Youth Concussions in the Spotlight


A concussion is essentially an injury to the tissues or blood vessels in the brain. It can occur when the soft tissues are pressed against the bone of the skull, resulting from an impact or blow to the head experienced during a fall or from sports injury. The Centers for Disease Control and Prevention (CDC) defines a concussion as “a type of traumatic brain injury, or TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works.” In addition, the CDC notes that “Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a ‘ding,’ ‘getting your bell rung,’ or what seems to be mild bump or blow to the head can be serious.”

Shining a Spotlight on Youth Concussions

Over the past few years, there have been a variety of efforts to educate the public about the dangers of childhood concussions. In particular, a great deal of focus has been placed on preventing “second impact syndrome” and managing the recovery of young athletes. For example:

In 2007, the Pennsylvania Department of Education, the Brain Injury Association of Pennsylvania, and the Pennsylvania Department of Health joined together to create the BrainSTEPS program—a “Return to School Protocol” designed to help shorten the duration of concussion symptoms by eliminating all activity that might worsen the child’s condition. This includes ceasing all physical activities during recess, all sports, physical education classes, and similar activities.

In 2009, Washington State become the first state in the U.S. to enact a comprehensive youth sports concussion safety law (called the Zackery Lystedt Law). By early 2014, 47 other states and the District of Columbia had followed Washington’s lead.

In 2014, the NCAA and the U.S. Department of Defense funded the largest study of sports-related concussions in history to further our scientific understanding. Researchers from 21 schools will “eventually gather data from 35,000 athletes and military academy cadets across all sports at 30 campuses…”

Concussion Symptoms: What Parents Should Know

Mild concussions in childhood are fairly common and are not usually a cause for serious concern. However, childhood concussions should never be taken lightly and it’s important to know what symptoms to look for. These symptoms can vary depending on the severity of the injury and the individual themselves, and some are so mild that they may be difficult to notice. Sometimes they go away quickly, sometimes they return and sometimes their appearance is delayed for days or even weeks. Other times, they linger for years or even get worse.

  • Dizziness
  • Loss of consciousness
  • Seizures
  • Mild to moderate headache
  • Mood changes, such as unusual irritability or loss of interest in favorite activities
  • Difficulty focusing or remembering things
  • Drowsiness and reduced energy

Ask your child if they have any of the symptoms, and make sure to observe them closely for a few weeks. Your child is at increased risk if they have experienced previous head injury, are taking a blood thinning medicine, suffer bleeding disorders, are under one year old, have other neurological problems, have difficulty walking or are active in high contact sports.

If your child is harder to wake up than normal, shows worsened symptoms, won’t stop crying, doesn’t eat well, has worsening headaches or symptoms that have lasted longer than six weeks, then contact your doctor or caregiver. If your child shows a change in personality, bleeds out of the ears or nose, has trouble recognizing people, or vomits repeatedly, go to the emergency room. Dial 911 in the event of seizures, unequal pupil size and longer-term unconsciousness.

Irrespective of advice you get on the Internet or by phone, if you have any doubt in your mind about your child’s health after a head injury, seek the help of a professional. You know your child best!

Proper Form for Football Tackles: Is Improved Technique Enough to Protect Youth Players?

There is no question that football is a full-contact sport that has the potential to cause a variety of injuries, some of which can be very serious.  There is also no question that tackles are the most dangerous part of the game. Concussions and other head injuries, plus damage to the neck and spine can not only put a player out of commission, they may also lead to permanent injury or death.

Today’s professional football players are large, strong and fast. The traditional wraparound tackle places the head into harm’s way and increases the risk of injury. Football officials are promoting a method to change all this. To prevent or lessen this danger, the objective is to take the head out of play as much as possible. This is called the “heads-up” method of tackle. The experts say that you should not lead with your head down, as this can be dangerous not only for the tackler but also for the ball carrier.

Why has this become such an issue? The Washington Post reported in early 2013 that professional football injuries have risen between 2000 and 2011 from 2,640 to 4,473 injuries. In that same period, the average number of weeks a player spends on the NFL injury report has grown from 3.24 to 4.12 weeks. So, there are not only more injuries across the board, but longer lasting injuries as well.

