Parents, student-athletes must weigh costs of sports injuries
By Denise Baran-Unland For The Herald-News May 10, 2011 1:02PM
Joliet Catholic Academy's starting pitcher #11 Ashley Searing. Sun-Times Media | File photo
Updated: September 29, 2011 12:34AM
At some point, every child will get hurt playing outside or participating in a sport.
When it happens, parents are faced with the daunting task of gauging the severity of the injury to determine if it merits a quick bandage or a trip to the doctor.
The National Institutes of Health estimates that more than 38 million children and adolescents participate in organized sports in the United States each year. That doesn’t account for the kids who play a pickup game of kickball or participate in other informal recreational activities. Of the 38 million, nearly 1.9 million children under age 15 were treated in emergency departments in 2001 for sports-related injuries, according to a report by the Centers for Disease Control.
When a child is severely injured, perhaps more difficult for parents is deciding when to let a child return to physical activity or whether the child should participate at all.
Should children continue playing sports after being injured?
Only if they meet certain criteria, said Dr. Henry Fuentes, board certified orthopedic surgeon at Parkview Musculoskeletal Institute in Joliet and Illinois High School Association tournament physician.
“One of the hardest things to tell an athlete is, ‘Don’t go back right away, even though you want to,’ ” Fuentes said. “And if a kid can’t go back at all, I do tell the parents.”
No child, after being injured, should return to playing until he or she has full range of motion in his or her joints, 85 percent of the strength compared to his or her contralateral normal side, and no swelling. No exceptions.
“For concussions, I send patients to the ER and have them see a neurologist to make sure it’s safe to go back,” Fuentes said. “A lot of kids return to sports too soon after a concussion. Even when parents have their kids in wrestling for possible scholarships, I err on the side of caution.”
Twenty years ago, Joyce Nahorski’s daughter Jenni, now 35, tore her ACL (one of four major ligaments in the knee) around the end of basketball season during her freshman year. Doctors gave Jenni a choice: repair the ACL and wear a brace or replace the ACL and eliminate sports for nine months.
Since softball, Jenni’s favorite sport was approaching, she chose the first.
Because the brace hindered Jenni’s ability to run, she tried out for pitcher instead and made the team and pitched for four years.
“She was all conference junior and senior year,” Nahorski said. “She ended up playing one year in college, but her knee was hampering her ability to play, so she didn’t play after that.”
Nahorski wondered if the outcome would have been different if Jenni hadn’t tore her ACL or if she had replaced the ACL, which was uncommon two decades ago (Jenni eventually had the surgery as an adult).
“Her knee still gives her problems to this day,” Nahorski said.
ACL not a quick fix
Fuentes is conservative regarding female athletes and torn ACLs. Sometimes the girls delay reconstructive surgery and return to the game wearing a knee brace, but that doesn’t keep the knee from giving out or developing subsequent injuries, such as a torn meniscus.
Youths do best when this surgery utilizes their own tissues, but if they tear the ACL again, cadaver ligaments are used instead. At least six months should pass before a return to pivotal sports, but after the second tear, Fuentes recommends the athlete pursues a different sport.
“That’s hard to do,” Fuentes said. “You ask these kids if they love their sport and want to go back to it and nearly 100 percent say, ‘Yes.’ But if they keep playing they can develop other injuries and arthritis at a young age. You don’t want to see that.”
Part of the reason for injuries is the way kids today now play sports. In the past, children were engaged in a variety of activities; there was not a high emphasis on perfecting one sport. “Because of that, they’re not letting certain joints rest during the year,” Fuentes said.
Marianne Searing’s daughter Ashley has been injured multiple times.
During grade school basketball, Ashley, then 11, of Joliet broke her hand during a basketball game when she was going up for a rebound and collided with a girl from the other team. At 12, Ashley broke her growth plate in the ankle again during a basketball game.
In high school, Ashley switched to volleyball and softball.
At pre-freshman summer volleyball tryouts, Ashley broke her foot while jumping rope.
In her sophomore year, Ashley went up for a block during club volleyball and landed “funny.” She tore her ACL and received a total ACL reconstruction.
Two weeks after surgery, Ashley broke her patella (knee cap) while walking down bleachers. “She ended her volleyball career, but then focused on softball which is her passion,” Searing said.
These examples, as well as her own daughter’s experiences, concern Nicki Todorovich-Blowers of Joliet, who says more education is needed about ACL injuries in female athletes, since they appear to rupture them at higher rates than male athletes do.
Todorovich-Blowers’ daughter Sarah tore her ACL twice before it was replaced in 2009. Todorovich-Blowers clearly remembers the first time it happened, during a Joliet West junior varsity basketball game.
“She went up for a stop shot and she stopped. The next thing I knew she was on the ground,” Todorovich-Blowers said. “She screamed for mom to come out on the court. Kids don’t yell for you to come unless it’s pretty bad.”
Last spring, Sarah had a meniscus repair. Several months later, she broke her ankle, although that injury had nothing to do with sports. Despite the injuries, Sarah, who now plays softball at Aurora University, will not forsake sports.
“I want her to quit because I don’t want to see my child suffering,” Todorovich-Blowers said. “But she won’t quit because that’s where her passion is. She won’t even take pain medicine because she doesn’t believe in pills. She’s a very holistic kind of kid. She’s thinking about a possible career in physical therapy so she can help other people.”
Return to football
When Lisa Baucke Kovanda’s son Shaun was injured on the field — he took a hard hit to his neck and spine when the air bladder in his brand-new football helmet ruptured — Baucke Kovanda at first issued a “no more football” edict until she realized how much the game meant to him.
“All the force had come down his neck and straight into his spine,” Baucke Kovanda of Nebraska said. “It was touch and go for several hours. We knew his spine was not broken, but he did have swelling. We didn’t know if he would walk again.”
She felt torn between keeping her son physically safe and emotionally whole. His heart was in playing. He could not sit on the sidelines. She discussed Shaun’s condition with his doctors, physical therapists and trainers and they did everything possible to insure — although not guarantee — his safety. She allowed Shaun to return to football.
“This is where his heart was and I could not take that from him,” Baucke Kovanda said. “I wanted to keep a healthy balance for him. If his coach said it was not healthy, I would have been more likely to say, ‘Shaun, this is not smart. You can’t lose your life over a high school sport.”
Sidelined for good
But there is more than one way to lose your life, as Sally J. Walker of Nebraska knows.
In the mid-1950s, Walker, now an emergency room and critical nurse, had an older brother, a reckless freshman with poor socials and a dislike for studies. Nevertheless he maintained the C average necessary for playing football because he thrived on physical activities. Because he had made junior varsity, Walker’s brother felt respected and accepted.
Unfortunately, Walker’s brother took a bad hit during his first game. It ruptured his spleen, requiring emergency surgery. The family, who lived to “hand to mouth” (Walker’s father was a hired farm hand) and had no medical insurance, forbade further sports participation. That edict destroyed her brother’s waning interest in school.
“Without the possibility of participating in a socially equal activity like sports, he had no incentive to care,” Walker said. “No matter how my parents encouraged or threatened him, his behavior deteriorated in and after school. He gained the reputation as one of the ‘bad kids’ who smoked and got in fights. The following year he quit school all-together. And that pretty much established his pattern for the rest of his life.”
As a nurse, Walker has seen a variety of debilitating and life-threatening athletic injuries. Yet, she is a staunch advocate of youth sports. “If we do not take pride in training the body to excel, how can we expect to train the mind?” Walker said. I believe the body and the mind are inseparable, especially in training the young, instilling confidence in simple disciplined effort.”