Brian Wolf, MD, orthopaedic surgeon at University of Iowa Hospitals and Clinics, talks about the types of injuries young boys and girls can incur and how to prevent them.

I understand there are basically two types of sport injuries, acute and overuse. What is the difference between the two?

The difference really boils down to how that injury came on. With acute injuries, as the name implies, usually there’s some event, something that the athlete or the parent can remember, that caused the problem to begin. With overuse injuries, it’s usually a vague onset of pain or a problem and hard to identify what may be causing that. So how they present gives us the difference between the two.

Can children suffer from overuse injuries?

It’s becoming more and more common with our children these days. There’s a lot of pressure on the kids to participate in fewer sports and to participate in sports year round. As a consequence, we see more overuse injuries in kids at a younger age than we ever have before. This is due to participation in one sport or even at one position more than they used to. In treating this, it’s really trying to alter the way children participate and if they have a problem, allowing them to rest, maybe minimizing their participation on the number of teams or the duration they’re playing that sport during the year.

If a child does not rest, say an injured shoulder, is he or she at risk for long-term disability or reoccurring injury?

Fortunately, children are very resilient and we don’t see long-term disability from childhood injuries very often. It does occur but it’s pretty rare. However, if they have repetitively caused a problem, it may lead to recurrent problems that may have implications on their ability to play a particular sport or do a particular event.

Should children go through sports training similar to adults?

I think it’s helpful and we’re seeing this more and more with our kids. It’s really analogous with what we see with summer sports camps and sports training programs. Fortunately, they focus a lot on mechanics for the event, for conditioning, and things of that nature. In general I think that this is helpful, as long as it’s in moderation.

If the same injury is reoccurring in a child, what is the best advice you can give that child’s parent?

Really three things:

• One—remove the child from that event or sport so that they’re not causing continued problems
• Two—visit with a physician who is comfortable taking care of children’s injuries and comfortable with sports medicine type problems
• Three—consult with either a coach, a trainer, or someone who has some advance knowledge on that particular sport to look at mechanics of what that child might or might not be doing that could be contributing to the problem

In your opinion, are coaches, maybe for a lack of a better term trainers or semi-medical personnel at that level up to speed? Are they aware? Is more education needed to help prevent recurring injuries?

I think it’s quite variable. We have some very well informed and some very thoughtful coaches out there. We also have some people that could use a little bit more training as far as level of competition and some of the instructions to avoid injuries.

You really see it all over the board, but I think it’s getting better, especially the games like baseball, where pitch counts have come into play with Little Leaguers. I think we are starting to see a trend to becoming more cognizant of these problems and to take action to try and prevent some of the injuries we are seeing.

Does The University of Iowa have a dedicated sports medicine program for children?

We have a comprehensive program from athletic trainers to orthopaedic surgeons to physical therapists that are very comfortable taking care of these kids’ injuries. We have three orthopaedic surgeons, including myself, who are very comfortable taking care of children’s problems, especially in the area of sports medicine or even orthopaedic problems. We have a pediatric sports medicine specialist in our clinic that has advanced training for children’s injuries in sports.

If someone wanted to make an appointment for their child, do they need to be referred or can they make that appointment on their own?

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