ACCIDENTAL, NOT-PREVENTABLE SPORT, RECREATION AND EXERCISE INJURIES

Human beings take risks while doing life normally. Living requires mental and body actions and Accidents happen. For Example: driving a car, sawing, hammering, delivering the mail, flying an airplane, sailing a boat etc.

“Participation in Sports, Recreation, and Exercise (SRE) is increasingly popular and widespread in American culture.

Recent reports estimate millions emergency department visits occur each year for injuries related to participation in sports and recreation.” [12.]

Everyone knows SRE accidents happen, while playing by the rules of the game, in safe SRE environments, with proper athlete protection, coaching supervision and conduct.

Serious Injuries and Deaths that occur during blameless circumstances are Inherent and Natural to the game that athletes play.

These incidents are called Accidental and Not-Preventable.

For example, an aggressive clean football tackle that fractures an arm is an Accident and Not Preventable.

50% of Sport, Recreation and Exercise (SRE) injuries are Accidental, Not Preventable injuries. Unfortunately, 50% of SRE injuries are Preventable, Not-Accidental. [CDC] This report is not about the latter, which can be read elsewhere on this website, but about the former.

When Child Amateur Athletes sign-up to play SRE, the children and parents accept that there are potential accidental injuries, which are part of the game they play. However, in contrast, they don’t sign up for maltreatment, endangerment, improper supervision, human rights violations and sexual abuse.

“To optimize the safety and benefits of organized sports for children and preadolescents and to preserve this valuable opportunity for young people to increase their physical activity levels, the American Academy of Pediatrics recommends the following:

1.Organized sports programs for preadolescents should complement, not replace, the regular physical activity that is a part of free play, child-organized games, recreational sports, and physical education programs in the schools. Regular physical activity should be encouraged for all children whether they participate in organized sports or not.
2.Pediatricians are encouraged to help assess developmental readiness and medical suitability for children and preadolescents to participate in organized sports and assist in matching a child’s physical, social, and cognitive maturity with appropriate sports activities.
3.Pediatricians can take an active role in youth sports organizations by educating coaches about developmental and safety issues, monitoring the health and safety of children involved in organized sports, and advising committees on rules and safety.
4.Pediatricians are encouraged to take an active role in identifying and preserving goals of sports that best serve young athletes.” [Committee on Sports Medicine and Fitness, 2000-2001, Reginald L. Washington, MD, Chairperson, PEDIATRICS Vol. 107 No. 6 June 2001, pp. 1459-1462, AMERICAN ACADEMY OF PEDIATRICS: Organized Sports for Children and Preadolescents, Committee on Sports Medicine and Fitness and Committee on School Health]

Balance, moderation, time management, appropriate parental support and proper Child Custodial Protection and Coaching Supervision and Athlete Safety First are necessary for Athlete-Centered Sports and Athlete Rights. [The Negative Effects of Youth Sports, Livestrong.com, Steve Silverman]

• “More than 7.7 million high school athletes participated in school sports during the 2012-2013 academic year.
• In total, approximately 46.5 million children play team Sports each year in the U.S.” [National Sporting Goods Association. 2011 vs 2001 Youth Sports Participation, NSGA. http://www.nsga.org/files/public/2011vs2001_Youth_Participation_website.pdf]
•”More than 1.35 million Children Athletes were seen in an emergency department (ED) for sports-related injury in 2012 or 1.35 million/year.
•” If each ED visit was by a different Child Athlete, that is equivalent to 1.35 million children / per year divided by / 46.5 million total Child Athletes participating in team Sports
• Which = 0.0290 Child Athletes are injured requiring ED examination and treatment each year
• or 2.9% Child Athlete injuries requiring emergency department examination and treatment / year [Ferguson RW. Safe Kids Worldwide Analysis of Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System (NEISS) data, 2013]
• The dark-side is that 50% of those 2.9% Child Athletes injuries are caused or allowed to be caused directly or indirectly from physical and emotional maltreatment, endangerment, sexual abuse,
• Secondary to inadequate coaching and improper conduct, incorrect instruction, inappropriate supervision, negligence and/or human rights violations.
• The dark-side, the Not-Accidental, Preventable Children Athlete injuries, caused or allowed to be caused by the above, requiring ED examination and treatment each year is equivalent to 1.45%.
• Those injures will never be totally eliminated in the near future, but can be controlled and reduced.

