Risk management and education are key to lowering the risk of sports injuries

If there’s one sure thing you can count on in sports, it’s that athletes get injured. Athletes of all ages and sizes participating in any sport from archery to wrestling risk being injured. Injuries can occur during warm-up, practice, and play. They even occur on the sidelines, in locker rooms and on the bus heading to a tournament.

However, many potential injuries can be prevented through best risk management practices. And when injuries do occur, it’s important that the proper steps are immediately taken.  Too many injury-related insurance claims and lawsuits arise out of improper attention to injuries. Sports administrators, coaches and trainers who implement the following guidelines greatly reduced their risk of liability.

Pre-injury planning

Maintain and post an emergency phone list that includes:

• EMS, Police and Fire: 911
• Water Emergency
• Gas Emergency
• Electricity Emergency
• Site Map: include a detailed map of all fields, parking areas, buildings, and streets. Include symbols for emergency access points for EMS, first aid stations, AED’s, fire extinguishers, and utility disconnect or shut off points. List the exact name and address of the facility and the names of the closest roads and intersections. Keep this list with the first aid kits.

First Aid Kit:  Keep a first aid kit available at all practice and game locations.  Each coach should always keep a fully-stocked first aid kit in his or her vehicle.  Ensure access to ice or cold packs at all practice and game locations.

First Aid and CPR Training: Each coach and manager should provide documentation of their successful completion of a Red Cross-certified first aid and CPR training course within the past three years. (Note: First aid training and CPR may be a standard according to some authorities. However,  there is not widespread compliance within most non-scholastic, volunteer-run youth sports programs. Do not list this provision unless the organization is in full compliance.)

Emergency Information and Medical Consent Forms:  Keep either a hard copy or electronic copy available at all times in the event emergency treatment is required.

Pre-participation Screening

Some sports governing and sanctioning bodies require submission of an approved pre participation medical clearance form. Others may require an actual sports physical. The difference is that a medical clearance form can be signed by a healthcare professional based on a recent physical whereas a sports physical requires a new evaluation. There are various legal definitions of “approved healthcare professional” among the 50 states,  but generally this term includes a medical doctor (MD), osteopathic doctor (DO), physician’s assistant (PA), nurse practitioner (NP) or athletic trainer (AT). Non-contact sports generally don’t require preseason physicals and medical clearance forms. Note that it is not the standard in all sports to require either a pre participation medical clearance or a pre season physical.

Flexibility Conditioning, and Strength

Warming up raises the body temperature, which prepares muscles for exercise. Participants also need to stretch after the warm up.  Coaches and trainers should require engagement in standard flexibility and stretching exercises by all participants prior to practices and games.

Conditioning exercises increase physical fitness and athletic skill. Sport-specific strength training programs are fundamental to an athlete’s development and success. Instruction on and implementing reasonable and age-appropriate conditioning and strength training programs are key to injury prevention. However, strength training with weights is normally not encouraged for athletes aged 12 and younger.

Emergency Weather Plan

In the event of lightning, follow the 30/30 lighting rule. Suspend all outdoor play with appropriate evacuation whenever the time between lightning strike-to-thunder clap is under 30 seconds. Do not resume play until thunder ceases for 30 consecutive minutes. If no fully-enclosed buildings are on-site, evacuate players to vehicles.  Please see our “Lightning Safety” article for more detailed information on this subject.

Tornado warnings require immediate suspension of all outdoor play with appropriate evacuation to appropriate shelter. Underground shelters such as storm cellars and basements offer the best protection from a tornado. However, other shelter options to consider are:

• A small interior room or hallway on the lowest floor possible of a sturdy building. Baseball dugouts, tents, and sheds are not appropriate shelters.
• Rooms constructed with reinforced concrete, brick or block with no windows and a heavy concrete floor or roof system overhead.
• Avoid auditoriums, cafeterias and gymnasiums, which have flat, wide-span roofs that can be ripped off in high winds.

Avoiding Heat Illness:

Educate all staff and players on pre-activity hydration and the prevention of heat illness. We encourage use of our article “Heat Illness: Avoidance and Prevention” to satisfy this requirement.

Be prepared to postpone or reschedule practices or games to avoid peak temperatures. Ensure that water and/or sports drinks are readily available. Schedule mandatory fluid breaks during practice and games. Modify the duration, intensity, and equipment usage during practices as necessary. Likewise, modify the game rules to allow unlimited substitutions.

Make use of the Wet Bulb Globe Temperature (WBGT), which is the new standard for decision making. Keep a WGBT meter on site or use the Weather FX app, available on iTunes and Google Play.

Create and always follow an emergency action plan for participants who do become ill from heat. Include plans for EMS access to the venue. When a player presents symptoms of heat stroke, call immediately EMS and start cold water immersion while waiting for their arrival. A cold water immersion tub should be available on location. It does not need to be expensive as a Rubbermaid container or plastic kiddie pool will work.

Concussions/Brain Injury

We highly recommend the sports organization adopt and implement our Concussion Awareness Risk Management Program as part it overall risk management program.

Post Injury Treatment

• First Aid: No staff member administering first-aid should exceed the scope of his or her training. Stabilizing and preventing the injury from worsening is the purpose of first aid. After achieving stabilization, allow medical professionals provide all further treatment. Provide EMS with participant’s Emergency Information and Medical Consent Form.
• Medical Emergency: Call 911 if immediate attention is necessary. Refer to the site map when speaking to EMS to provide clear instructions about the location of the facility.
• Parent Notification: Notify parents/guardians immediately when a treatable injury occurs.
• Notification of Risk Management Officer: Notify your RMO who initiates documentation of the injury.
• Return to Play: Require players treated by a medical professional to provide a written return-to-play clearance form from one of the medical professionals listed in the Pre-participation Screening paragraph above. However, note that some states and governing bodies will only allow MDs and DOs to sign such a form after a concussion. Do not put pressure on players to return too early. Honor the instructions of healthcare professional. 
• Concussions: Follow the removal, treatment, and return-to-play protocols that can be found in our Concussion Awareness Risk Management Program.