Adolescents are prone to the same types of sporting injuries as adults, however, the risk of hospitalisations required as a result of these injuries is more common. For example, according to the Australian Institute of Health and Welfare, there were 58,500 people who were hospitalised for an injury sustained while playing sport in 2016-17.
For the 15-24 age bracket (as shown in the graph below), there were:
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Males - 817.3 cases per 100,000 people (total numbers: 13,318).
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Females - 244.8 cases per 100,000 people (total numbers: 3,808).
Which equates to an actual combined number of 17,126 or 29.27% of the total sports injury hospitalisations.
The four sports/activities with the highest rates of injuries requiring hospitalisation include:
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All football codes - 38.1% (males) and 15.0% (females). Total rate (both genders) 31.6% or 18,481 cases. 8,258 of these cases were in the 15-24 age bracket.
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Cycling - 12.1% (males) and 7.2% (females). Total rate (both genders) 10.7% or 6,253 cases.
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Netball and Basketball (combined) - 5.0 (males) and 12.8% (females). Total rate (both genders) 7.2% or 6,253 cases. 1,475 of these cases were in the 15-24 age bracket.
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Wheeled motorsports (typically undertaken by people over the age of 17, therefore not a typical adolescent sport) - 8.2% (males) and 1.9% (females). Total rate (both genders) 6.4% or 3,769 cases.
In comparison, the sports with the lowest rates of hospitalisation for injuries (although not particulary common amongst adolescents) include:
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Golf - 0.6% (males) and 0.7 (females). Total rate (both genders) 0.6% or 376 cases.
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Boating sports - 0.7 (males) and 0.8% (females). Total rate (both genders) 0.7% or 434 cases.
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Water skiing - 0.8% (males) and 0.7% (females). Total rate (both genders) 0.8% or 455 cases.
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Fishing - 1.3% (males) and 0.3% (females). Total rate (both genders) 1% or 597 cases.
Fitness and gym related activities is another relatively safe form of exercise accounting for only 1.2% (males) and 1.6% (females), or 1.3% total for both genders or 773 cases, of injuries requiring hospitalisation.
Note: These statistics and therefore the risks of injury are specific to incidents that required hospitalisation, rates for other less serious injuries are not available.
Adolescents are undergoing significant growth and maturation and this time period can result in an increased likelihood of sustaining injury. These injuries may be a single traumatic event (ie. a fracture) or an ongoing issue due to repetitive overuse or incorrect technique.
The main reasons for an increased risk of injury during sporting and fitness activities are:
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Brain development - The human brain is not fully completed until the early to mid 20's. This can result in teenage behaviour that is impulsive, emotionally charged and a reduced ability to anticipate or appreciate consequences.
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Rapid growth spurts - Can causes a temporary reduction of bone strength, resulting in more fractures, and an increased stress on muscles which means they are tighter and more inflexible, resulting in more sprains and strains.
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Coaching error - Poorly trained coaches who overtrain, promote incorrect technique, do not provide safety equipment, and do not allow appropriate warm-up/preparation exercises can result in an increased rate of player injury.
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Equipment and surfaces - Inappropriate footwear, playing surfaces, and equipment condition can impact on injury prevalence.
The most common types of injuries sustained in 2016-17 were:
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Fractures - By far the most common type of sports injury that required hospitalisation in 2016-17, accounting for 30,200 or 52% of the total number of hospitalised injuries. The most common type of fracture for males is the elbow and forearm, followed by the wrist and hand and then the knee and lower leg. Females also fracture the elbow and forearm the most followed by the knee and lower leg.
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Soft-tissue injuries (sprains and strains) - Approximately 10,000 cases.
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Intracranial injury - Approximately 3,800 cases.
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Open wounds - Approximately 3,300 cases.
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Dislocation - Approximately 2,200 cases.
A fracture is a broken bone. Severity can range from a thin crack (hairline fracture) to a complete break, or in some cases shattering of the bone/s. Fractures commonly occur from falls, trauma, a direct blow to a bone, or repetitive forces (stress fractures).
Symptoms include:
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Swelling.
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Redness.
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Pain.
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Deformity (especially in the case of limb fractures).
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Inability to bear weight and/or actively move/function as normal.
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An audible cracking sound may be heard.
