Ask the Experts:
Sports Medicine
Sports-Related Injuries
in Nonathletic Children
Cordelia W. Carter, MD; and Lyle J. Micheli, MD
Cordelia W. Carter, MD, is a Clinical Assistant
Professor, Department of Orthopedics, Seattle
Children’s Hospital. She completed a fellowship in
pediatric orthopaedic surgery at Children’s Hospital Los Angeles in 2010, followed by another fellowship in pediatric sports medicine at Children’s
Hospital Boston in 2011. She can be contacted at
Seattle Children’s Hospital, 4800 Sand Point Way
NE, Seattle, WA 98105; email: cordelia.carter@
seattlechildrens.org.
Lyle J. Micheli, MD, is the Director, Division of
Sports Medicine, Boston Children’s Hospital; and
Clinical Professor of Orthopaedic Surgery, Harvard
Medical School. He is the past President of the
American College of Sports Medicine and is currently the Secretary General of the International
Federation of Sports Medicine. He can be contacted at Boston’s Children Hospital, 319 Longwood
Avenue, Boston, MA 02115; email: l.micheli62@
gmail.com
Disclosure: The authors have no relevant
financial relationships to disclose.
doi: 10.3928/00904481-20121221-03
8 | Healio.com/Pediatrics
Q: ARE KIDS WHO ARE LESS
PHYSICALLY ACTIVE OR
OVERWEIGHT AT INCREASED
RISK FOR SPORTS-RELATED
INJURIES?
A. Yes. Last month we reviewed how
pediatricians can explain to parents the
benefits of physical activity for kids,
beyond weight control. This month we
thought it would be important to follow
up with advice on addressing parents’
concerns for when their typically inactive children get involved in sports by
dealing with this important question.
Early data in support of a relationship between poor physical fitness and
activity-related injury came from investigation of army trainees: a history
of inactivity, higher body mass index
(BMI), and low aerobic fitness were all
believed to contribute to physical training-related injuries in this population.1
In fact, there are good data demonstrating that youth with increased
BMIs have a significantly higher risk
of sustaining a sports-related injury
then their normal-weight peers. In a
review of the available literature on
obesity and injury, McHugh reported
that in 11 of the 13 studies included in
his analysis, a higher BMI and/or high
percentage of body fat were associated
with an increased risk of sports-related
injury.2 The reported increases in injury risk ranged from 1.4 to 3.9 times the
risk identified for the normal-weight
control groups.
The most common injuries reported
in the overweight/poorly conditioned
athletes were ankle sprains, tears of the
medial collateral ligament of the knee,
and dental injuries. Proposed mechanisms for an increased sports-related
injury rate in overweight and obese
children include: poor postural control
(leading to problems with balance and
coordination); poor physical fitness
(associated with early muscle fatigue
and subsequent injury); and low preparticipation physical activity levels
(associated with impaired or delayed
neuromuscular and motor learning).2
Overweight or poorly conditioned
children do seem to have an increased
risk for sports-related injuries than
their normal-weight peers.
REFERENCES
1. Jones BH, Bovee MW, Harris J, et al. Intrinsic risk factors for exercise-related injuries
among male and female army trainees. Am J
Sports Med. 1993;21(5):705-710.
2.McHugh MP. Oversized young athletes:
a weighty concern. Br J Sports Med.
2010;44:45-49.
PEDIATRIC ANNALS 42:1 | JANUARY 2013