Youth Sports Coach’s Guide to First Aid: Treating and Preventing Physical Injuries in Young Athletes

March 27, 2020

The National Federation of State High School Associations reports that during the 2014-2015 academic year, there was an estimated 7.8 million student athletes participating in sports in the United States. Of those, about 2.5 million participated in contact sports. Previous studies from 2013 found that there were an estimated 1.3 million emergency room visits for injuries related to 14 different sports commonly played by children ages 6-19. Youth sport injuries often consist of, but are not limited to:

Asthma
Cervical spine/neck injury
Exertional sickling
Heat illness (heat stroke)
Mental health
Misuse of opioids/amphetamines
Misuse of performance-enhancing drugs/supplements
Sudden cardiac arrest
Traumatic brain injuries and concussions

It is important for schools to verify that their sports staff (coaches, athletic trainers, and nurses) are adequately trained and educated on injury prevention and treatment. Even those who aren’t hands-on in the coaching or athletic training process may find it useful to be up-to-date on their injury prevention and treatment methods to accurately report and analyze the games’ events.

The American College of Sports Medicine also reports that 96% of Americans believe it is important for a student-athlete to be evaluated by a qualified medical professional prior to playing sports to make sure they are healthy enough to play. This can help to ensure the athlete isn’t already injured, as well as prevent future injuries from happening.

Professional and even college sports have major economic and social importance, but injuries can impede performance, disrupt teams, and even end athletic careers. Students of sport business management as well as coaches, parents, and athletic leadership all have a role in ensuring adequate safety and preventive strategies are employed to keep athletes of all ages safe and in the game.

Basic First Aid Guidelines

Basic first aid guidelines are always changing. Below are the current tips for intervening during an injury.

CPR, AED, and First Aid Certifications

Typically, it is required that coaches and any other first aid staff on hand at sporting events be up to date on their automated external defibrillator (AED) knowledge, basic first aid certification, and cardiopulmonary resuscitation (CPR) certification.

Automated External Defibrillator (AED): An AED is a medical device that is used to help those experiencing sudden cardiac arrest. It analyzes the heart’s rhythm, and when necessary, delivers an electrical shock (defibrillation) to help the heart to reestablish an effective rhythm. These devices can be found in various locations throughout a facility. It’s important for medical and sporting personnel to know where these devices are located at all times, especially during a sporting event.

Due to the fact that the average response time for first responders is 8-12 minutes, having access to an AED and knowing how to use one is critical. For every minute defibrillation is delayed, the chance of survival decreases by about 10%.

Basic First Aid Certification: When people are certified in basic first aid, they have the basic information and skills necessary to help children and adults in the case of a medical emergency. Having these skills is especially important for youth sports coaches because it allows someone to begin administering treatment while waiting for the athlete’s parents and/or first responders to get to the scene. Certifying in first aid means they are certified in, but are not limited to aiding in:
- Asthma emergencies
- Anaphylaxis
- Burns
- Choking
- Diabetic emergencies
- External bleeding
- Environmental emergencies
- Heart attack
- Poisoning
- Neck, head, and spinal injuries
- Stroke
- Seizure
Cardiopulmonary Resuscitation (CPR) Certification: Being certified in CPR means you are able to accurately perform an emergency procedure that consists of methodically timed chest compressions, and in the past, mouth-to-mouth breathing. It is important for sports coaches to know how to perform CPR because, like many other life-threatening injuries, performing CPR on an athlete could be a matter of life or death. CPR helps keep the blood flow active and can extend the opportunity for a successful resuscitation in those who have experienced sudden cardiac arrest.

When getting CPR certified, people will undergo classes that inform them of the different CPR methods (AED, hands only), the difference between performing CPR on different genders, why CPR is needed, and when.

Have a First Aid Kit on Hand

Having a first aid kit available at a youth sporting event is vital because it can aid the sports management personnel or coach in quickly tending to an injury. All first aid kits should contain, but shouldn’t be limited to:

Ace bandage wrap (typically for wrists, ankles, knees, and elbows)
Adhesive bandages
Aluminum finger splints
Antibiotic ointment
Antiseptic wipes
Calamine lotion
Disposable/instant ice bags
Face mask
First aid manual
Hand sanitizer
Hydrocortisone cream
Latex/non-latex gloves
Sterile cotton balls and cotton tip applicators
Sterile gauze pads
Syringe, medicine cup, medicine spoon for medications
Thermometer
Tweezers

The first aid kit should be stored in a location that is easy and quick to access.

