Participants in youth sports and recreational activities number in the millions across the country. Every field, court and gym in every city throughout America is filled with kids playing a variety of sports, year round. But what do we really know about this population from a health care standpoint? And how can we effectively develop programs that address their needs, promote injury prevention and management as well as attract them to a wellness-based fitness facility?


Youth Sports Injuries

            It's an undeniable fact athletic kids are susceptible to injuries. Every year, more than 3.5 million children, ages 14 and under, receive medical treatment for sports-related injuries, and according to the US Consumer Product Safety Commission, more than 775,000 are treated in emergency rooms. As physical activity is being increasingly promoted to counteract childhood obesity, these numbers could rapidly increase. If not taken seriously, injuries affecting joints and muscles of the body can become chronic later in life.

            In reality, young athletes are not just small adults. Their musculoskeletal systems are still growing, which makes them susceptible to unique injuries that are not seen in the adult population. For example, what appears to be a simple sprain may, in fact, be an injury to the growth plate of the joint, the area of developing cartilage where long bone growth occurs. This particular region is weaker than ligaments and tendons in youngsters and, therefore, more susceptible to injury. In addition, improper training and conditioning, performing exercises with poor technique and too much resistance with too many training sessions per week can contribute to a variety of overuse injuries in this population. And youth athletes are increasingly focusing on just one sport, placing repeated stress on the same body areas, which also contributes to overuse injuries.


Common Injuries

            Sprains occur very frequently in this population, especially in the ankle and knee. However, because of the high degree of joint flexibility in this age group, the injury stress is often transferred to the bones and thus, fractures may occur. Muscle strains of the calf (gastrocnemius), anterior and posterior thigh (quadriceps and hamstrings) are also common, but again, the amount of flexibility in this age group makes these injuries less common than in populations with mature musculoskeletal systems.

            Overuse injuries are as common as sprains and strains and if not managed properly, may also result in fractures. A primary example of this is a condition called "Little League Elbow." This condition is caused by overuse and repetitive motion, often with improper technique. In this age group, the muscles surrounding the elbow joint, being stronger than bones, exert undo stress on their bony attachments and may cause an avulsion fracture, where a small piece of bone is pulled away from its normal position. This injury can be extremely disabling and if not managed properly, may cause permanent damage to the joint.

            Catastrophic injuries must be considered with this population as well. Heat illness and head injuries are two examples that unfortunately occur too frequently. Both of these potentially life-threatening conditions can be prevented through education and early recognition of symptoms. Obtaining and documenting medical history is also very important in recognizing previous injury or illness and identifying potential predisposition to recurrence. In addition, an emergency medical plan must be developed and implemented for all programs and youth sports leagues.


Prevention through Education

            Parents value the health and safety of their children above all else. Educational programs, specifically focused on injury prevention and management as well as proper training and conditioning, which are offered on a regular basis to parents, coaches and kids, are of great value and can differentiate your facility from the competition. Taught by certified athletic trainers or unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of musculoskeletal injuries and related conditions, these programs can be as short as 30 minutes or can extend to all-day programs and can be specifically designed for volunteer coaches or sport program coordinators. Typical topics of such programs include proper management of head injury or concussions; preventing, recognizing and properly managing heat-related illness; and guidelines for proper diet and nutrition. Another method of providing valuable

education is by posting health and injury information on your facility's Web site. Include a question/answer section where specific health and injury questions can be addressed.


Rehabilitating Youth Injuries

            Injury rehabilitation is an important component of a fitness and wellness facility. And special considerations need to be incorporated for youth participants. Protocols should include lighter resistance with higher repetitions, using bands and tubing. Alternative activities need to be suggested while the injury is healing. For instance, if it's a lower extremity injury, suggest stationary biking or swimming to provide non-weight bearing exercise. Typically, certified athletic trainers can be a great resource of such services, since they are trained and skilled in providing musculoskeletal rehabilitation. The good news is that kids heal fast, so their recovery time for most injuries is less than that of most adults.


Outreach Programs

            Your staff can also provide outreach health and injury care to local youth sport leagues for their practices, games and tournaments. The certified athletic trainer can establish an emergency medical plan, be on site to manage any injuries that may occur, communicate with parents, make appropriate referrals to physicians or a medical facility as well as follow up with treatment and rehabilitation if needed. Such a professional is usually contracted to the league for an established number of hours per week at a set hourly rate. Or you may offer the service at no charge and build it into your marketing budget. This is an excellent way to market your facility and have direct contact with potential clients.


Performance Enhancement Programs

            Training and conditioning for specific sports, either as an individual or with teammates, has become increasingly popular for youth athletes. Program packages, usually offered in four- to six-week time periods, twice a week with 75-minute sessions, emphasize speed, agility, coordination, balance and strength training to improve sport performance. Many teams and youth sport leagues encourage participation in such programs since youth athletes typically don't have access to school-sponsored strength and conditioning programs.


Marketing to Local Physicians

            The value of fitness and wellness, training and conditioning and injury prevention and proper management is definitely recognized by physicians. These programs enhance the health and wellness of their young patients. Marketing your programs directly to physicians could lead to valuable referrals and relationship building, resulting in a community-wide referral network to your facility. For the youth population, you want to target pediatricians, family practice physicians and orthopaedic surgeons. Focus on those physicians within a 20-minute drive from your facility. Some may be part of a local hospital system and others in private practice.

            Prepare marketing materials emphasizing the health care programs that you specifically offer for youth participants. It is important to make personal appointments to meet with physicians to explain your programs and their benefits in more detail. While in discussion, ask if you can leave information in the waiting room. Suggest that patients be referred to your facility for training and conditioning as well as for injury rehabilitation. Have a physician open house, and consider offering discounts for these doctors, their office staff and for the patients that they refer. The local medical community needs to be integrated into your programs and become active participants in your facility.

            Customizing programs for the youth population will properly address the unique needs of this age group, which will enhance your business and establish a loyal client base for the future. And just as importantly, such an addition to your facility will assist in the prevention and proper management of injuries and related illnesses in this population.


            Marjorie J. Albohm, MS, is a certified athletic trainer and Vice President of the National Athletic Trainers Association (NATA). She is Director of Business Development and Orthopaedic Research at OrthoIndy and the Indiana Orthopaedic Hospital. For more information on NATA, visit