Changing The Culture Of Youth Sports - Safe Kids Worldwide
Changing the Cultureof Youth SportsAugust 2014
Exploring the Culture of Youth Sports1.24 million kids were seen inemergency rooms for sports injuriesin 2013.That’s 3,397 every day141 every hourAmong children ages 19 and under,13 to15-year-olds accounted forthe largest number of injuries.1 every 25 seconds.90% of athletes said they havebeen injured while playing a sport.Sometimes seriously:Concussions/head injuries 12%Dehydration 24%Broken/fracturedbones 13%Sprains/strains 37%37%Many respondentssaid they don’t doanything to preventinjuries.23% of coaches54% of athletes saidthey have played injured.WE ASKED WHY“I was needed andcouldn’t let theteam down.”“I didn’t want tobe benched.”“It was an importantgame.”28% of athletes31% of parentsFewer than half of coaches say theyhave received certification onhow to prevent and recognize sportinjuries.80% of parents said they would wanttheir child’s coach to be certified ininjury prevention. 50%80%
42% of athletessaid they havehidden or down-played aninjury during agame so theycould keep playing.62% knowsomeone elsewho has.Only 27% of coaches reporta player having hidden ordownplayed an injury.More than half of coaches (53%) say they have felt pressure from a parent or player to putan athlete back into a game if a child has been injured.73% of athletes say they have beenyelled at by a coach.33% of athleteshave been injuredas the result ofdirty playfrom an opponent.28% of athletes agree that it is normal tocommit hard fouls and play rough to“send a message” during a game.Of those, 40% of kids said thatbeing yelled at by a coach madethem want to quit playing a sport.Strategies for Smart PlaySet the ground rules at the beginning of the season. Coaches bring together parents and athletesbefore the season begins to agree on the team’s approach to prevent injuries.Teach athletes ways to prevent injuries. Proper technique, strength training, warm-up exercises andstretching can go a long way to prevent injuries.Prevent overuse injuries. Encourage athletes to take time off from playingonly one sport to prevent overuse injuries and give them an opportunity toget stronger and develop skills learned in another sport.Encourage athletes to speak up when they’re injured. Remove injuredathletes from play.Put an end to dirty play and rule breaking. Call fouls that could cause injuries.Get certified. Learn first aid, CPR, AED use and injury prevention skills.
4 Safe Kids Worldwide
Executive SummaryThe culture of youth sports has been under close scrutinyrecently. Parents and athletes are faced with morequestions than ever: Are certain sports unsafe? Will thecoach know what to do if an athlete is injured? How doesan athlete know when to speak up about an injury? Withrule changes and a win-at-any-cost mentality, are sportsno longer fun?To better understand what young athletes, parents andcoaches are confronted with in youth sports, Safe KidsWorldwide surveyed 1,000 young athletes, 1,005 coachesand 1,000 parents. Despite greater public awarenessabout youth sports safety, we still found an alarming gapin what is being done to keep young athletes safe whileplaying sports.One in four coaches say they don’t take any specificactions to prevent injuries to their players during practiceor games. Nine out of 10 athletes say they have beeninjured playing a sport, and 54 percent say they haveplayed with an injury such as a sprain or even a brokenbone.We found that one-third of athletes say they have beeninjured as a result of dirty play. Of these, 13 percent saythey have had a concussion or head injury, 13 percenthave had a broken bone, and 18 percent suffered asprained ankle. These injuries indicate a greater culturalissue: 28 percent of athletes agree that it’s normal tocommit hard fouls and play rough to “send a message”during a game.We also learned more about the pressure that coachesare under—and the impact this has on their teams. Halfof coaches say they have felt pressure from a parent orplayer to put an injured athlete back in the game. Almostthree-quarters of athletes say they have been yelled at bya coach during a game or practice. How did being yelledat make athletes feel? “Embarrassed in front of my friendson the team.” “I was frustrated and didn’t want to playanymore.” “Small and belittled.”Fewer than half of coaches say they have receivedcertification on how to prevent and recognize sportinjuries. Fewer coaches of community and recreationalteams report receiving sports injury certification thancoaches of school, intramural and club teams.Fortunately we know what works to prevent some ofthe most serious sports injuries. Some examples areconditioning programs to prevent knee injuries, and crosstraining and diversification to prevent overuse injuries.Proper technique and early recognition are important toprevent and manage concussions. Staying hydrated andencouraging training and certification for coaches in firstaid, CPR, AED use and sports injury prevention are otherways to keep athletes safe.Playing