The enormous benefits of 46.5 million Child Athletes participating in SRE, while playing by the rules of the game, in safe SRE environments, with proper Athlete protection, coaching supervision and conduct, far outweighs the downsides of 1.45% Accidental, Not-Preventable Child Athlete injuries, comparatively speaking.

Reducing the 1.45% dark-side, which tarnishes the name and wonderful benefits of Child Athletes participation in SRE, will help reduce medical and insurance costs and potential criminal risks for teachers, coaches, supervisors and parents, who manifest abnormal coaching and supervision behaviors. The dark-side of SRE negatively impacts SRE, Athletes and the entire SRE community. Preventable injuries and deaths and Risk Assessment count.

“Mahoney suggested that participation in voluntary, school-based, extracurricular activities increases school participation and achievement because it facilitates:
(a) the acquisition of interpersonal skills and positive social norms
(b) membership in pro-social peer groups.
(c) stronger emotional and social connections to one’s school.

“In turn, these assets should increase mental health, school engagement, school achievement, and long-term educational outcomes and should decrease participation in problem behaviors, provided that problem behaviors are not endorsed by the peer cultures that emerge in these activities.” [Mahoney et al]

“Participation in extracurricular and service learning activities has also been linked to increases in interpersonal competence, self-concept, high school grade point average (GPA), school engagement, and educational aspirations” [Elder & Conger, 2000; Marsh & Kleitman, 2002; Youniss, McLellan, & Yates, 1999], as well as to higher educational achievement, better job quality, more active participation in the political process and other types of volunteer activities, continued sport engagement, and better mental health during young adulthood [Barber, Eccles, & Stone, 2001; Glancy, Willits, & Farrell, 1986; Marsh, 1992; Youniss, McLellan, Su, & Yates, 1999].

“Sports participation has been linked to lower likelihood of school dropout and higher rates of college attendance, particularly for low achieving and blue-collar male athletes (Gould & Weiss, 1987; Marsh & Kleitman, 2003; McNeal, 1995).

These studies provide good evidence that participating in extracurricular activities is associated with both short and long term indicators of positive development including school achievement and educational attainment. [Extracurricular activities and adolescent development. Journal of Social Issues, December 22, 2003, Eccles, Jacquelynne S.; Barber, Bonnie L.; Stone, Margaret; Hunt, James]

“How young people spend their time outside of school has consequences for their development.” Organized extracurricular activities, after-school programs, and youth organization have significantly escalated. Research reveals positive outcomes “of participation for academic, educational, social, civic, and physical development”. Combining this with the potential for safety and supervision provided by organized activities while parents are working has increased local, state, and Federal authorities to increase these opportunities.

“(1) The primary motivations for participation in organized activities are intrinsic (e.g., excitement and enjoyment, to build competencies, and to affiliate with peers and activity leaders). Pressures from adults or educational/career goals are seldom given as reasons for participation;”
“(2) American youth average about 5 hours/week participating in organized activities. At any given time, roughly 40% of young people in the US do not participate in organized activities and those who do typically spend less than 10 hours/week participating. Many alternative leisure activities (e.g., educational activities, playing games, watching television) consume as much or considerably more time. However, a very small subgroup of youth (between 3 and 6 percent) spends 20 or more hours/week participating;”
(3) “Youth who participate demonstrate healthier functioning on such indicators ranging from academic achievement, school completion, post-secondary educational attainment, psychological adjustment, and lowered rates of smoking and drug use, to the quantity and quality of interactions with their parents.
(4) Very high levels of involvement in organized activity participation (e.g., 20 or more hours/week), adjustment appeared more positive than, than youth who did not participate.