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In more severe cases (compound fractures) the skin may be broken and bone may be protruding from the wound.
Soft tissue injuries are common in the ankles, knees and wrists and result in damage to the muscles, ligaments and/or tendons, commonly caused by a sprain, strain, single incidence of impact, or overuse of a particular area.
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Sprains - A pull or tear of a ligament. Some of the common causes (among others) are: rolling of the foot inward, the sudden twisting of the knee, or falling onto an outstretched hand. Symptoms include: Bruising, pain, swelling, limited flexibility, and difficulty moving the joint's full range of motion.
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Strains - Overstretching or tearing of a muscle or tendon. Whilst this type of injury can happen suddenly, they also often develop over time due to overuse, repetitive actions, incorrect technique or posture. Symptomes include: Muscle spasms, pain, swelling, limited flexibility, and difficulty moving the joint's full range of motion.
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Contusion - Otherwise known as a bruise. Caused by blunt force trauma such as a kick, fall, or blow. Symptoms include: Pain, swelling, and discolouration due to underlying bleeding into the tissue.
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Tendonitis - An inflammation of the tendon caused by a repetitive motion. This is a gradual condition which worsens over time. Sports which common see instances of tendonitis include tennis, golf and swimming.
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Bursitis - A swelling and irritation of a bursa which is a saclike structure that cushions the joints. Caused by a repetitive motion, an acute injury, arthritis, or an infection. Symptoms include: Joint pain, stiffness, swelling and redness.
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Stress Fractures - A small crack in a bone caused by overuse during physical activity. In its milder form a stress fracture is treated the same way as a soft tissue injury, however if the action that caused it is allow to persist then a stress fracture can progress into a complete fracture or break and cast immobilisation will be required.
Otherwise known as a traumatic brain injury. Caused by a violent blow or jolt to the head or body. This type of injury ranges in severity from mild to serious and the affects can be temporary, permanent or even lead to death. This type of injury is often caused by high-impact or extreme sports such as boxing, football, hockey, and cycling (if a fall is sustained, especially if no helmet is used).
Symptoms include:
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Loss of consciousness.
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No loss of consciousness but being in a dazed, confused or disoriented state.
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Headache.
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Nausea and vomiting.
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Fatigue or drowsiness.
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Problems with speech.
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Difficulty sleeping.
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Sleeping more than usual.
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Dizziness or loss of balance.
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Convulsions or seizures.
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Dilation of one or both pupils.
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Clear fluids draining from the nose or ears.
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Sensory symptoms such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell. Also a sensitivity to light or sound.
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Cognitive or mental symptoms such as memory loss, concentration difficulty, mood changes, feelings of depression or anxiety.
Wounds are an internal or external break in body tissue, usually the skin, which results in bleeding and other damage. Wounds can be caused by a variety of sharp objects or trauma. There are four classifications of wounds:
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Abrasion - Caused by skin rubbing against a rough surface such as asphalt or gravel. Also known as a graze or a scrape. This type of wound is usually superficial and requires basic first aid to cleanse the area and stop minor bleeding.
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Laceration - A deep cut or tearing to the skin. Commonly caused by accidents with knives, tools, and machinery. Bleeding can be rapid and extensive. Medical treatment and stitches are often required.
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Puncture - A deep narrow wound caused by a sharp pointed object such as a nail.
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Avulsion - A partial or complete tearing away of skin and tissue beneath. This type of wound usually occurs during violent accidents. They cause heavy bleeding and are very serious.
Additionally, and particularly common in sports and physical activity, is a small wound known as a blister. This type of wound is a small pocket of body fluid within the uppoer layers of the skin caused by forceful rubbing (friction).
An injury to a joint whereby the bones are forced from their normal positions causing pain and temporary immobilisation and visual deformity. Commonly occurs in the shoulder, fingers, elbows, knees and hips. Often caused by contact sports such as football and hockey and also in sports where falls are common such as downhill skiing and gymnastics.
Common conditions associated with dislocation include:
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Shoulder Instability - When the upper arm bone is forced out of the shoulder socket as a result of sudden injury, overuse, or in some cases because the patient is predisposed to having loose shoulder joints. This condition can then become ongoing whereby the shoulder joint becomes instable and frequently separates (dislocates) either partially or fully. Common amongst young atheletes, particularly volleyball players, swimmers and baseball pitchers who use a stretching motion of the shoulder on a regular basis. Symptoms include: Pain, repeated shoulder dislocations, repeated instances of the shoulder 'giving out', a persistent feeling os the shoulder feeling loose or weak.
