As Chief of Orthopedics and a prominent hand surgeon at Tufts Medical Center, Dr. Charles Cassidy sees plenty of sports-related hand injuries. But even he was surprised when his son, a 15-year old lacrosse goalie, suffered his third broken hand bone.
“The way the stick is held leaves the fingers, hand and wrist exposed to the ball,” said Dr. Cassidy. “And that ball comes in fast and can do quite a bit of damage.”
Lacrosse injuries are becoming more common, mostly because the sport has increased dramatically in popularity over the past 10 years. Today, more than 800,000 young people play lacrosse, according to US Lacrosse, appealing because it provides a faster, more physical game than other spring team sports such as baseball.
“Lacrosse is similar to soccer in that the body pivots a lot from one direction to another and that can cause ankle sprains and knee injuries, like ACL and meniscus tears,” said Matthew Salzler, MD, an orthopedic surgeon in the Sports Medicine and Shoulder Program at Tufts Medical Center. “But lacrosse also has short, high-speed bursts of play, similar to hockey. That higher speed can lead to more injuries.”
Concussions are also associated with lacrosse, the result of body-to-body contact or the athlete hitting the ground. Occasionally, Dr. Salzler says an inadvertent stick or ball to the head or face can result in a concussion.
“Lacrosse is an excellent sport. But like any competition that is fast and physical, players and coaches need to be cautious of any head injury, evaluate the player and sit him or her out, if there is any question,” advised Dr. Salzler.
Gyms and programs that offer high-intensity, interval training like CrossFit have come under scrutiny in recent years. While many people enjoy the results and the camaraderie associated with the workout, others have pointed to the risks. The routines involve a combination of lifting weights, endurance training, such as running and jumping, gymnastics and body-weight training, such as pull-ups and squats – all done in rapid sequence.
“This is not an exercise for those just starting on their road to fitness,” said Dr. Salzler. “We see tendinitis, rotator cuff and bicep injuries – often due to improper technique.”
In fact, one study, published in the Orthopedic Journal of Sports Medicine found about 20 percent of Crossfitters suffered an injury, with men more likely to become injured than women.
The appeal of the activity has begun to catch on with teens. Gyms are pulling together modified versions of high-intensity interval training for youth. National competitions like the CrossFit Games now allow kids as young as 14 to participate. But Salzler says it’s particularly important for younger participants to have professional assistance when doing high-intensity interval training to make sure they are not doing exercises that could cause harm.
“Kids should not be doing powerlifting until their bones reach maturity,” said Dr. Salzler, adding the American Academy of Pediatrics recommends no heavy weightlifting until late teens. The Academy says other types of strength training are okay starting at age eight.
Too much of a good thing?
Young athletes often dream of being superstars. They can close their eyes and see the ball sail over the Green Monster or make the end zone catch in front of a packed Gillette Stadium. While practice can help a talented boy or girl turn into a champion, too much of it too soon may not be a good thing for a growing body.
“Kids and even parents feel like they need to make a decision early to be a specialist in a given sport,” said Dr. Salzler. “But with rare exception, waiting to specialize in one sport is a more successful strategy to make it to the collegiate and national level.”
ACL tears, hip problems and stress fractures are some of the problems that can arise when a young body is constantly moving the same way. Developing muscles can become imbalanced which can make getting to a high level of play difficult. In 2014, the American Medical Society for Sports Medicine (AMSSM) released a position statement discouraging early sport specialization and intensive training among young athletes due to growing research evidence that associated these activities with overuse injuries and burnout.
“I advise parents to mix it up when their children are younger. Let them get a taste of a range of sports,” said Dr. Salzler. “If they love one, that’s great, but continue to counsel them to do a variety of activities.”
In the end, though, any activity is better than none.
“The sad part is that more and more young people are choosing not to be active,” he said. “With child obesity numbers increasing, it’s more important than ever for parents to get their kids excited about regular physical activity and make sure they continue to exercise as they grow.”
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