Image: Soccer cleats
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Your little soccer star may experience leg pain if she doesn't take the proper exercise precautions. Warm-up or cool-down laps in running shoes, which are much gentler on the body than soccer cleats.
updated 5/25/2009 12:29:12 PM ET 2009-05-25T16:29:12

Accidents happen — and in the summer, the risk jumps. A lot.

Emergency rooms report 18 percent more traffic in May through August, when children are outside running, kicking, riding, and swimming. So America's top ER and pediatric doctors want to give you advice about what lands kids in the hospital — and how you can help them avoid the trip.

Tune up old bikes
A dusty old bike may up your kid's accident risk.

Young cyclists — along with inline skaters and skateboarders — should always wear helmets, period. "But it's not just head injuries that send kids to our doorstep," says Barbara Gaines, MD, surgical director of the pediatric ICU at Children's Hospital of Pittsburgh. "We see a lot of abdominal injuries that occur when bikers stop short and fly into the handlebars. And if the protective foam covering has worn off the handles, exposed metal edges can cut into skin." At the beginning of each summer, give family bikes a good once-over. Make sure the brakes work, and look for worn parts.

Know the signs of concussion
Between 1.8 and 3.8 million sports-related concussions go undiagnosed every year in the United States, reports the CDC.

Although treatment usually involves only a few days of rest, more serious damage can result if a child suffers a concussion and then reinjures his head before it heals — and this can lead to permanent problems with coordination, speech, and even memory.

If your child receives a blow to the head, watch for concussion symptoms: confusion, memory loss, headache, dizziness, ringing in the ears, slurred speech, nausea, or vomiting. Some can be subtle, so if there's any doubt, play it safe: Take him out of the game, and call his doctor. "Contrary to what people think, you don't always lose consciousness, and often there's no bump or visible sign," explains Shannon. Finally, don't be fooled if your child insists that he feels fine — pain isn't a good guide in this case, since his motivation to get back in the game may make him downplay his symptoms.

Make your kids drink
They should guzzle water at least every half hour to prevent dehydration.

"Kids will play outside until they drop, so you need to be sure they stay hydrated in order to prevent heatstroke and exhaustion," says Gaines. Even thirsty children need nudging: They tend to relax and socialize during game breaks rather than refuel with water, found University of Connecticut researchers who studied the habits of kids at sports camp.

If you're supervising an activity, call a time-out every 20 to 30 minutes, and encourage players to drink up at least 4 to 5 ounces each time. "If you're not there to enforce the rule, pack water bottles and remind kids to sip and refill frequently," says Gaines.

Always designate a lifeguard
Even if your kid's the next Michael Phelps, don't assume he's safe alone in the pool.

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"One misconception I've seen is parents' belief that once their child is 6 to 8 years old, they can reduce their vigilance at the pool," says Michael Shannon, MD, emergency medicine chief at Children's Hospital Boston. "But even if they've been swimming for years, young children can tire suddenly — to the point where they can't make it to the pool's edge." And don't think it's okay to simply keep an ear tuned in to pool activity, warns Gaines: "People think that a child who falls into the water will splash and make a lot of noise, but the truth is that drowning tends to be silent."

Choose the right shoes
Your little soccer star may experience leg pain if she doesn't take the proper exercise precautions.

If your child wears her cleats during team workouts or for extended runs, the stiff soles and poor support may cause kneecap pain or shin splits, says Rebecca Demorest, MD, an assistant attending physician at the Hospital for Special Surgery and assistant professor of pediatrics at Weill Cornell Medical College in New York City. Make sure kids do warm-up or cool-down laps in running shoes, which are much gentler on the body. And tell them to test the ground before a game; in late summer (depending on where you live), it's often hard and dry enough that cleats aren't necessary.

Have young athletes cross-train
Even with proper footwear, child athletes who pound the same pavement every day can quickly develop repetitive-motion injuries.

Watch for signs of soreness or inflammation lasting more than a day. "If kids want to exercise daily, make sure they mix things up," says Ted Ganley, MD, orthopaedic director of the Sports Medicine and Performance Center at Children's Hospital of Philadelphia. "If basketball is their preferred sport, reserve 2 days a week for activities like swimming or biking, which don't put all their weight on their legs."

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