Every year, the final weeks of August are the “last reprieve” for Dr. Neeru Jayanthi, an Atlanta-based sports medicine physician.
That’s because as students return to school and resume sports, the injuries start rolling in.
“We actually prepare for it as high schools and contact sports start opening up,” said Jayanthi, who runs Emory Healthcare’s Sports Medicine Research and Education division. “With the clinics, we already expect to see more volume.”
More children go to the emergency room for sports-related injuries in September than at any other time of the year, according to an analysis of two decades of hospital data by GateHouse Media.
According to Newton Medical Center, September 2018 saw more sports injury patients than any other month that year — 18. More than half of the patients seen that month were football players. According to NMC, last year the facility treated 37 patients for injuries sustained in football, with basketball second at 25.
According to the national data, football accounts for more than half of all sports-related visits in September for patients under 18. ER trips due to soccer and volleyball injuries also peak that month.
And according to new data collection by the Kansas High School Activities Association, one of those sports saw more concussions than any other — not only in aggregate numbers but by percentage.
The 2018-2019 school year marked the first year member schools were required to report concussions to the Kansas State High School Activities Association. Over 2,100 concussions were reported across grades 7-12.
According to KSHAA, 6.16% of football players in Kansas suffered a concussion last year — with 903 reported statewide. The average days a football player spent sitting out was 18.72 days.
The Kansas high school football season will kick off this week.
The Emergency Room numbers come from the National Electronic Injury Surveillance System, a database run by the U.S. Consumer Product Safety Commission for more than four decades. Some 100 hospitals around the country participate, sending detailed data about a broad spectrum of ER visits to the commission.
Not all sports injuries peak in the fall. Wrestling- and basketball-related ER visits are at their highest in January. Meanwhile, softball and baseball injuries tend to spike in May.
Sports medicine experts say athletes are more at risk for injury at the beginning of the season because they tend to jump back into intense training even though their bodies aren’t conditioned for it.
The pattern has been noticed even at the most elite levels of play, like in the National Football League, where officials are weighing whether to shorten the preseason due to the prevalence of injuries.
Many youth sports lost participation in recent years, according to the Sports & Fitness Industry Association. Not only are parents more aware about the risk of injury, but kids increasingly are rejecting the high-pressure atmosphere of competitive sports, said Jayanthi.
“It’s great for kids to really want intensity,” he said, “but there’s a cost to that as well.”
Risks of concussion
Charelle Tootle, a mother of two from Kansas City, Mo., said her teenage son Parker withdrew from football because of those concerns.
He sustained a severe concussion in 2014 while trying to eke out a few more yards on a first down. It was just before his first season as the high school’s varsity quarterback. The recovery process caused Parker to miss months of school, and the fear of permanent damage was too much to endure — even for their football-obsessed family.
“What my son went through, it’s not worth it,” Tootle said. “When your child is laying on the field, knocked out, there’s nothing scarier. And looking back, I would say no to football.”
Football does tend to have high concussion rates, according to Safe Kids Worldwide, which used the same ER data to examine injury rates by sport in 2013. Other activities like ice hockey and wrestling had even higher concussion rates.
Still, “every sport is safe if the right things are followed,” said Ali Flury, Safe Kids’ sports safety program manager. “You do your pre-participation physical, you do your warmup and stretch routine every single day, you drink water, you wear the appropriate equipment.”
ER visits for football-related injuries among older youths dropped dramatically after peaking in 2010 at 12,064, according to the data. Eight years later, ERs treated 7,713 football-related injuries. But a higher percentage of those injuries were concussion-related.
Emergency room physicians say they are encouraged to see more young athletes asking questions about concussions and overuse injuries.
Rest and heal
Annie Slater, a pediatric emergency medicine physician in Seattle, emphasized making sure young athletes take appropriate time off after an injury.
Even an ankle sprain weakens tendon and soft tissues, she said. Athletes who fail to properly heal put themselves at risk for further injury.
“I see kids come in and they just want to play their sport, and they just want to get back on the field,” Slater said, “but my biggest thing is you have to rest.”
Parents also need to think critically about how many competitive sports their child can effectively handle, said Dr. Irene Tien, a Boston-area pediatric emergency room physician.
“Bodies do need a rest,” Tien said. “It is actually productive to rest.”
Jayanthi, who is a lifelong tennis player, encourages parents let their children guide the sports selection and intensity level.
Instead of focusing solely on safety, parents should also consider the psychosocial and health benefits of sports, he said.
For example, while football may score lower on physical safety, it’s among the sports that ranks the highest in both psychological and social benefits.
“I want to remind people that sports is a great, great avenue for young folks and young people,” Jayanthi said. “Let’s not look at the data and say move away from sports — because now you have kids playing Fortnite.”