Participation is associated with positive developmental outcomes for most youth. “The well-being of youth who do not participate in organized activities is reliably less positive compared to youth who do participate.”[Organized Activity Participation, Positive Youth Development, and the Over-Scheduling Hypothesis, Joseph L. Mahoney, Angel L. Harris, and Jacquelynne S. Eccles, Volume XX, Number IV, Social Policy Report, 2006]

CLASSIFCATION OF ACCIDENTAL, NOT-PREVENTABLE SPORT, RECREATION AND EXERCISE INJURIES

“Traumatic injuries account for most injuries in contact sports such as ice hockey, association football, rugby league, rugby union, Australian rules football, Gaelic football and American and Canadian football because of the dynamic and high collision nature of these sports.

“Collisions with the ground, objects, and other players are common, and unexpected dynamic forces on limbs and joints can cause sports injuries. Traumatic injuries can include:

•Contusion or bruise
•Strain
•Sprain
•Wound – abrasion or puncture of the skin
•Bone fracture
•Head injury – concussions or serious brain damage
•Spinal cord injury – damage to the central nervous system or spine
•Cramp – a strong muscle contraction
•Concussion
•Fatal Spontaneous Brain hemorrhage from congenital or acquired blood vessel weakness / aneurysm during participation might accidently occur with light contact or exertion. These catastrophic injuries occur spontaneously during sedentary and SRE activities and cannot be predicted. No teacher, coach, supervisor, parent or other child caretaker can be blamed for aneurysm rupture.

“Subarachnoid hemorrhage (SAH) is usually the result of bleeding from a berry aneurysm in the Circle of Willis. These are called berry aneurysms because of their shape. They were once thought to be mostly congenital but it is now thought that the etiology may involve susceptibility of the elastic lamina, in some patients, to stressors such as hypertension and atherosclerosis.

“Subarachnoid Hemorrhage (SAH) Epidemiology
•SAH affects 6-9 people per 100,000 of the population per year and constitutes about 6% of first strokes.
•Approximately 85% of patients bleed from intracranial arterial aneurysms, 10% from a non-aneurysmal peri-mesencephalic hemorrhage and 5% from other vascular abnormalities including arteriovenous malformation, vasculitis and abnormal blood vessels associated with tumor.
•SAH represents only 6% of cases of vascular accidents and strokes but it is relatively far more important, as it tends to affect younger people, of whom about half die in that episode.
•The mean age is 50 years: most patients are under 60 years.
•Women have a higher risk than men: relative risk 1.6.
•Patients of Afro-Caribbean descent have a higher risk than white Europeans: relative risk 2.1:1 ” [Subarachnoid Hemorrhage, Patient Platform]

SRE protective equipment should be standard and supplied to each Athlete: helmet, mouth guard, goggles, pads, shoes etc.

Weather conditions, gym floors and fields, training should be safe. Athletes should warm-up, not over-training or become fatigued and injuries allowed time to heal prior to returning to participation. 5. 6.

Pre-participation physical and medical examination are extremely important to limit the risks of injury, to diagnose early onsets of a possible injury and to rule-out conditions that might become exacerbated and lead to Athlete severe injuries and even deaths. 7.

“The objective of a preseason screening is to clear the athlete for participation and verify that there is no sign of injury or illness, which would represent a potential medical risk to the athlete (and risk of liability to the sports organization).” 3.

Sufficient water and nutrition can aid in injury prevention and rehabilitation. 8.

There are approximately 8,000 children treated in emergency rooms each day for sports-related injures. 13.

According to the Centers for Disease Control and Prevention (CDC), many sports-related injuries are predictable and preventable. The CDC says 50% of Child Athlete SRE injuries are Not-Accidental and Preventable. Reducing and controlling this category of Child Athlete Injuries are necessary for sustainability of SRE activities. 15.

All SRE teams must have a 911 Emergency Action Plan in case of emergency.

Kids need to have breaks and drink water as well to keep them hydrated.