Reacting to and Assessing an Injury

Coaches should also know the proper time to intervene during a sporting event to perform an injury assessment. Initial on-the-field injury assessment begins by following the “ABCDE” rule.

A: Airway maintenance with cervical spine protection
B: Breathing and ventilation
C: Circulation and hemorrhage control
D: Disability (neurological evaluation)
E: Exposure and environment

The common methods of assessing injuries may vary depending on the sport, since different sports have different risk factors. After the initial evaluation, it may be in the best interest of the athlete to get a second opinion, whether it be by the athletic trainer or a paramedic, to best ensure they get the proper treatment.

Typically, an injury can be spotted on the field when the athlete stops moving, lies down, begins to limp, or the referee notifies the coach. It is important for a coach to pay attention to these signs to help prevent the possibility of worsening the injury.

Talking to Parents and Guardians About Youth Sports Injuries

Discussing injury prevention practices with parents can be a tense conversation. Coaches of student-athletes will want to take the time to talk to each of the athlete’s parents or guardians about the importance of injury prevention, what to do if the athlete is injured, and recovery time. This can be done either one-on-one, in a group setting, or via email/phone call.

It is important, while conveying the message, to speak clearly and provide details and examples. For instance, if the child is hurt during a game or practice, explain what happened right away and be straightforward. This is to help ensure the parent/guardian isn’t left wondering for too long and they are getting the answers they need upfront.

It’s natural to have parents who are upset when presented with an injured child. These situations can be difficult to handle, so it’s best for the coaches to be prepared for these conversations ahead of time. A few tips for coaches who have to handle difficult parents are as follows:

Define and communicate shared goals, values, and procedures to parents and players.
If the situation gets too out of hand, the best option would be to physically remove yourself from the conversation.
Outline clear roles for coaches, parents, and players.
Remember that you can only control your actions and words, so when you’re speaking with the parent remember to listen, empathize, and explain.
Try to exude a positive attitude, even if the situation isn’t ideal.

Sports Injury Prevention Strategies

Implementing coaching techniques that help to ensure injury-free practices and games can help decrease the different risks in youth sports. This can include, but is not limited to, safe gyms and playing fields and the proper use of gear and equipment.

Keeping Fields and Gyms Safe

It’s not uncommon to hear of injuries that are caused due to improper maintenance of playing fields. To prevent injuries, coaches, players, and maintenance staff should engage in the upkeep of the sports field by:

Clearing Debris: Debris and other foreign materials can get in the way of the field’s readiness for play. Prior to practices and games, get rid of trash, rocks, unnecessary equipment, water bottles, etc. to ensure a clean surface area for playing.
Considering Using Field Covers and Protectors: It’s important to maintain the field’s integrity, even when it is not in use. This can be done by using field covers and protectors to help prevent debris and weather damage to the field during the off-season.
Keeping in Mind Surface Hardness: A majority of concussions in sports-related incidents are a result of the player’s head hitting a hard surface. This can be prevented with the help of tests that are conducted on the surface hardness of the field. If it’s too hard, take the necessary steps to make it softer.
Leveling the Playing Field: It’s important to be aware of holes or divots in the field, as these areas could cause the athletes to trip, stumble, and fall — causing injuries in the process.
Making Sure Necessary Equipment Is Secure: Making sure the field equipment, such as soccer goals and football goal posts, are properly secure can help prevent damage to the field — as well as prevent injury caused by inaccurate installation of equipment.