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Joint Hypermobility Syndrome - A condition whereby the joints are more flexible than most people's, also referred to as being double jointed. Symptoms include: Pain, stiffness, clicking joints, repeated sprains and strains, dislocating joints, poor balance or co-ordination, thin stretchy skin, diarrhoea or constipation.
A collective term for different types of growth and developmental disorders that affects the growth of bones in children and adolescents.
Common types of osteochondroses include:
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Legg-Calve-Perthes Disease - Affects the ball of the femur (thighbone) where it connects to the hip socket, cutting off blood supply to the ball and causing the bone to die. This condition can mean that the ball becomes flat and breaks away from the hip. More common amongst young males. Symptoms include: Limping, knee pain, groin pain, reduced muscle strength in the thigh, a decreased range of motion, and shortening of the affected leg.
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Patellofemoral Pain Syndrome - Pain experienced behind the kneecap, where the patella (kneecap) articulates with the femur (thigh bone). This joint is known as your patellofemoral joint. The syndrome is mainly due to excessive pressure of this joint due to poor alignment of the patella. Activities that put the most pressure on this joint are running, jumping, and squatting.
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Sever's Disease - An inflammatory condition of the lower back of the heel where the Achilles tendon attaches. The heel bone grows faster than the ligaments in the leg thus resulting in very tight and overstretched muscles and tendons, repetitive stress on the Achilles tendon causes the inflammation to occur. Symptoms include: Heel pain, limping, discomfort or stiffness in the feet upon waking, and swelling and redness in the heel.
Defined as a condition or inability to perform physical exercise at a normally expected level or duration. It is not a disease or syndrome in and of itself but can result from various disorders, some of which can be very serious.
In younger people, children and adolescents, the two leading causes of exercise intolerance are:
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Asthma.
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Cystic Fibrosis.
These conditions are likely to be diagnosed and therefore familiar to the client and their family prior to exercise or physical activity commencing, they may be reason that the client is commencing a fitness program. For example, asthma is often greatly improved by undertaking swimming programs.
Symptoms of undiagnosed exercise intolerance include:
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Fatigue – Organs and muscles of the respiratory system are affected during exercise and can result in dizziness and shortness of breath. As oxygen is no longer being processed efficiently rest is required.
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Muscle cramps – They can happen to anyone, even professional athletes. However, if they occur in individuals with a minimal amount of exertion this may indicate an issue. Also if they continue after exercise has ceased.
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Insufficient heart rate – The client’s heart rate does not increase to meet that of the physical activity. Weight, age and history may add to this result happening, however, depending on the clients’ profile may be an indication of exercise intolerance.
Exercise intolerant clients should be closely monitored and collaboration sort from medical professionals however they do not necessarily need to cease all exercise activity. If their medical professional is aware of their exercise program and has indicated that exercise will be beneficial for their condition then they can continue.
Ensure that you monitor these clients closely and be on the look-out for any of the conditions/injuries where the cessation of exercise is advised. Monitoring may include the use of technology such as heart rate monitors or apps on smartphones to help determine if the client is stable. Clients must also be aware that they are considered a moderate to high-risk client and that they must not overexert themselves and preferably not exercise alone.
If a client experiences and injury, or is in a moderate to high-risk category you may be required to refer them to a medical and/or allied health professional and then incorporate any recommendations from these personnel into the program plan. It is therefore important that you understand the different roles and responsibilities of these professionals.
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Allied Health Professionals - University qualified professionals who are not part of the medical, dental or nursing professions. They specialise in identification, evaluation and prevention of a range of conditions and illnesses. As a general rule allied health professionals do not prescribe medication, however, there are some circumstances and certain products that they are permitted to prescribe/administer.
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Medical Professionals - University qualified professionals who have completed a medical, nursing or dentistry degree and may also have undertaken further specialist training/education. General Practitioners (GPs) or a Dentist are usually the first point of contact for patients (depending on the health concern) and they may then refer a patient to a specialist or an allied health professional for ongoing treatment.
