Helping Children Play Safely in Sports
By JANE E. BRODY
Polly Becker 
In an article published last month in The New York Times, the sportswriter Bill Pennington noted that although much attention is now focused on concussions, there are more deadly hazards — sudden cardiac arrest and heat stroke — that active children, parents and coaches should know about and do more to prevent. Less serious but often debilitating injuries can usually be avoided by attending to guidelines developed by organizations like the National Athletic Trainers’ Association, the National Alliance for Youth Sports and the Youth Sports Safety Alliance.
Children should not have to pay a painful, and sometimes deadly, price for doing what is good for them. The risks can be minimized when young athletes have proper equipment, a safe environment in which to play, and access to health care professionals who know when and how to intervene.
Whether your child plays organized sports like soccer, football or basketball, or participates in cheerleading or marching band, the advice that follows can help prevent potentially serious injuries. Much of it is based on safety tips issued last month by the athletic trainers’ association.
Prepare Your Child
Never push children into a sport they do not want to do. Children should be physically and psychologically ready to participate.
A pre-participation exam by a physician who understands the possible risks is vital to avoiding them. Ideally, it should include an EKG to uncover heart defects that can cause sudden cardiac death during vigorous activity. When completing a participation form, be completely honest: Share the child’s full medical history.
Encourage your child to speak up if symptoms or injuries occur during or after a sports event. Especially important are the signs of a concussion, like dizziness, memory loss, difficulty with balance or undue fatigue. Children should not go back into the game until all symptoms are fully resolved, and then only gradually increase participation.
Check the Coach’s Qualifications
Most league sports rely on volunteer coaches. They should be well versed in the sport and able to place the health and well-being of players above the desire to win. Putting an injured star back in the game too soon is a recipe for long-lasting injury.
Coaches, or someone present at all practices and games, should have training in basic first aid and cardiopulmonary resuscitation, and know how to use an automated external defibrillator (A.E.D.).
The athletic trainers’ association has produced an online course on sports safety for coaches, available for $19.95 on its Web site. Parents may insist that their children’s coach complete it.
Quiz the coach about his philosophy and ability to support young players. Every child on a team, regardless of ability, should be given a chance to play. Children should be praised for trying hard, whether or not they succeed on the field, and no child should be publicly or privately berated for making a mistake. Rather, mistakes should be parlayed into learning experiences.
Ensure Proper Equipment
Make sure your child has and uses whatever protective equipment is recommended for the sport, including shin guards for very young children who play soccer.
Check the playing surface and equipment for safety hazards, including field goals, basketball flooring, gymnastics equipment and field turf. Find out if there is an A.E.D. nearby at all practices and games, and if someone who has been trained in its use is readily available. An A.E.D. can save the life of a child in sudden cardiac arrest if the first shock is administered within a few minutes of collapse.
Be sure to complete an emergency medical authorization form, available from the school or league, and provide parent contact information and permission for emergency medical care should your child need it. And check whether the team has a written emergency action plan, with individual assignments and needed equipment and supplies on hand.
Be Wary of Heat and Humidity
Olympic athletes know the importance of acclimatization before a meet. You and your child should, too. A child who has been in an air-conditioned environment most of the time may adapt poorly to outdoor exercise when temperatures and humidity soar. Heat stroke can occur suddenly, and it can be fatal.
Different bodies adjust to heat at different rates. Know your child’s tolerance. For most, heat tolerance during vigorous exercise should be developed gradually over a period of about two weeks.
Both before and during practices and games, adequate fluid intake — water and diluted sports drinks — is vital to prevent heat-induced illness. Caffeinated beverages (and caffeine pills and gums) should be avoided.
If the child’s core temperature rises and heat illness develops, cooling must be started immediately, even before medical help is summoned. The child should be immersed in cold water (applying cold towels or ammonia is not adequate), which means that a tub filled with water and ice should be readily available at the event site.
Know the Risks of Overuse
Gone are the days in which young athletes were encouraged to excel in several sports. The current emphasis on developing skill in just one or two sports can result in overuse injuries. Young pitchers are especially at risk, but any child who plays too long and hard too often may be headed for trouble.
The number and duration of organized practices and games should be based on a child’s age. According to the alliance for youth sports, for children up to age 8, these should be held for no more than one hour, three days a week; for those 9 to 12, a maximum of one and a half hours, four days a week; and for those 13 and older, not more than two hours, four days a week.
The days in between (and between seasons) should be used for rest and recovery, according to Larry Cooper, chairman of the trainers’ association’s secondary school committee.
Be a Supportive Parent
Parents should encourage children to do their best, emphasizing the importance of playing fair and having fun, not winning. Attend games whenever possible, and find nice things to say about a young athlete’s performance or behavior. If any health or safety concerns arise, let the coach or team manager know.