Gyms are often used to help strengthen and condition student-athletes. That means it is also important to maintain a safe workout environment for those using the facility:

Don’t Forget the Locker Room: Even though the athletes may not be using the locker room to work out, it is still important to make sure they’re safe while they’re in there. This can be done by making sure there are the proper number of drains and mats to prevent slipping, the proper chemicals are used to clean to prevent the spread of foot fungus/warts, there are no fire hazards, and there is a staff member near the locker rooms at all times to prevent any physical altercations — especially after an intense practice or game.
Exercise/Weight Equipment Safety: A lot of injuries can happen from the improper use of exercise and weightlifting equipment. This can be prevented by informing the athletes of the correct way to use the equipment, as well as frequent maintenance and wiping down the equipment after each use.
Placement of Safety Devices Around the Facility: Check to see if the gym is stocked with first aid kits, fire extinguishers, AEDs, smoke alarms, and security systems.
Pool Safety: Make sure the pool area, if there is one, is monitored by an employee at all times and there is an adequate number of signs with cautions and risks to ensure the athletes, or anyone else using the pool, don’t slip/trip.
Take a Walk Around the Facility: Bring a notepad and pen to write down any improvements that need to be made to ensure safety throughout the facility. Ask yourself questions like “How could this go wrong?” “Is the equipment placed too close together?” “Have the machines had their regular maintenance?”

Injury Prevention Equipment

It’s crucial that schools provide their student-athletes with the essential safety gear needed for youth sports.

Baseball/Softball: Baseball and softball players will need
- Baseball cleats
- Baseball glove
- Batting helmet
- Catchers gear
- Protective cup
- Water bottle

Basketball: Basketball checklist may consist of items such as
- Athletic tape
- Compression shorts/sleeves
- Game-day basketball shoes
- Mouthguard
- Wrist bands

Football: Football players will need
- Football cleats
- Football gloves
- Football pads
- Helmet
- Jockstrap/cup
- Mouthguard
- Neckroll/collar
- Water bottle

Soccer: Youth soccer players need gear such as
- Shin guards
- Soccer cleats
- Water bottles

On-Field Management of Common Youth Sports Injuries

It can be difficult for a coach to notice the signs of an injured player, especially when the athlete doesn’t vocalize that they are injured. This is why it is so important for coaches to let their players know to mention any injuries as they occur. Some of the most important roles of a coach in the recovery process are to:

Be an active listener. Aside from listening to what they have to say, watch their body language.
Be aware of the fear of re-injury.
Communicate clearly during the process of returning to the game.
Continue to coach them and give them words of encouragement.
Stay connected with the player to help them feel like they are still an important part of the team.
Don’t punish the player for getting injured by telling other teammates they aren’t tough enough or just don’t want to play.
Keep the player connected to the team and the sport.
Trust the recovery team and doctors. If the doctor’s orders have specific instructions on the recovery time, make sure the athlete and other coaches follow them exactly, regardless of how much they want to get back into the game.

Concussions

Coaches can identify potential cases of concussions by being aware of the symptoms, which include:

Amnesia surrounding the traumatic event
Headache or a feeling of pressure in the head
Appearing dazed
Confusion or feeling as if in a fog
Delayed response to questions
Dizziness or “seeing stars”
Fatigue
Nausea
Ringing in the ears
Slurred speech
Temporary loss of consciousness
Vomiting

In fact, sports laws include a three action step plan for concussions:

Step One: Educate coaches, parents, and athletes about concussions through training and/or a concussion information sheet.
Step Two: Immediately remove any athlete from the game who is believed to have a concussion.
Step Three: Permission must be obtained by a healthcare professional to return to play or practice after at least 24 hours.

Dehydration and Heat Stroke

A coach should suspect a child may be having heat stroke or experiencing dehydration if they show any of the following symptoms:

Cramps
Disinterest in the game
Dry or sticky mouth
Dizziness
Excessive fatigue
Headache
Inability to run as fast or play as well as usual
Thirst

Coaches can help prevent dehydration and heatstroke by:

Decreasing or stopping practices or competitions if necessary, or moving them indoors or to a shady area.
Ensuring that fluids are available at all times.
Limiting activity at midday, when the temperature is hottest.
Making sure the athletes’ clothing is light-colored, lightweight, and loose-fitting.
Requiring their athletes to drink plenty of fluids before practice and during regular beverage breaks — even if they aren’t thirsty.