sports safely isn’t about limiting kids—it’s aboutkeeping athletes healthy and injury-free so they can keepplaying to their greatest potential. Here are five waysthat kids, parents and coaches can work together to keepathletes from getting injured. Set the ground rules at the beginning of theseason. Coaches bring together parents andathletes before the season begins to agree on theteam’s approach to prevent injuries. Teach athletes ways to prevent injuries. Propertechnique, strength training, warm-up exercisesand stretching can go a long way to preventinjuries. Prevent overuse injuries. Encourage athletesto take time off from playing only one sportto prevent overuse injuries and give them anopportunity to get stronger and develop skillslearned in another sport. Encourage athletes to speak up when they’reinjured. Remove injured athletes from play. Put an end to dirty play and rule breaking.Call fouls that could cause injuries. Get certified. Learn first aid, CPR, AED use andinjury prevention skills.By embracing these strategies, we can make sure thatplaying sports—and scoring the goal, making the basket,or winning the game—continues to be one of the bestparts of being a kid.Staying in the Game: Changing the Culture of Youth Sports Safety5
Sports Injuries in Children:Not Just Bumps and BruisesIn 2013, there were an estimated 1.24 million emergencydepartment visits for injuries related to 14 commonlyplayed sports in children 19 and under.1 Younger childrensuffered fewer injuries than older children. However,the greatest numbers of injuries were seen in childrenages 13 to 15 (Figure 1).1 These teens accounted for 37percent of emergency department visits related to sportsinjuries.Figure 1: 13- to 15-year-olds make up 37 percentof sports-related ER visits among children.180,000160,000Number of ER e 2: 90 percent of young athletes say they havesuffered an injury while playing a sport.No10%Yes90%Among those that say they have been injured:Cuts/scrapes 49%Bruises 48%Sprains/strains 37%Joint soreness 36%Sprained ankles 33%Headaches 28%Dizziness 26%Dehydration 24%Broken/fracturedbones 13%Concussions/headinjuries 12%The majority of coaches—84 percent—have had asports injury on their team. Among coaches who haveexperienced an injury on their team, 57 percent saythey or another coach have treated an athlete’s injury(Figure 3).Figure 3: 57 percent of coaches who have had aninjured player on their team say that a coach hastreated an injured player.20,000Injury treated by you oranother coach0Injury treated by theplayer’s parent4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19andunderAgeTo better understand what is leading to such largenumbers of sports injuries in children, Safe KidsWorldwide surveyed three groups: 1,000 athletes in the7th through 10th grades; 1,005 coaches of athletes thisage; and 1,000 parents with kids who play sports in the1st through 10th grades.Nine out of 10 kids say that they have been injuredwhile playing a sport (Figure 2). Many are the types ofinjuries that require medical attention. One in eight—12percent—say they have had a concussion or head injury,and even more report having a headache (28 percent)or dizziness (24 percent) after playing a sport, bothpossible symptoms of a concussion or dehydration. Onein four say they have been dehydrated. Thirteen percenthave had a broken bone, and 4 percent have had a tornligament. Thirty-three percent of athletes say they havehad a sprained ankle.6 Safe Kids WorldwideBone bruises 9%Shin splints 9%Overuse injury 8%Faintness 6%Tendonitis 5%Torn ligament (ACLinjury) 4%Injury treated by a pediatricianor the child’s doctorInjury treated by a trainerInjury treated immediately at theemergency roomInjury treated by thechild themselvesInjury treated by a teammateInjury treated by a specialist/other doctorInjury not treated0% 10% 20% 30% 40% 50% 60%
Playing Injured to Stay inthe GameHave you ever played with an injurybefore? What was the injury and whydid you keeping playing?When kids were asked what the worst part of beinginjured was, aside from the pain or discomfort, 49 percentsaid it was being out of the game and not being ableto play. The fear of missing out on a game or practice isa significant factor for kids hiding injuries—42 percentof athletes said they have hidden or downplayed aninjury during a game so they could keep playing, and 62percent know someone else who has hidden or downplayed an injury during a game so they could keepplaying.More than half of athletes—54 percent—say they haveplayed injured, and 70 percent of athletes who playedinjured had told a coach or parent they were injured.The most common injuries that athletes played withwere sprains (27 percent), general pain (21 percent) andbruises (14 percent). Athletes also reported playing withsome serious injuries: 7 percent said they had played witha broken bone or dislocation (Table 1). The top reasonsathletes gave for playing injured were that it wasn’t thatbad (18 percent), they were needed and couldn’t let theteam down (13 percent), and they didn’t want to bebenched (12 percent).