By Frank S. Chen, M.D.

In today’s competitive world, many children want to excel at sports - and many parents encourage them.

The benefits of moderate exercise include a reduced chance of obesity, an early start toward maintaining a healthy lifestyle and the opportunity to build important social skills. However, intense training and competition among young athletes can cause serious physical damage.

Children’s skeletal structures and soft tissues are immature and weaker than those of adults, putting them at higher risk for acute and chronic injuries. In some cases, the child’s “growth plate” may be injured. This is the area of developing tissue at the ends of long bones around joints at the shoulders, elbows, wrists, fingers, hips, knees, ankles and feet that is replaced by solid bone during adolescence.

The most common acute injuries are sprains and strains. A sprain involves stretching or tearing of a ligament, while a strain is an injury to a muscle or tendon. Chronic repetitive motion injuries result from cumulative stresses and can involve both bony and soft-tissue structures. Growth plates are commonly injured when the attached ligaments or tendons continually stress the bone, leading to inflammation and sometimes even stress-type fractures. Inflammation of the tendons, or tendonitis, can also result from overuse.

Children and adolescents participating in sports that involve a repetitive overhead motion such as throwing a baseball, swimming or playing racquetball are susceptible to a broad spectrum of shoulder and elbow injuries, most of which can be prevented with proper conditioning and awareness.

To help their children avoid injury, parents should become educated about which sports are most likely to cause injury. They should also make sure their children use the proper protective gear, that the sports area is well-maintained and safe and that their children perform the right warm-up exercises, such as stretching and conditioning, to minimize the chance of muscle strain or other soft-tissue injuries during sports.

In general, injuries respond well to non-surgical treatment as long as the treatment begins soon after the symptoms occur. Treatments generally include rest and physical therapy, and doctors also provide education about how to prevent the injury from recurring. For example, if a child plays baseball the doctor may provide instruction on proper throwing mechanics and the maximum number of pitches per game to ensure that the injury does not return.

If a child suffers a sprain, strain or bone injury, the best immediate treatment is RICE - rest, ice, compression and elevation. Parents should seek professional treatment for any severe injury, such as a fracture or dislocated joint or severe swelling or pain. Surgery is an option for more serious injuries that do not respond to modified activity and physical therapy.

Increased fitness and enhanced social skills are benefits of sports, but overdoing it can lead to injury. Parents should educate themselves about ways to prevent injuries and seek immediate medical assistance for any serious injury to avoid long-term problems.

Dr. Frank Chen is an attending physician in the Sports Medicine Department at the Palo Alto Medical Foundation.