The method recommended by professional football officials, including the NFL commissioner, and even the CDC, involves a specific form of stance and approach. With the head up and back, the chest forward and the arms extended slightly with elbows pointed down and knuckles pointed up, the tackler uses their leg muscles and hips to lunge upward, driving the chest and shoulders into the ball carrier. The tackler ends by throwing what looks like double uppercuts.

But not everyone agrees that the technique promoted by football officials is practical or that it’s likely to reduce the game’s inherent risks in any meaningful way. Matt Chaney, an analyst of football health issues, including catastrophic injuries, wrote a scathing critique of the method in a 2012 issue of Slate magazine. Chaney wrote, “As a former head-basher in NCAA football, I can say that this is a technique that I’ve seen precisely no one, ever, use on the field.” So, even though coaches may train and drill the technique, according to Matt Chaney, it isn’t used in the real world. Chaney explains, “To ask the body, while traveling at [football] speed, to crane the neck up and back, in defiance of physics, is a fool’s errand.”

At the same time, however, it is clear that some approaches to tackling—and being tackled—are safer than others. And the incentives to reduce serious injuries are beginning to grow for everyone in the broader football community, from team owners and coaches to the players themselves. Rule changes, improvements in protective gear and—yes—advances in tackling techniques all have a role to play. This is especially true in youth football programs.

Professional football players take their chances. After all, it’s part of their chosen career. However, juvenile players require more care and guidance. So what can be done to protect youth players? While some believe that better education and training (as well as better equipment) is the answer, others think that the nature of tackle football itself is the problem. Unlike baseball, which is sometimes described as men playing a boys’ game, tackle football is in some respects a man’s game being played by boys. This is the perspective taken by Matt Chaney. “If the NFL is truly serious about protecting kids,” wrote Chaney, “instead of building up the sport’s talent pool, then the league and the players’ union should start listening to the growing medical call to end tackle football for pre-adolescents.”

Overuse Injuries in Young Athletes: An Introduction for Parents

There’s a curious dynamic at work in youth sports these days. Maybe you’ve noticed?

On the one hand, public health officials are worried about a broad decline in team sport participation among children. According to a recent survey, the number of kids between the ages of 6 and 17 who play organized baseball, basketball, football, and soccer fell about 4% between 2008 and 2012.

And on the other hand, healthcare professionals are also worried about many of the estimated 60 million children in the U.S. who do play organized team sports. They see signs that young athletes may be taking their sports too seriously—training too hard, playing too much and specializing too early in life. The popular media offers many statistics and anecdotes that seem to point in this direction:

  • “While injuries from recreational activities such as biking have fallen over the last decade, team sports including football and soccer saw injuries rise by 22.8% and 10.8% respectively…” (Wall Street Journal)
  • “While concussions account for about 15% of youth sports injuries, experts say many sports carry risks for musculoskeletal injuries, in large part due to increased emphasis on year-round competition, single-sport concentration and intense training regimens, even for pre-teen athletes.” (Wall Street Journal)
  • “Overuse and overtraining are also major concerns… As children become good at competitive sports, there is sometimes an impulse to keep them in the same sport year round, which may not be the healthiest thing for a young athlete.” (HealthDay News)

What’s more alarming to physicians than the number of youth sports injuries is the nature of those injuries. A troubling new pattern seems to be emerging. According to Dr. Amy Valasek, a sports medicine expert at Johns Hopkins Children’s Center, only about half the sports injuries she sees are the sorts of sprains, strains, fractures and concussions that have traditionally been common among young athletes. 50% to 60% of them are related to overuse. Because the musculoskeletal system of children and teenagers is still growing, they may be especially susceptible to these kinds of injuries.

Unsurprisingly, each sport has its own risk profile when it comes to overuse injuries. For instance, overuse injuries of the shin and knees are most common to runners. Baseball, softball and football players often have elbow and shoulder injuries. Cheerleaders, skaters and dancers are prone to ankle injuries. And gymnasts frequently encounter wrist injuries as a result of the extreme demands their sport places on this particular part of the body.

In addition, doctors say they tend to these types of overuse injuries more often in children who play one sport year-round or play over multiple consecutive seasons without taking a break rather than in those who participate in a variety of athletic activities. Recent research found serious overuse injuries are 2.3 times more common in young, single-sport athletes than they are in more well-rounded athletes, even after accounting for the number of hours committed.