“Concussion. I didn’t want to tell anyone.””I had a sprained ankle and I was told towork through it.”“Fractured bone. I wanted to keepplaying.”“Sprained foot—kept playing becauseI didn’t want to get yelled at in front ofeveryone or get kicked off the team.”“I was hit in the mouth with someone’selbow and my front teeth were loose andbleeding. I kept practicing after taking ashort break because I don’t let that holdme back from making progress.”“I had a sprain and I never get to play soI did not tell the coach, and I was afraidhe would yell at me and bench me for therest of the season.”Table 1: What was the injury that you played with?InjuryPercentageof %Broken bone or dislocation7%Unspecified injury involving a body part such asknee, arms, foot, etc.6%Strain/pulled muscle6%Cut4%Scrape/scratch4%Staying in the Game: Changing the Culture of Youth Sports Safety7
In one momentBrie Boothby’slife changedforever. OnSeptember10, 2013, Briewas playing ina high schoolfield hockeygame when shegot hit in the head with a hockey stickand blacked out. After a few minutes onthe sideline, she went back onto the field.“There was no reason to go back into thegame after a head injury like that,” saysBrie.A week later Brie forgot how to spell hername. She suffered a severe concussionthat is still dominating her life a yearlater. Instead of being a normal highschool teen, she deals with the sideeffects of a traumatic brain injury, likean aversion to bright lights and loudsounds and an inability to focus, whichaffects her grades. Instead of going tothe movies she goes to physical therapy.Sleepovers have been replaced bydoctors’ appointments. And she sits onthe bench instead of playing the sportshe loves. Doctors tell her she can’t everplay a contact sport again because of herconcussion.“I’ve learned to take it one day at atime,” says Brie. To help adjust, Briestarted a support group with a fewother teens who have also suffered fromconcussions. “By sharing my story, I hopeI can help other athletes cope and knowthat they’re not alone.”8 Safe Kids WorldwideCoaches are aware of their players playing while injured,and even hiding injuries. Half of coaches say they havehad a player play with an injury, and 27 percent say theyhave had players keep an injury hidden from coaches andparents (Figure 4). More intramural coaches (41 percent),club coaches (35 percent) and school coaches (34percent) know of a player keeping an injury hidden thanrecreational coaches (28 percent).Figure 4: Half of coaches have had a player playinjured, and 27 percent have had a player hidean injury.Have had a playerplay with an injury50%Have had a playerkeep an injury fromcoach or parents40%Percent of CoachesBrie's Story30%20%10%0%YesNoDon't knowMore than half of coaches (53 percent) say they havefelt pressure from a parent or player to put an athleteback into a game if a child has been injured. Intramuralcoaches more often report being pressured by parents(53 percent) than school coaches (45 percent) orrecreational coaches (42 percent).
Staying in the Game: Changing the Culture of Youth Sports Safety9
Dirty PlayOne way that athletes report being injured is by foul ordirty play from an opponent—one-third of athletes reportbeing injured this way (Figure 5). Eighteen percent reporthaving had a sprained ankle as a result of foul or dirtyplay, 13 percent had a concussion or head injury and13 percent had a broken or fractured bone. Alarmingly,almost one-third of athletes (28 percent) agreed that itis normal to commit hard fouls and play rough to “send amessage” during a game.Figure 5: One-third of athletes have been injuredas the result of foul or dirty play from an opponent.Yes33%No67%Of these:27% cuts or scrapes19% strains or sprains18% sprained ankles13% concussions/head injuries13% broken/fractured bonesWe also learned that many athletes consider it normal toyell at others and be yelled at while playing sports. Twoout of five athletes (41 percent) report having yelled at ateammate during a game or practice. Sixty-eight percentof athletes agreed that it’s normal for coaches to yell atplayers to get the best out of them; 42 percent agreed it’snormal to see parents yell at other parents, coaches andreferees at games (Figure 6).10 Safe Kids Worldwide10
Figure 6: Many athletes think it's normal to yell,trash-talk and even commit fouls to “send amessage.”AgreeDisagree“Embarrassed in front of my friends onthe team.”It's normal to commit hard foulsand play rough to 'send amessage' during a game.“I was frustrated and didn’t want toplay anymore.”It's normal to trash-talk and tauntother players during games.“Wasn’t all that bad. I probably hadit coming.”It's normal to see parents yell atother parents, coaches andreferees at games.