At Baptist Children’s Hospital Emergency Center, my colleagues and I see a lot of children and teens with sports injuries. Every day, in fact. The most common injuries involve soft tissues, such as sprains and strains and contusions, often involving the foot, ankle or knee. Contusions are essentially bruises. Sprains involve the stretching or tearing of a ligament, and strains involve stretching or tearing of muscle and tendons.
Small children usually don’t get sprains because their ligaments are stronger than their bones, which still have open growth plates. We are more likely to assume a small fracture, and order an X-ray, when we see swelling and bruising in the ankle or wrist of a pre-adolescent. Once the child has reached puberty and the growth plates have closed, sprains are more common joint injuries.
When does a sports or other injury warrant a trip to the Emergency Department? Here are some guidelines:
• Head injury or concussion. If your child hits her head and loses consciousness, she needs to be evaluated in the hospital. Other signs of concussion are confusion, nausea, head pain, and blurry vision.
• Likely bone fractures. If there is a deformity at the joint, the bone is probably fractured and your child needs immediate care. If there is a loss of function, such as an inability to move the injured joint, or if your child can’t bear weight on the injury, those are signs to take him to the Emergency Department. If the injured extremity looks pale or bluish, is numb or tingling, bring your child to the ER. About a quarter of the injuries we see are fractures, often of the wrist or clavicle (collar bone). Many are minor fractures that don’t require resetting. We refer families to an orthopedic specialist after stabilizing the injury.
• Pain. Pain is a warning sign for the body. If your child is old enough to say his or her pain is a 7 or more on a scale of 1 to 10, that warrants a trip to the ER.
• Swelling. If there is massive swelling anywhere, your child needs immediate attention.
• Change in behavior. If you as the parent sense something is not right with your child, trust your instinct. I always listen closely when parents tell me they know something is wrong, even if it’s not obvious to the physicians. Parents are the ones who know their children the best.
Tony Tavarez, M.D.
Associate Medical Director
Baptist Children’s Hospital Emergency Center