There may be several reasons for the apparent trend in overuse injuries. Experts believe that there’s growing pressure among athletes to specialize in one sport—and sometimes even in one position—at a younger and younger age. They also believe that youth training programs and competition schedules are simply becoming more demanding. At the same time, though, it’s likely that many managers and coaches at this level (not to mention parents) don’t fully understand the risks and don’t work with their young athletes to build healthy training and injury prevention habits. And when they are injured, it’s not uncommon for children to return to practice before their injuries are completely healed.

So what’s the best advice for the parents of a talented (or even just enthusiastic) young athlete?

  • Encourage a wide variety of athletic activities and well-rounded development. Evidence suggests that playing more sports leads to fewer overuse injuries, lower burnout rates and better overall performance in the long run. While there’s no hard-and-fast “rule,” many experts suggest that children and parents avoid specializing in a single sport before the age of 14.
  • Take time off. The American Academy of Pediatrics Council on Sports Medicine and Fitness advises that children practice no more than five days per week and take at least one day off from any organized training. Some experts offer an alternative rule-of-thumb: young athletes shouldn’t participate in a sports more hours a week than their age. The Council also suggests a 2- to 3-month break to recover between seasons.
  • Teach—and practice—injury prevention from an early age. Warm-ups and whole-body stretches should become lifelong habits.
  • Be sure your athlete understands what overuse injuries are, how to recognize them and how they should be treated.


Additional Resources

Intense, Specialized Training in Young Athletes Linked to Serious Overuse Injuries.

Sports Should Be Child’s Play.

Guidelines for Young Athletes to Reduce Injuries.

Voices of the NFL Speak Out About Chiropractic Care

Football is very, very hard on players’ bodies. By some estimates, American football players suffer about 500,000 injuries a year—twice as many as in any other sport. NFL injury data indicate that there were over 1,300 on-field injuries during the 2013/2014 season.

A company called SimpleTherapy analyzed this data and found that some parts of players’ bodies are actually much more likely to be hurt than others. Knees are most vulnerable (involved in 22.3% of injuries), followed by ankles (15.3%), lower legs (11.5%) and shoulders (8.6%). That said, it’s pretty clear that a player’s entire musculoskeletal system is put at risk every time they suit up.

Given this reality, it’s not surprising that every one of the NFL’s 32 teams has a chiropractic physician on staff to prevent and treat injuries as well as to help players improve performance. Dr. Spencer Baron is the Team Chiropractor for the Miami Dolphins and has served as president of the Professional Football Chiropractic Society. He offers this perspective on the relationship between professional football and chiropractic care:

“The robust need for chiropractic care in the NFL has been deeply driven by the players’ desire for peak physical conditioning and not simply for injuries. From the earliest years of full contact football, their bodies are subject to structural stress that doctors of chiropractic are specially trained to care for. Many DCs who provide their services to professional athletes travel with their respective teams throughout the season, treating players up until game time, during the game and sometimes immediately following.”

But what about NFL players themselves? How do they view chiropractic care? Some of the game’s most-recognized players have spoken publicly over the years about their own experience.

Joe Montana (San Francisco 49ers, Kansas City Chiefs)

“I’ve been seeing a chiropractor and he’s really been helping me out a lot.  Chiropractic’s been a big part of my game.  Chiropractic care works for me.”

 Emmitt Smith (Dallas Cowboys, Arizona Cardinals)

“Do I need to find a chiropractor? It was time for me to invest in me… I found a specialist that’s really good in balancing out my body to make sure my hips are rotated right, and my body is functioning properly…”

“I remember somebody telling me that what I put myself in during the games is like having a car wreck every Sunday. It’s against the norm. You can find yourself in awkward positions. That stuff takes its toll. But if you take advantage of the health care, balance your body back out, put it back where it’s supposed to be, you function better, and you recover faster… You can have a Ferrari body, but your wheels need balancing. I felt if I took care of my body, I could still function when I got older.”

Jerry Rice (San Francisco 49ers, Oakland Raiders, Seattle Seahawks)

“Most injuries require chiropractic care. It works better for me than anything else.”

“I believe in chiropractic, and I know that it works. You probably know about my long and successful career in football. I’m flattered by the testimonials to my durability. Football is a very rough and vigorous sport. Chiropractic was the key to keeping me in the game.”

“If I had everything in alignment, I knew I could play my best football.  Dancing with the Stars was every bit as exhausting and challenging.  Though not nearly as brutal as football, it required many hours of practice and I had aches and pains that I’d never had before.  Again, chiropractic made the difference, and kept me dancing and in the competition.”