“Small and belittled.”It's normal for coaches toyell at players to get the bestout of them0%Has your coach ever yelled at youduring a game or practice?How did it make you feel?20% 40% 60% 80% 100%Almost three-quarters of athletes say they have beenyelled at by a coach (73 percent) (Figure 7). While somesaid it made them feel motivated (36 percent), others saythey felt embarrassed (14 percent), angry (14 percent),sad (13 percent), and even felt like a loser (9 percent).Two in five athletes say that being yelled at by a coachhas made them think about quitting a sport. Coachesclearly play a critical role in both the players’ safety aswell as their interest in playing the game.“Like I was doing something wrong or notgood enough.”“Embarrassed and angry. But he is alwaysyelling at everyone.”“A little angry. It made me want toyell back.”Figure 7: 73 percent of athletes have been yelled atby a coach. Of these, 40 percent said being yelled atby a coach has made them want to quit playing thesport.No27%Yes73%Staying in the Game: Changing the Culture of Youth Sports Safety11
Training Coaches:Can We Do More?Parents are confident in their coach’s knowledge aboutpreventing sports injuries: 94 percent of parents saidtheir child’s coach was very or fairly knowledgeable aboutpreventing sports injuries, compared to 89 percent ofathletes and 89 percent of coaches. In contrast, only5 percent of parents said their child’s coach was notknowledgeable, compared to 11 percent of coaches and11 percent of athletes.However, fewer than half of coaches say they havereceived certification on how to prevent and recognizesport injuries. For example, 43 percent of coaches saythey have received certification to prevent and recognizeconcussions, 32 percent have received training on overuseinjuries, and 26 percent have received training on tornligaments (Figure 8).While injury prevention certification programs varyby sport and certifying body, one place that coachesand parents can start is by completing a course in CPR(cardiopulmonary resuscitation) and AED (automatedexternal defibrillator) use. While rare, the incidence ofsudden cardiac arrest is greater in young athletes thanamong nonathletes.3 The American Heart Associationoffers Heartsaver CPR AED and the American Red Crossprovides training and certification in first aid, CPR andAED use. In our survey, we found that only 52 percent ofcoaches said their team has an AED where they practiceand play games; 37 percent said there wasn’t an AED,and 11 percent didn’t know. Of coaches who said therewas an AED, 86 percent had received training on how touse it.Table 2: Have you received any certification thatincludes prevention and recognition of any of thefollowing injuries?Figure 8: Most coaches haven't received injuryprevention alCoachClubCoachYes – Tornligament, such asan ACL injury32%32%26%34%Yes – Sprains orstrains40%39%39%44%Overuse injuriesYes – Dehydration54%54%51%57%Sprains or strainsYes – Concussionsor head injuries47%46%46%49%Yes – Broken orfractured bones46%47%37%48%Yes – An overuseinjury, suchas swimmer’sshoulder, runner’sknee, pitcher’selbow or tenniselbow38%40%33%40%TendonitisTorn ligamentsConcussions orhead injuriesDehydration0%10%20%30%40%50%Percentage of coaches who have received certification that includesprevention and recognition of specified injuriesCoaches’ certification varies depending on where theycoach. More school coaches (38 percent), intramuralcoaches (40 percent) and club coaches (40 percent) thanrecreational coaches (33 percent) report having receivedcertification that includes the prevention and recognitionof overuse injuries (Table 2).Nearly nine in 10 coaches—84 percent—say theyare very or somewhat likely to get certified in injuryprevention. Eighty percent of parents said theywould want their child’s coach to be certified in injuryprevention.12 Safe Kids Worldwide
Staying in the Game: Changing the Culture of Youth Sports Safety13
The majority of coaches inthe survey were volunteercoaches — for example,83 percent of basketballcoaches who responded tothe survey were volunteers.14 Safe Kids Worldwide
Athletes, parents and coaches were asked what, ifanything, they do to prevent sports injuries. They couldwrite in anything they do to prevent injuries, and wereprovided with the option to select “I don’t do anythingto prevent injuries.” We found that about one in fourathletes and coaches responded that they don’t doanything to prevent injuries (Figure 9). Intramuralcoaches were more likely to say they don’t do anythingto prevent injuries (31 percent) than school coaches(24 percent) or recreational coaches (21 percent).Figure 9: One in four athletes, parents and coachesdon't do anything to prevent sports injuries.Don't do anythingStretch/warm upWear protective gearBe careful/play safeAthletesCoachesPay attention/be alertParentsDrink waterTrain well0%5% 10% 15% 20% 25% 30% 35% 40%“What parents oftendon'
numbers of sports injuries in children, Safe Kids Worldwide surveyed three groups: 1,000 athletes in the 7th through 10th grades; 1,005 coaches of athletes this age; and 1,000 parents with kids who play sports in the 1st through 10th grades. Nine out of 10 kids say that they have been injured while playing a sport (Figure 2). Many are the types of
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Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.
