Posts Tagged ‘sports injuries’

Improper Sports Injury Care is a Leading Cause of Sports Lawsuits

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 EmergencyEmergency contact form
  • 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 Lightning 30-30 ruleevacuation 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.

Cheer Injuries: Low Frequency But High Severity

Risk management and coach training integral to safety

In the last 20 years, high school cheerleading has morphed from an activity on the sidelines of the athletic field to a highly competitive sport. This and the increasingly difficult stunts cheerleaders perform are contributors to the increase in serious cheer-related injuries. However, findings of a recent study published in Pediatrics show that cheer injuries tend to be more severe in nature but fewer in number in comparison to almost all other high school sports.

The study’s results found that only gymnastics had a higher proportional rate of injuries than cheer that resulted in athletes being benched for periods of three weeks to an entire season. Other significant findings are that male cheerleaders are more likely to experience injuries and that most injuries occur during practice.

What’s behind the injuries and how to prevent them

Nearly half of cheer injuries are suffered by cheerleaders who make up the formation bases for pyramids and other stunts. Fliers account for 36 percent and spotters 10 percent.

Concussions, while the most common cheer injury, were significantly lower than all other high school sports combined. However, most cheer concussions were the result of elbows and other body parts hitting a cheerleader’s head rather than the head hitting the ground or other surface. Other common cheerleading injuries are ligament fractures, sprains, and muscle strains.

The complexity of the stunts performed and the height at which cheerleaders fly mean that having an experienced coach is integral to each team, according to Mark Riederer of Pediatric Orthopaedic Surgery and Sports Medicine at C.S. Mott Children’s Hospital at the University of Michigan.

Proper safety equipment, making sure the cheerleaders are all at the same performance level, and having an athletic trainer on the high school staff can all help reduce the risk of injuries.

Sport or extracurricular activity?

Approximately 400,000 students across the U.S. participate in high school cheerleading each year. This number includes more than 123,000 who participate in competitive squads that include dynamic tosses pyramids, and other stunts in their routines.

Not all schools classify cheerleading as a sport. The distinction between cheer as a competitive sport and a non-athletic extracurricular activity is significant because sports incorporate stricter safety rules. For cheer rules would designate  practice locations that are relatively free from distractions and specify coach certification requirements.

All in all, cheerleading is not a particularly dangerous sport and appears to be safer than other sports, said Dustin Currie, lead author of the study. But, he added, precautions to minimize the potential risks of injury and to alleviate parents’ fear of participation in cheer should be a priority.

According to John Sadler, this information is consistent with our studies on youth cheer outside of school sports. We see relatively few injuries by frequency but some are severe. Therefore, quality, high limit Accident and General Liability insurance is still a must. Also, there is definitely a correlation between injuries and the quality of coach training and certification, as well as the standards that are being followed.

We have several articles on the topic of cheer safety on our blog and in our risk management library. And please contact us or  click here for further information or a fast quote for cheerleading insurance.


Sources:
Ashley Welch. “Cheerleading injuries less common, more severe than other sports,” cbsnew.com. 10 Dec. 2015.
Maureen Salamon. “Concussion is top injury among cheerleaders, study finds,” chicagotribune.com. 10 Dec. 2015.

Reducing the risk of ACL injuries

Is prevention the best medicine?

 

You’d be hard pressed to find any youth soccer, basketball or football team that doesn’t have at least one player with an ACL injury.

ACL diagramThe anterior cruciate ligament, or ACL, stabilizes the knee and is highly susceptible to injury during high impact sports. As the popularity of youth sports continues to grow, so does the number of teen and young ACL injuries. How can this be minimized?

Training for prevention

Young athletes receiving universal neuromuscular training is proving to be an effective deterrent to ACL injuries, according to a recent Columbia University Medical Center study. The training teaches athletes proper bending, jumping, landing and pivoting techniques. The study focused on 10,000 “at-risk” athletes between the ages of 14 and 22. The results showed an average reduction of 63 percent in ACL injuries in those who received universal training.

Screening for ACL weaknesses also helps reduce the number of ligament sprains and tears, but reduced the rate by only 40 percent.

Counting the costs

The estimate to run a universal training program for coaches and players is about $1.25 per day, according to the study researchers. ACL reconstruction can cost anywhere from $5,000 to $17,000.

“According to our model, training was so much less expensive and so much more effective than we anticipated.” said orthopaedic resident Eric F. Swart, the lead author of the study

While preventive training and screening might sound like the best option, screening is a high-cost variable if implemented on a team-wide basis.

Source: “Universal neuromuscular training reduces ACL injury risk in young athletes,” Medical Xpress. 14 Mar. 2014.