Tom Brady (New England Patriots)

“Chiropractic just makes you feel so much better. When I walk out of the clinic, I feel like I’m about three inches taller and everything’s in place. And as long as I see the chiropractor, I feel like I’m one step ahead of the game.”

Lance Moore (New Orleans Saints, Pittsburgh Steelers)

“Not only did my chiropractor get me back on the field,” he said, “but he helped me to stay on the field. My body just feels much better overall because of the care I’ve gotten.”

Reggie Bush (New Orleans Saints, Miami Dolphins, Detroit Lions)

“I look at chiropractic care as important to keeping me healthy and at the top of my game.”

“As a professional athlete, I am highly competitive—only accept the best. When it comes to healthcare, chiropractic is an essential service. It keeps my on-field performance at its highest level and contributes to the success of the entire team.”

 Hines Ward (Pittsburgh Steelers)

“In this game you have to take care of your body. Over the course of a game your body just feels wrecked. Every Monday it hurts to get out of bed. I told my chiropractor, I want to feel good in the morning. A lot of my credit goes to him for keeping me healthy.”

But the players aren’t the only ones in the NFL with physically demanding jobs. While it’s not widely recognized by the public, cheerleading is difficult and dangerous work. Recent studies have indicated that two-thirds of the serious sports injuries reported by women in the United States occur in connection with cheerleading. The number of cheerleading-related emergency room visits increased from around 5,000 in 1980 to over 26,000 by 2007.  The Consumer Products Safety Commission estimates that there were almost 37,000 emergency room visits for cheerleading injuries among girls aged 6 to 22 in 2011. So—once again—we see some of the NFL’s finest athletes turning to team chiropractors.

Chelsea Causey and Amanda Mitchell (Washington Redskins’ Cheerleaders)

“I’ve experienced multiple injuries during my career as a cheerleader—everything from pulled hamstrings to sprains and even lower back pain—setbacks that chiropractic care has always helped me recover from.”

“Without chiropractic care I would not have made it past my first year. After receiving treatment, I began to notice the pain starting to subside as well as improvement in flexibility during performances.”


Additional Resources

Bumps, Bruises and Breaks.

Chiropractors in the NFL.

Cheerleading Accounts For More Than Half of ‘Catastrophic’ Injuries to Girl Athletes.

Cheerleading and Chiropractic – A Natural Choice!

Sport or Not, Cheerleading Has a Serious Side

Is cheerleading actually a sport?  At one level, the question is really only important because the technical definition (Is something a “sport” or just an “activity”?) determines whether or not athletic departments at federally funded educational institutions can count it for Title IX gender equality compliance purposes.  But—at another level—the question also matters for cheerleaders themselves and for the community that supports them.

Define a Sport

So what exactly makes something a sport?  According to the Women’s Sports Foundation, there are four criteria:

  • A physical activity which involves propelling a mass through space or overcoming the resistance of a mass
  • A contest or competition against or with an opponent
  • Is governed by rules which explicitly define the time, space and purpose of the contest and the conditions under which a winner is declared
  • The acknowledged primary purpose of the competition is a comparison of the relative skills of the participants

It’s this last requirement that currently keeps cheerleading off the list of recognized sports.  Simply put, the primary purpose of the vast majority of cheerleading programs is NOT to compete.  Most squads don’t enter any competitions at all.  This is true.  And for 28 years, the U.S. Department of Education’s Office of Civil Rights, which oversees Title IX compliance, warned schools not to include “drill teams, cheerleaders and the like” for the purposes of Title IX compliance.  But for all other practical intents and purposes, it’s pretty clear that modern cheerleading has come to resemble a sport.  In fact, there’s a growing movement to split “competitive cheerleading” programs from more traditional ones so that there’s an explicit distinction.

The Healthcare Perspective

Whether or not you believe cheerleading should be a “sport”, there’s no doubt that it’s physically demanding and that there are very real risks.  Participants perform routines that involve gymnastics or acrobatics or execute maneuvers that require them to support a lot of weight.  Performing well as a cheerleader requires excellent balance, strength and range of motion.  And it also requires a certain amount of courage.  The National Center for Catastrophic Sport Injury Research has found that “high school and college cheerleaders account for approximately two-thirds of the catastrophic injuries to female athletes.”

