As a parent, you want nothing more than to keep your kids safe from harm, but you can only go so far. At some point, you have to let them run and play, knowing they will probably get hurt eventually. But what they play, specifically when it comes to sports, may influence how often and how badly they get injured.
Which activities are most likely to land your kids in the hospital? NerdWallet analyzed five years of data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System to determine the top activities that send children ages 5 to 14 to the emergency room.
While the No. 1 activity may be no surprise – the rough-and-tumble play of football sent the most kids to the emergency room – there are some startling trends occurring in the world of play and safety. Biking – which in the past perennially duked it out with football for dominance in sending children to the hospital – has seen a notable drop of 13% despite an increase in bike sales.
While communities have battled over the rights of skateboarders in parks and public places, the number of skateboarding injuries from 2007-2012 has dropped a whopping 44.4%. Other top activities seeing a drop in ER visits are trampoline-related injuries (-13.8%) and non-inline skating (-6.9%).
“From a practitioner standpoint, we don’t see as many injuries from these recreational activities as we once did,” Dr. Russell Petrie, a sports medicine orthopedist from Hoag Orthopedic Institute in Irvine, California, told NerdWallet. “One commonality is riding bikes, jumping on trampolines, and skateboarding still remains largely recreational; and with the exception of skateboarding, the professional sports opportunities and college scholarships are not available with these sports.”
That’s the good news. The bad news is one of the most popular recreational activity for kids in the summer has seen a 28.2% increase in hospital visits from 2007 to 2012: swimming.
Feeding the trend are more homeowners building private pools and whirlpools, says Ellyn Pollack, spokesperson for the Consumer Product Safety Commission.
“And pools are the No. 1 cause of accidental deaths of children under the age of 5,” says Pollack.
Other sports and activities seeing a rise in child-related injuries from 2007 to 2012: Volleyball (22.1%), basketball (21.4%), soccer (19.8%), hockey (14%) and baseball (3.1%).
“All the team sports that are cutting, pivoting and player-to-player contact have an increase in injuries,” Petrie said. “Furthermore, all of these sports have collegiate and professional implications for young athletes.
“With the advent of year round sport, in Southern California, we have seen a rise of overuse injuries in certain sports. Football, basketball and soccer would lead that list,” Petrie added. “Thirty years ago, a specific sport last three or four months and then kids changed sport, now kids are playing sport year-round. This can overstress certain parts of the immature skeleton.”
Experts agree that the health benefits of physical activity far outweigh any remote chance your child will get injured. Still, it’s a reminder that when children play, they need to play safe. The Centers for Disease Control and Prevention estimate that half of all sports injuries in children are preventable.
Here’s a look at the top 11 activities that have sent children ages 5 to 14 to the hospital in recent years:
Measured by TV viewership, football is by far the most popular sport in America – 46 of the top 50 most watched sporting events in 2013 were NFL games. So it’s no surprise that football ranks at the top activity for children ER visits in 2012.
Still, the statistics belie a growing trend of children moving away from organized football in the wake of concerns about head injuries in professional football. From 2010 to 2012, Pop Football – the nation’s largest youth football program – saw a 9.5% drop in children participating in the program, according to ESPN. USA Football saw a 2011 drop of 6.7% of children ages 6 to 14 playing football.
Besides head injuries, ankle and knee ligament injuries such as ACL tears and shoulder dislocations are common reasons for an ER visit, Petrie said.
In 2007 and 2009, more children were sent to the hospital for bicycle-related incidents than any other activity, according to CPSC data. But the number of injuries has been steadily dropping in recent years, even as participation increased 5% from 2007-2012, according to the National Sporting Goods Association.
“Over the last 10 years there has been a push for greater helmet, wrist and knee protection with skateboarding and bicycles,” said Petrie, who said typical bike injuries he sees are clavicle and wrist fractures.
With its inclusion of both boys and girls in organized college and professional play, basketball leads the numbers for having the greatest participation of 6-to-17-year-olds. About 7 million American kids played in organized basketball leagues in 2012, according to a Sports and Fitness Industry Association/Physical Council Report.
More high schools have organized boy and girl basketball teams playing in leagues than any other sport, with about 17,500 high schools each, according to the National Federation of High School Associations.
Major injuries with basketball are often ankle sprains and fractures, as well as ACL tears in the knee, Petrie said.
According to a 2012 analysis by ESPN, youth baseball is the most popular organized sport for little athletes ages 6 to 8 and remains the second most popular organized sport behind basketball until high school. About 1.3 million children and teens participate each year in Amateur Softball Association Youth Leagues.
Repetitive arm stress and overuse are common injuries, experts say. Twenty percent of children ages 8 to 12, and 45% of those ages 13 to 14, will have arm pain during a baseball season, according to a 2009 American Academy of Orthopedic Surgeons study.
With the World Cup starting this month, soccer will be put in the (albeit rare) national U.S. media spotlight. But the popularity of the sport has been feeding participation – and the number of injuries, experts say.
“If one looks at the popularity of MLS (Major League Soccer) in this country I suspect you will see a commensurate rise in injuries, not from a increased prevalence but an increase because more kids are playing more often,” Petrie said. “More total hours played of a sport increases absolute injury numbers.”
Ankle sprain and ACL injuries are common.
“In goalies, we will often see soft tissue shoulder injuries when goalies dive and finger injuries when the ball hits the hand,” Petrie said. Also common are fractures where tendon or ligaments get pulled off the pelvis of the dominant fracture side, he added.