The teacher, coach, supervisor, parent or other child caretaker should know certain first aid treatment on injuries to apply when there’s an unforeseen accident.

All severely injured Athletes must be examined by a qualified Doctor.
“8 of 13 major sports many injuries acquired during competition require at least 7 days recovery before returning to SRE. More females are injured during practice than in competition. 16

This report not about Preventable, Not-Accidental injuries, which result from not playing by the rules of the game, participating in unsafe SRE environments, with improper athlete protection, poor supervision and unethical conduct, when a teacher, coach, supervisor, parent or other child caretaker, cause or allow to be caused, directly or indirectly Athlete injuries. These Preventable, Not-Accidental injuries are reported elsewhere on this website.

References:
1.”Sports Injury Statistics”. Children’s Hospital of Wisconsin. Retrieved 28 March 2016.
2.Herring, Stanley A.; Akuthota, Venu (2009). Nerve and Vascular Injuries in Sports Medicine. London; New York: Springer. ISBN 978-0-387-76599-0. Retrieved 28 March 2016.
3.Bager, Roald; Engebretsen, Lars (2009). Sports Injury Prevention. Chichester, UK; Hoboken, NJ: Wiley-Blackwell. ISBN 978-1-4051-6244-9. Retrieved 28 March 2016.
4.O’Connor, John William (2010). “Emotional Trauma in Athletic Injury and the Relationship Among Coping Skills, Injury Severity, and Post Traumatic Stress”. ProQuest Dissertations Publishing. Retrieved 28 March 2016.
5.Korkmaz, Murat (2014). “Financial Dimension of sports injuries”. European Journal of Experimental Biology. 4: 38–46.
6.’Intrinsic and Extrinsic Risk Factors for Anterior Cruciate Ligament Injury in Australian Footballers’ by John Orchard, Hugh Seward, Jeanne McGivern and Simon Hood
7.”Epidemiology of Collegiate Injuries for 15 Sports
8.”Nutrition and the Injured Athlete”. NCAA. Retrieved 24 April 2016.
9.Rowland, Thomas (2012). “Iron Deficiency in Athletes”. American Journal of Lifestyle Medicine. SAGE Publications. Retrieved 24 April 2016.
10.Cook, Gray; Burton, Lee (2006). “Pre-Participation Screening: The Use of Fundamental Movements as an Assessment of Function – Part 1”. North American Journal Of Sports Physical Therapy. 1: 62–72.
11.Cook, Gray; Burton, Lee (2006). “The Functional Movement Screen” (PDF). Retrieved 24 April 2016.
12.Beardsley, Chris; Contreras, Bret (2014). “The Functional Movement Screen”. Strength and Conditioning Journal. ISSN 1524-1602. Retrieved 25 April 2016.
13.’Statistics on Youth Sports Safety by SWATA’
14.’1.35 million youths a year have serious sports injuries’ by USA Today
15.Legislator’s Page by At Your Own Risk Retrieved 8 Nov 2016
16.Kerr, Zachary Y, PhD; Marshall, Stephen W, PhD; Dompier, Thomas P, PhD; Corlette, Jill, MS; Klossner, David A, PhD; et al. MMWR. Morbidity and Mortality Weekly Report; Atlanta 64.48. (Dec 11, 2015).
17.Haider, Adil H.; Saleem, Taimur; Bilaniuk, Jaroslaw W.; Barraco, Robert D. (Nov 2012). “An evidence-based review”. Journal of Trauma and Acute Care Surgery. 73 (5): 1340–1347.
18.Öztürk, Selcen. “What is the economic burden of sports injuries?” (PDF). Joint Diseases and Related Surgery. 24 (2): 108–111. doi:10.5606/ehc.2013.24.
19.Smith, A.M.; Nippert, A.H. (2008). “Psychologic Stress Related to Injury and Impact on Sport Performance”. Department of Kinesiology and Health Sciences. Concordia University- St. Paul, MN. 19: 399–418, x. PMID 18395654. doi:10.1016/j.pmr.2007.12.003.

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