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Playing Hurt: Are Parents And Kids To Blame?

Coaches want more safety training, but don't think it would make sports safer

Many sports injuries are preventable, but continue to occur because of misconceptions about sports safety, uninformed behaviors by parents, coaches, and youth athletes, and a lack of training, says a new survey from Safe Kids Worldwide.1

The combined results of separate nationwide online surveys, conducted in February and March 2012 by Harris Interactive and Survey Sampling International of 518 kids ages 8 to 18, and 750 parents and 752 coaches, respectively, paint a decidedly mixed picture of the state of youth sports safety in 2012: some good news, some not-so-good news, and some news that, is, to be blunt, downright disturbing.

Even today, with all the attention on concussions, Safe Kids Worldwide found that half of all coaches surveyed believe there is an acceptable amount of head contact (i.e.,getting their bell rung, seeing stars) young athletes can receive without potentially causing a serious brain injury (fact is, there isn't).

Soccer player holding hurt knee

And perhaps most distressing of all is that parents and kids are a major part of the problem, with nearly half of all coaches reporting that they have been pressured by parents or the kids themselves to allow athletes to play hurt. 

Good news 

First, the good news:

Parents:

  • 84% provide emergency contact information to their kids' coaches and make sure they are aware of any special medical condition (e.g. asthma, allergies, sickle cell trait) that could effect their practice or play.
  • 75% report that their kids are required to have a pre-participation physical examination (PPE) every year before they play sports, with the percentages higher for parents of older kids (ages 15-18) as compared to younger kids (ages 8 to 14) (no doubt because older kids play interscholastic sports, where PPE required, while younger kids play on club or rec teams, where no PPE mandated).

Kids:

  • More than 7 in 10 kids report being that their coaches have told them to take steps to prevent injury, with the top three being warming up and stretching, making sure to drink enough water, and telling an adult if they are hurt.
  • Are aware that football is the sport with the most injuries (mentioned by 39% of kids), followed by basketball (16%) and soccer (15%)
  • Mention head injuries (13%) as the third-most frequently mentioned injury type, behind only broken bones (23%) and injuries to specific body parts (e.g. dislocated shoulder/hurt back)(17%), with 9% specifically mentioning concussion.  This shows that concussion education is working, to a degree.  

Coaches:

  • Approximately 9 out of 10 coaches recognize that half of all sports injuries are preventable;
  • Overwhelmingly recognize the importance of being trained and knowledgeable in sports injuries (81% say it is very important, another 18% believe it is fairly important);
  • Want more training, especially in concussion prevention (76%), pre-participation physical exams (73%) and heat illness prevention (73%)
  • Most (9 out of 10) know that kids need to drink fluid every 20 minutes when playing sports and that most concussions occur without a loss of consciousness.
  • Slightly over half (52%) describe themselves as very knowledgeable/well-trained, with another 43% feel they are only fairly knowledgeable/well-trained, with the highest levels of knowledge and training among:
    • younger coaches ages 18 to 34
    • paid coaches, and 
    • coaches of school and select/travel teams.

The not-so-good news

The Safe Kids survey also contains some findings that aren't so good:

Parents:

  • Nearly 7 out of 10 (65%) allow their kids to play on more than one team at the same time (22% in the same sport, 43% in a different sport), despite substantial evidence that playing on more than one team at the same time increases the risk of overuse injury (3 out of 10 say that their youth athlete suffered the same injury more than once) and burnout, and thus is not recommended.
  • While the vast majority (92%) rely heavily on coaches to keep their kids safe, just two out of five parents (38%) even know how much sports injury prevention training their kid's coaches has had.  Despite statistics showing that 3.5 million children ages 14 years and under receive medical attention each year for injuries suffered while playing sports, a large plurality of parents (48%) are only somewhat concerned, or not at all concerned (22%) that their child's coaches haven't received enough training in sports safety, with only 12% and 19% of parents respectively being extremely or very concerned.
  • While most are worried about their children being injured (34% worry often or always), more than four in ten (43%) only worry sometimes, and one fourth (24%) either rarely worry (20%) or never worry (4%); among this group the prevailing attitudes were that "injuries are just part of the game," "children can protect themselves," and "accidents happen."
  • While eight out of ten parents believe they are either fairly or highly knowledgeable about sports injury prevention, a self-assessment higher among younger parents (ages 18 to 34) and parents of of kids ages 8-9, parents actually know a lot less than they think:
    • nine in 10 underestimate the length of time kids should take off from playing any one sport during the year (2 to 3 months);
    • Four in 10 underestimate the amount of fluids a typical young athlete needs per hour of play;
    • Are only good at recognizing some of the signs of concussion (dizziness or "seeing stars" and loss of consciousness recognizable as concussion signs by 87% and 81% of parents respectively), and less so others, such as vomiting (72%), pressure in the head (69%), and fatigue (63%).