Over the past few years, both the American Academy of Pediatrics and the American Medical Association have adopted the policy position that cheerleading should be considered a sport because of both the athleticism it requires and the dangers it involves.  The healthcare establishment hopes that having cheerleading officially recognized as a sport will lead to more effective safety measures for the athletes and better training for coaches.

Cheerleading and Chiropractic Care

Chiropractic physicians have long recognized the demands that cheerleading places on the body, and chiropractic medicine continues to play an important role in keeping cheerleaders healthy and helping them recover from injuries.  Chiropractic has made such a difference in professional cheerleading that the Washington Redskins Cheerleaders joined the Foundation for Chiropractic Progress to let others know how much chiropractic care helps both their performance and their musculoskeletal health.

“People don’t view cheerleading as a competitive sport, but you have to try out every single year in this industry and it takes a large toll on your body.  Without chiropractic care I would not have made it past my first year. After receiving treatment, I began to notice the pain starting to subside as well as improvement in flexibility during performances.”

– Amanda Mitchell

“I’ve experienced multiple injuries during my career as a cheerleader—everything from pulled hamstrings to sprains and even lower back pain—setbacks that chiropractic care has always helped me recover from.”

– Chelsea Causey

Studies show that chiropractic is an effective tool to prevent and treat sports-related injuries.  One study published in the Journal of Manipulative and Physiological Therapeutics was performed by Dr. Jay Greenstein and colleagues on 43 professional football cheerleaders who underwent a season-long chiropractic hamstring intervention.  Hamstring and other lower body strains account for half of all cheerleading injuries. Greenstein notes that “After the season closed, we found that those who had reported hamstring injury-related pain between June and September showed a significant decrease in pain after receiving treatment.”

Dr. Alex Vidan, chiropractor to the St. Louis Rams cheerleaders says, “The benefits of chiropractic treatment are felt immediately.  Along with providing relief from pain, chiropractic also facilitates healing, which means there’s less downtime after an injury.”  He added, “The squad performs a lot more than people think, making special appearances, and there’s a lot of travel involved, all of which can take their toll physically.  The Rams cheerleaders, like many others, have found that chiropractic methods, which are gentle and noninvasive, offer relief and foster sound physical health.”

Understanding the Vicious Cycle of Injury, Inactivity, and Weight Gain

Acute or chronic pain leaves most people on the couch or in bed. Discomfort in the back, neck, hips, shoulders, and extremity joints can make even moderate activity difficult and strenuous activity (such as jogging, biking, or hiking) nearly impossible. If not addressed quickly, this inactivity can begin a vicious cycle that leads to obesity, ill health, and even death.

The Vicious Cycle of Injury, Inactivity, and Weight Gain

Recent research on obesity shows that inactivity plays a significant role in a person’s likelihood of being obese. Analysis of National Health and Nutrition Examination Surveys from 1988 through 2010 found that 52% of women reported a sedentary lifestyle in 2010 compared to 19% in 1988. There is a similar jump in men: in 2010, 43% reported no physical activity compared to 11% in 1988. These findings coincide with an obesity rate that doubled between 1980 and 2010.

There are many reasons for the recent decline in physical activity. Families are more likely to have two cars, which reduces the need for walking. Entertainment and shopping are easily accessible by computer. Appliances and power tools reduce physical work in the kitchen and home. Even obesity itself is a factor: a study published in the journal Mayo Clinic Proceedings shows that obese people engage in less than one minute of vigorous activity per day.

Injury complicates this picture. Chronic or acute pain makes physical activity difficult, leading patients to choose the couch over the treadmill. This inactivity can easily lead to weight gain. Now there are two obstacles to getting enough activity: the injury makes movement difficult, while excess weight forces the patient to work harder for every step he or she takes. Activity becomes even more difficult, leading the patient to remain sedentary, which leads to greater weight gain. Unless changes are made, it is unlikely that this pattern will resolve itself.

Breaking the Cycle

If chronic discomfort or injury is preventing you from engaging in the activity your body needs, a chiropractor can help you break free from the cycle of inactivity and weight gain. Your chiropractor will work with you to find the root cause of your discomfort. He can then perform chiropractic adjustments to correct misalignments and reduce or relieve your pain, putting you in a better position to comfortably begin exercising.

