Clinical management of musculoskeletal injuries in active children and youth

Clin J Sport Med. 2010 Jul;20(4):249-55. doi: 10.1097/JSM.0b013e3181e0b913.


Objective: To describe how different health care specialists manage musculoskeletal injury in children and examine factors influencing return to play decisions.

Design: National survey.

Setting: Secure Web site hosting online questionnaire.

Participants: Medical doctors, physical therapists, and athletic therapists who were members of their respective sport medicine specialty organizations.

Independent variables: Professional affiliation and the effect of the following factors were examined: pushy parent, cautious parent, protective equipment, previous injury, musculoskeletal maturity, game importance, position played, team versus individual sport, and time since injury.

Main outcome measures: Recommendation of return to activity after common injuries seen in children and adolescents as described in 5 vignettes; consistency of responses across vignettes.

Results: The survey was completed by 464 respondents (34%). There were several differences between the professional groups in their recommendations to return to activity. Most factors studied did not tend to influence the decision to return to activity, although protective equipment often increased the response to return sooner. The number of participants who would return a child to activity sooner or later for each factor varied greatly across the 5 vignettes, except for pushy parent or cautious parent.

Conclusions: Management practices of sport medicine clinicians vary according to profession, child, clinical factors, and sport-related factors. Decisions regarding return to play vary according to 5 specific characteristics of each clinical case. These findings help establish areas of consensus and disagreement in the management of children with injuries and safe return to physical activity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Athletic Injuries / therapy*
  • Attitude of Health Personnel
  • Child
  • Decision Making*
  • Humans
  • Parents
  • Physical Therapy Specialty
  • Practice Patterns, Physicians'*
  • Risk Assessment
  • Sports Equipment
  • Sports Medicine
  • Surveys and Questionnaires