Kids:

  •  4 out of 10 (42%) have been injured badly enough while playing sports that their coach or adult made them take break until they felt better, with the percentage higher for older kids (15-18 years)(52%) than younger kids 8-14 (44%);Teenager on crutches with ankle sprain
  • 44% rely on other players on team to keep them safe;
  • 10% have stopped playing a sport because of injury or fear of being hurt; of those 6% were forced to stop by parent who feared injury, the rates for older kids is significantly higher; and
  • Few mentioned a coach telling them to take time off from sports during the year as a way to prevent injury.

Coaches

  • While 6 out of 10 have received some form of sports safety training (with CPR (21%) and first aid (13%) the most common form of training) 40% have received no safety training.
  • While recognizing the importance of safety training, they see significant barriers to additional training as:
    • Cost (48%)(slight majorities, as a result, want free training, either online or at a local clinic)
    • Lack of time (46%)
    • No local source to easily access (41%)
    • Available training doesn't cover injury (24%)
  • Almost nine out of ten (88%) report that a child on their team had suffered some type of injury, with the most common being:
    • Cut or scrape (70%)
    • Bruises/black and blue (54%)
    • Sprain, strain or pulled muscle/ligament (46%)Play at the plate
    • Broken bone (21%)
    • Overuse/stress related (17% overall but 26% for coaches of kids 15-18)
    • Concussion (16% overall, higher for kids ages 15-18)
    • Dehydration/heat illness (16%)(considered the most preventable of all sports injuries)

The bad news

Most disturbing of all were the survey's findings that misperceptions and uninformed behaviors are all too common, resulting in overuse injuries, dehydration, concussions, or worse.

Parents:

  • Nearly half of all coaches report being pressured by parents, or the kids themselves, to play an injured child during a game.
  • The most notable pressure is coming from parents, and being directed towards paid coaches, demands which may be hindering coaches' ability to keep player safety as a top priority.

Kids:

  •  3 out of 10 agreed with statement that "good players should keep playing their sport even if they are hurt unless a coach or adult makes them stop " (44% of boys 15-18 agreed with this statement).  This shows that a warrior mentality is, unfortunately, still alive in well in youth sports, particularly among high school boys.

Coaches

  • An alarming half (52%) of all coaches mistakenly believe that there is an acceptable amount of head contact (ie. getting their "bell rung", seeing stars) young athletes can sustain without potentially causing a serious brain injury, with the percentages of those who felt this way highest among coaches under age 35, male coaches, and paid coaches. This despite the fact that 9 out of 10 coaches know that most concussions occur without a loss of consciousness.
  • Despite a desire for more safety training, nearly 4 out of 10 (39%) don't think more injury prevention training would make much of an impact on the rate kids are injured;
  • Indeed, nearly half (47%) agreed with the statement that they had so many other responsibilities as coaches and so little time that they could not focus on injury prevention.  Surprisingly, this percent was highest among younger coaches aged 18 to 34 and paid coaches (perhaps because, unlike 6 out of 10 youth sports coaches, they do not have a son or daughter on the team?)

The irony is that it is parents, coaches, and the players who not only share the blame for making youth sports less safe but hold the key to making sports safer and preventing so many needless injuries.


1. Mickalide AD, Hansen LM. Coaching Our Kids to Fewer Injuries: A Report on Youth Sports Safety. Washington, DC: Safe Kids Worldwide, April 2012
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