College athlete’s gruesome leg break sparks national conversation about injury prevention in young players

by Tripp Underwood on April 5, 2013

Kevin Ware- Picture from USA Today

Last week, sports fans collectively gasped with sympathetic pain when Kevin Ware, a 20-year-old basketball player from the University of Louisville, suffered a devastating leg injury during a nationally televised NCAA tournament game. In an attempt to block an opponent’s shot, Ware leapt into the air and landed in such a way that shattered two bones in his leg—the tibia and fibula—just below his right knee.

The tibia break was especially gruesome, with the bone not only breaking, but ripping through his skin and protruding outward. (An injury known as a compound fracture.) In addition to being very painful, compound fractures can be harder to treat than typical breaks and carry an increased risk of infection.

“Anytime you have a fracture there is the risk of infection,” says Boston Children’s Hospital’s Division of Sports Medicine doctor Michael Beasley, MD, who along with thousands of other people watched the injury live on television last Sunday. “But when that fracture also breaks the skin the risk of infection to the surrounding muscle and tendons increases. You also significantly increase the risk of infection in the bone, which can be very troubling if not caught early.”

There is a lot of speculation as to what could have caused Ware’s leg to break so badly, especially since his fall didn’t appear too out of the ordinary for a basketball game. Stress reactions—chronic stress in the bone that doesn’t present obvious symptoms but can weaken the overall structure of the bone—have been presented as a possible culprit, but so far nothing seems to indicate this is true.

Regardless of why Ware’s injury happened the way it did, the national stage it occurred on has put the discussion of sport injury and its prevention in the spotlight. The topic is especially important for young athletes and their parents because severe and/or recurring injuries to growing and developing bodies could have serious lasting effects.

According to Beasley, one of the more common mistakes young athletes make is ignoring persistent pains. Aches and pains not associated with any specific injury are often dismissed as regular “wear and tear,” and many players will simply to try to play through them. In most cases the pain goes away in time; aches caused by muscle fatigue or overuse often go away with a little rest. However, in some cases the pain could be indications of a more serious injury that requires more than rest to heal. If your child is complaining of a nagging pain that doesn’t seem to be related to a specific injury, a good first step would be decreasing his or her training in order to allow his or her body time to heal. If that doesn’t seem to help, it could be time to see a professional.

“We are seeing more and more injuries in young athletes that are related to their growing muscle structure. But with the right preparation many of these injuries can be avoided.”

“Resting or scaling back the intensity level of the child’s workout is a good first approach to dealing with these kinds of seemingly random pains,” says Beasley. “But if the pain persists and rest isn’t helping it could be a sign of a more serious problem that needs a closer look from the child’s pediatrician or a sports medicine physician. For instance, stress fractures of the tibia often present like shin splints, when in reality they are a much more complex condition.”

If your child is active in sports, you may also want to consider taking him or her to see a sports medicine expert for a pre-season physical or baseline full body evaluation. This examination lets a specially trained doctor evaluate the child’s health, physical activity routine and identify any pre-existing conditions that could affect the type and amount of physical activity he or she undergoes in the upcoming season. Typically these evaluations are available by appointment, and take into account the athlete’s age, sport and level of competition.

“We are seeing more and more injuries in young athletes that are related to their growing muscle structure. But with the right preparation many of these injuries can be avoided,” Beasley says. “A preseason assessment that closely examines the athlete’s body structure can really go a long way in identifying potential problems so they can be addressed before they turn into a serious injury.”

Download this fact sheet on injury prevention for young basketball players.

 For more information on the services offered by the Division of Sports Medicine at Boston Children’s Hospital, including pre-season evaluations, or to speak with one of our sports medicine experts, please visit their website or call 617-355-3501.

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