Fractures

Fractures that often occur in sports are of the:

Ankle
Clavicle
Distal radius
Fibula
Fingers
Metacarpal
Metatarsal
Scaphoid
Tibial shaft
Toes

Coaches can be aware of fracture symptoms by looking out for:

Angulation of the affected area
Bleeding
Bruising
Discolored skin around the affected area
Dizziness
Non-weight bearing
Pain
Player is pale or clammy
Sickness/nausea
Swelling
Unable to be moved

Additional Injuries to Be Watchful For

Aside from the most common youth sports injuries listed above, coaches, athletic trainers, and parents will want to be watchful for these other injuries in youth sports as well.

ACL Tear/Strain: This can be caused by the athlete trying to cut, pivot, or change directions too quickly. Symptoms often include a loud popping sound, severe pain, swelling, loss of range in motion, bruising, and being unable to bear weight. A slight ACL strain or tear can be healed without surgery using rest and ice. However, a complete ACL tear would require surgery, along with months of recovery time and physical therapy.
Hamstring Strain: Poor stretching techniques or lack of stretching can be the cause of a pulled hamstring. Often an athlete with a hamstring tear will experience bruising and pain behind the thigh and/or knee area. This can be treated by resting and applying ice, followed by gentle stretching and strengthening to prevent another injury.
Hip Flexor Strain: This can be detected if the player is experiencing pain when raising their leg and/or bruising in the front of the upper thigh and groin area. Typically, hip flexor strains are treated with rest and icing for 15 to 20 minutes at a time for 48 to 72 hours. If the pain is still there after two weeks, the player should see a medical professional.
Shin Splints: Athletes who experience shin splints often complain of pain in the lower leg bone. This injury is commonly found in athletes who are runners. This injury too can be treated with rest and icing. Purchasing good shoes with proper arch support can help to reduce the pain in the shins and help with recovery. It is recommended that the athlete gradually gets back into running during the recovery process.
Shoulder Injuries: Shoulder injuries are typically caused by dislocations, misalignments, strains, and sprains. This can either be caused by a lack of flexibility, strength, or stabilization and can be treated with rest and ice. If the pain continues after two weeks, it is recommended that the athlete be evaluated by a physical therapist.

Educational Resources for Coaches

The following resources will provide coaches with additional information and tools that may prove to be invaluable in their efforts to prevent and address sports injuries.

Printable First Aid Manual

Coaches of youth sports teams may want to print off a first aid manual from the Red Cross. Here they will find information on general first aid, CPR, and AED, as well as medical information on:

Anaphylaxis and epinephrine auto-injectors
Breathing emergencies
Environmental emergencies
Injuries to muscles, bones, and joints
Injury prevention and emergency awareness
Soft tissue injuries
Sudden illnesses

First Aid and Injury Prevention Games

It can be hard to express the importance of first aid and injury prevention, especially when teaching them to athletic youth. First aid games can be a powerful educational tool to help teach athletes injury prevention practices in a way that will keep them engaged and willing to learn. These first aid games can include:

Arm sling relay
Bandage relay
First-aid baseball
First aid bingo
First aid carry relay
First aid flashcards
First aid scenarios
Stretcher relay

Further Information

For more information, coaches, staff, and other school personnel can utilize resources that provide additional guidance such as:

Pressure to Perform: This article addresses the different pressures student-athletes may feel in regard to youth sports. Reading it can help the coaches to see the athlete’s point of view, aiding them in better communication.
Signs of Steroid Use: An informative article for coaches educating them on the signs of steroid abuse, legitimate uses for steroids, side effects, how to talk to someone who is using steroids, and much more.
Sports Safety Checklist: This is a checklist that can be resourceful for parents. It provides information such as physical preparedness, different stretches, warm-ups, hydration techniques, appropriate gear, and much more.
Stop Sports Injuries: An injury prevention curriculum for coaches.

Source List:

National Athletic Trainers’ Association – Youth Sports Safety Statistics

What is an AED?

First Aid Training

What is CPR?

U.S National Library of Medicine – First Aid Kit

On Field Evaluation of the Injured Athlete

Coaches Tips For Difficult Parents

Field Maintenance Safety and Injury Prevention

The Equipment Needed To Play Baseball

Basketball Checklist: Apparel, Equipment & Accessories for the Court

Football 101 – What Equipment Is Needed