As a result of their training, most chiropractors take a holistic view of their patients’ health. This is why conversations about healthy lifestyle habits (not just about symptoms and treatment options) feature so prominently in our relationships with patients. Put simply, it is impossible to maintain or improve your health over the long run if your own day-to-day behaviors are working against you. Office visits just won’t be enough.  Good communication is a key part of any effective treatment plan. Talking candidly about your diet, exercise, sleep, work and stress management patterns helps us understand you as person—not just your symptoms. In return, you’ll receive advice that can help you better manage your overall health, including your weight. Between pain relief, rehabilitation and positive lifestyle changes, you will have the tools you need to exit the vicious cycle of injury, inactivity, and weight gain.

What are Muscle Cramps and How Can They Be Prevented?

Have you ever had a good night’s sleep interrupted by a stabbing pain through the calf of your leg? Have you ever been gripped by agonizing spasms in your lower back that threatened to knock you down? When a muscle tightens without you “telling it to” and just won’t relax despite your best efforts, you are suffering a muscle cramp. Most muscles in your body are what are called “voluntary” muscles. These can usually be contracted and relaxed in order to control your arms, legs, fingers, neck, posture and more. Even the simplest movements are a highly synchronized sequence of muscle contractions and relaxations.

A muscle—or even a few fibers of a muscle—that contracts without conscious control, is having a spasm. When such a muscle remains powerfully contracted for an extended period of time, it becomes a cramp and the muscle becomes visibly hardened.

A muscle cramp can involve part of a muscle, the entire muscle or a group of muscles. It can last anywhere from a few seconds to several minutes—and sometimes far longer. Some children can experience cramps, but it is more common with adults, especially as they age. Nearly everyone experiences a cramp at some time in their life.

All of the skeletal muscles that we use to move our body are subject to cramping. Perhaps the most frequent cramp is in the calf of the leg—what is commonly called a “charley horse.” So what causes these cramps?

Vigorous movement when the body is not used to such activity can result in muscle fatigue and cramping. You can reduce the risk of cramps by gently stretching the muscles before and after any activity to warm up and cool down. Also, build up to the activity slowly. Don’t go from zero to peak exertion right away. Let your muscles get used to the change in activity. Also, do your best to be consistent with your exercise regimen. On-again, off-again workouts can increase the risk of cramps. Remember—good exercise habits build flexibility, balance and coordination as well as stamina and strength. That don’t build flexibility as well as strength and, otherwise you might confuse your muscles, resulting in greater risk of cramps.

But exercise isn’t the only thing that can trigger a muscle cramp. What about those spasms that start while you’re asleep and wake you up in the middle of the night? If you tend to get cramps while you sleep, then try stretching your muscles before going to bed.

A chemical imbalance in your body can also result in cramps—especially if you’ve been under a lot of stress or not eating a healthy, balanced diet (or both). Your nervous and musculoskeletal systems rely on a combination of specific nutrients for muscle control. Vitamin B, plus calcium, magnesium and potassium can help restore the chemical balance within your body. Natural sources are always the best. Bananas, raw avocados and cooked spinach are great for extra potassium and other nutrients. Staying hydrated with electrolytes can help prevent or alleviate cramping. Some athletes even swear by drinking sour pickle juice for its minerals!

You should also be aware that a thyroid condition, diabetes or certain medications can also increase the risk of cramps. If you’re experiencing frequent or unusual muscle spasms that seem unrelated to exercise or diet (especially if you’re aware of other health problems or are taking prescription medications), you should consult your physicians about your symptoms.


Trampoline Safety: What Parents Should Know

From a health and safety point of view, the best advice we could give parents who are considering letting their kids use trampolines at home is “Don’t do it!”

Since 1977, the American Academy of Pediatrics (AAP) has strongly recommended against the use of home trampolines by children. In 2009, the last year for which complete data is available, nearly 100,000 people suffered injuries from trampoline use that required a visit to the Emergency Room.

The most compelling reason for not allowing trampoline use in your home is the risk of permanent neurological damage. One study found that 1 out of every 200 trampoline mishaps resulted in this type of injury.  While the overall odds of this happening are small, the effect on a child’s life is potentially devastating.

According to the National Electronic Injury Surveillance System (NEISS), 75% of all trampoline injuries occurred when there were two or more people on the trampoline at one time. NEISS data also show that 29% of trampoline injuries in kids 6–17 were dislocations or fractures. This percentage jumps to 48% in kids 5 and under. What this tells us is that the smaller kids are the most vulnerable.

