing new strategies to prevent drunk driving.

Other researchers are calling for improving the safety of bathtubs.

A study by investigators at the Columbus Children's Research Institute at Columbus Children's Hospital shows slips and falls account for more than 80 percent of childhood bathtub injuries.

The survey, reported in Clinical Pediatrics, also found 85 percent of bathtub-related injuries in children under 5 occurred with an adult standing by.

"Because so many of the injuries occurred while an adult was present, we need to look to passive methods of prevention, ones that don't rely on adult action, such as more effective slip-resistant bathtub surfaces," says Dr. Gary Smith, director of the Center for Injury Research and Policy at CCRI and faculty member at The Ohio State University College of Medicine and Public Health.

The study of 204 children ages 4 months to 16 years points to the need to re-evaluate the voluntary standard for slip resistance in bathtubs, last updated by the industry in 1999, he says.

Smith also advocates installing slide-free surfaces outside the bathtub, using more impact-absorbent materials for tubs, padding or eliminating sharp edges and employing recessed fittings.

Other scientists are looking to immigrants to get clues on how to prevent injuries in children.

A study of 5,000 5-year-olds, published in Health Psychology, shows 27 percent of youngsters with U.S.-born mothers suffered an injury requiring medical attention in the past year, compared to only 13 percent of those with immigrant parents.

The scientists at the University of Alabama, Birmingham, are not certain about the reason for the difference but hope to get some clues from examining the less-accident-prone groups.

The immigrants' secret they want to see to keep all children injury-free.

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UPI Consumer Health welcomes comments on this column. E-mail: lwasowicz@upi.com