Swimming is one of the most popular summer pastimes for youths – 36% of children between the ages of 7 and 17 go swimming at least six times a year, according to the CDC. So a 28.2% increase in swimming-related injuries should raise alarm bells. The NerdWallet analysis of 2007-2012 data mirrors results from a 2013 study from Nationwide Children’s Hospital, which showed that the number of ER visits for children ages 7 to 17 increased by 30% from 1990 to 2008.
Hot summers, a growth in the number of private pools and the heavy migration of population toward coastal areas appear to be leading the trend. Ocean coastlines constitute only 10% of the area of the U.S., yet 39% of the U.S. population lives in a county adjacent to coastal areas in 2010, and that is expected to climb to 47% by 2020, according to the National Oceanic and Atmospheric Administration.
To help reverse the trend, the CPSC is asking all adults and children to go to their website and sign its Pool Safely Pledge.
“Adults should always designate a pool watcher, should always have proper fencing and drain covers, learn CPR and make sure their children learn to swim,” said CPSC spokesperson Ellyn Pollack.
She also encourages people to take part in “the world’s largest swimming pool lesson” on June 20.
Trampolines have a long and controversial history in backyard play. Health groups like the American Academy of Pediatrics have long advised against their purchase because of spinal injury risks due to somersault and flip attempts. According to a recent study by Indiana University, there have been 1 million ER visits from 2002-2011 due to trampoline-related injuries, costing just over $1 billion in health care costs.
Study author Dr. Randall T. Loder thinks trampolines should be banned. “I think trampolines should not be allowed in backyards. It’s that simple,” he said in a recent interview. “It’s a significant public health problem.”
The average age of the injured was 9 years old, the study said.
“About 60% of the fractures were upper-extremity injuries, notably fingers, hands, forearms and elbows,” the study said. “Lower-extremity fractures most commonly were breaks in the lower leg — the tibia and fibula — and ankles … An estimated 2,807 spinal fractures were reported during the period studied.”
Manufacturers now advise users to only allow one child at a time on a trampoline – 75% of all injuries occur when there are two or more jumpers. Enclosures to prevent errant bounces onto the ground are now standard. And injuries, which peaked at 110,000 ER visits in 2004, have been on a long downward slide. The AAP attributes the decline, however, to declining trampoline sales rather than improved safety.
“Trampoline design changed with enclosed trampolines and awareness of different sized children on a trampoline, as a risk factor for injury has been better recognized,” Petrie at the Hoag Orthopedic Institute said. “I can’t remember the last time I saw a trampoline injury.”
Roller skating and ice skating have the longest history of any of the sports on this list. The first roller skate was introduced in 1760, following the long history of ice skating, which traces its history back some 3,000 years in modern-day Finland.
Roller skating has had its ups and downs – often following the trajectory of the U.S. economy, as a recent Atlantic article notes. The number of roller skaters has dropped to 13.35 million in 2012 from 19.74 million in 2007, according to website Statistica. Ice skating enjoys perennial popularity thanks to its Olympic and professional skating status, as well as its close cousin ice hockey (see No. 10 below).
Still, thanks to the decline of roller skating popularity, skating-related injuries are also down. Wrist, elbow and ankle injuries are most typical, according to the American Journal of Sports Medicine.
Skateboarding has lost its cool.
The number of people who skateboard has dropped by 47% from 2007 to 2012, according to the National Sporting Goods Association. While that drop worries aficionados and skateboard manufacturers, it has brought a bright spot to the ER doctors and parents – the number of ER visits for skateboard-related injuries dropped 44% during the same time period.
Skateboard injuries are often wrist, knee and ankle injuries, Petrie said. Again, he believes the use of helmet, wrist, knee and elbow pads is further reducing the number of injuries doctors have seen recently.
Hockey is now the sixth most popular sport in the U.S., according to a recent Harris Poll, up from No. 11 in 1985. The National Hockey League – which only had four U.S. teams in 1967 – now has 23 in the U.S., including sunny climes like Los Angeles, Tampa Bay and Miami. Viewership of the NHL regular season on NBC reached record viewership this year.
So it’s no surprise that more kids are heading to the rink and coming off bruised and bumped. Youth participation has grown from 200,000 in 2000 to more than 350,000 in 2012, according to the American Academy of Pediatrics. Especially controversial is at what age children should be allowed to “check” opponents – full body defensive blocks of whomever controls the puck. USA Hockey allows checking starting at the 11-to-12-year-old Pee Wee League, but a recent AAP study recommends raising the age to 15.
“Boys who play ice hockey in leagues that allow body checking are two to three times more the likely to suffer serious injuries and concussions compared to boys in non-checking programs,” the AAP study says.
The growth in the number of volleyball-related injuries is a head-scratcher. Some key benchmark statistics show a rise in popularity in the sport – but nothing to match the 22.1% increase in ER visits for children ages 5 to 14, the second highest rise next to swimming.
Wholesale sales of volleyball sets of nets and balls climbed to $65 million in 2013 from $56 million in 2008, an increase of 16%, according to the Sports and Fitness Industry Association. Participation in volleyball in high school has grown to more than 470,500 students from just under 445,000 in the 2007-08 school year – an increase of 5.8%, according to the National Federation of High School Associations.
Volleyball’s growth is fueled by popularity among girls.
In general, “there is a higher prevalence on certain knee ligament injuries in females compared to males,” Petrie said. “With increasing sports participation in the female population, one would expect some increase in injuries.”
Illustration and infographics by Brian Yee. Statistics from the Consumer Product Safety Commission’s National Injury Surveillance System.