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Am Fam Physician. 2007;75(11):1620

Author disclosure: Nothing to disclose.

to the editor: It was refreshing to read the review article, “Prevention of Unintentional Childhood Injuries,” in the December 1, 2006, issue of American Family Physician.1 However, youth sports injuries, an important area of preventable, unintentional injuries, was overlooked by the authors.

It is currently estimated that at least 30 million American youths participate in some sort of athletic activity.2 This equates to roughly one half of all children five to 18 years of age.3 More than one third of these young participants sustain an injury that is significant enough to be evaluated by a medical professional. The peak sports-related injury rate occurs in children five to 14 years of age, accounting for more than 750,000 annual visits to the emergency department.4 The absolute number of injuries, however, is believed to be much higher because many young athletes do not seek medical attention. Although many childhood sporting injuries are of limited long-term significance, others (such as eye injuries, concussions, anterior cruciate ligament tears) can have significant long-term sequelae. Sports-related injuries, therefore, are a significant cause of morbidity that all physicians who care for adolescents or children will commonly encounter in their practices.

Sports and athletics are an inextricable component of modern American society, and increasing athletic participation is a key focus in the fight against the growing epidemic of childhood and adolescent obesity. However, the push to participate and the pressure to succeed undoubtedly lead to many otherwise preventable injuries in children. Additionally, relatively few scientific data exist on effective ways to promote safe participation and prevent injury in youth sports. With this in mind, we support the following principles to govern participation in youth sports and help prevent unnecessary injury:5,6

  • Children should always participate in athletics at a level that is commensurate with their skill and ability.

  • Organized sporting activities should always have adequate supervision.

  • Organized sporting activities should always provide participants with the proper protective equipment.

  • Training programs for young athletes should always proceed at the proper intensity to avoid overuse injuries.

  • Funding and priority should be increased for research into equipment modifications and training program enhancements that will decrease sports injuries in young athletes.

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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