If you do decide to allow your children to use a home trampoline, there are a few things you (and they) can do to help prevent some types of injuries.

  • Safety Net—ensure that your trampoline includes a safety net. The AAP has stated that safety nets have not improved injury statistics, but this could be because such netting is rarely installed or used properly.
  • Ground Level—if at all possible, install your trampoline at ground level. This will require digging a hole in which to set up the trampoline. This way, if the safety netting slips or fails, the person using the trampoline won’t have as far to fall.
  • One at a Time—never let more than one person on the trampoline at a time. Allowing multiple users only magnifies the risk and the energy with which users are catapulted upward.
  • Store—when the trampoline is not in use, disassemble it and place it in storage.
  • Repair—never use a trampoline that is ripped or damaged.
  • Padding—make sure the trampoline is properly padded, covering the springs and other hardware with a different color.
  • Center—always jump in the center of the trampoline for greatest control.
  • Simple Jumps—never attempt somersaults or other complex maneuvers. Such moves should only be attempted under the strict supervision of trained professionals and/or with special safety equipment to ensure maximum protection.
  • Supervision—children should be actively supervised by an adult at all times. This means that the adult responsible should not be distracted or doing something else. The trampoline user should have their entire attention and the adult should be able to control the user. In other words, if the user does not obey the commands of the adult, the trampoline session should end immediately.

As healthcare professionals, our primary message here is a very simple one—and it bears repeating. When it comes to home trampoline use, the best thing you can do for your child’s safety is to wait until they are older before allowing it. The risks far outweigh the benefits.


Youth Sports: Are Single-Sport Child Athletes Really More Likely to Succeed Later?

Especially if they’re athletes or sports fans themselves, it’s not unusual for mothers and fathers to have secret (or not-so-secret) hopes that their kids can become good enough in a sport to earn a college scholarship or go on to a professional career. Some parents believe that the best way to work toward this goal is to encourage their children—sometimes as young as 6 or 7 years old—to focus on a single sport as early as possible. The reasoning behind this early specialization is pretty simple: Kids who are not splitting their time among multiple sports will get better, faster (and be more competitive) than their “distracted” peers. In other words, the children who commit early get a developmental head start that will make them high-performers later.

While this idea may make intuitive sense, a new study from the University of California, Los Angeles (which has a reputation as a major power in collegiate athletics) suggests that the logic simply doesn’t hold true. In a study presented at the annual meeting of the American Medical Society for Sports Medicine (AMSSM) in San Diego, Dr. John DiFiori, chief of sports medicine at UCLA’s School of Medicine, says that researchers can find no evidence that athletes who focused early on a single sport rose to elite levels in that sport.

To the contrary, most of the collegiate athletes surveyed were more like their peers, kids who enjoyed a wide range of recreational sports growing up, waiting until well into their teens before specializing on one sport. As DiFiori says, “Most successful athletes participate in a number of sports when they’re 6, 8 or 10 years old. That way, kids learn different skills and have the chance to discover which sport they truly enjoy.”

The study surveyed 296 male and female NCAA Division I athletes and found that 88% of them had participated in an average of two or three sports as children. In addition, 70% of them did not specialize in any one sport until after the age of 12. In a similar study on Olympic athletes, researchers found that most had participated in two or more sports before specializing.

While there are famous athletes like Tiger Woods or Andre Agassi who focused on one sport early in their lives, the research suggests that they are the exception and not the rule. The vast majority of successful collegiate or pro athletes dabbled in a number of other sports before settling on the one that brought them success. The data seems to indicate that early specialization may not help and may, in fact, be detrimental. Previous research has indicated, for example, that kids who train extensively in one sport are more prone to overuse injuries than kids who had more varied athletic experience, and played other sports as well. There’s also a greater risk of premature disengagement or “burn-out” that can come with focusing exclusively on one activity.

Based on this research, Dr. DiFiori feels that parents of kids who seem talented in one sport at an early age should allow and encourage them to play other sports. They may, after all, discover another sport that they enjoy more and are even better at. And—even if they do not—they will be exposed to sports that train them in a wider variety of motor skills. “Physical activity contributes to a happy and healthy childhood,” says Dr. DiFiori, “however, parents, coaches and children should monitor and measure their involvement level in a singular sport against the overall well-being and future success of the participant.”