The number of U.S. kids ages five to 18 years old going to the emergency department for sports injuries increased yearly between 2001 and 2013, according to a new study.

Three quarters of all injuries that required emergency treatment were linked to four sports: football, soccer, baseball and basketball - although the proportion tied to baseball and basketball dropped over the study period.

While the raw number of sports-related injuries increased overall, it is not clear from this data if injuries actually became more common in youth sports, or if more kids were participating in sports over time and the injury rate did not change, said senior author Teresa Maria Bell of Indiana University School of Medicine in Indianapolis.

"We don't know whether people are playing more sports or if people are becoming more competitive and injuring themselves more," Bell told Reuters Health by phone.

The researchers used data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System of 100 hospital emergency departments. Their analysis focused on patients between the ages of five and 18 years presenting at the emergency room for injuries related to 21 sports, including football, basketball, soccer, baseball, softball and ice hockey.

Between 2001 and 2013, there were 485,514 injuries reported by the 100 emergency departments, which translates to about 16,000,000 sports-related injuries among kids presenting to all emergency departments nationally, the researchers estimate.

Football, basketball, soccer and baseball accounted for 74.7 percent of all injuries. Golf, martial arts and ice hockey accounted for the lowest proportion of total injuries, each making up less than 1 percent of reported injuries.

Injuries decreased over time for basketball, baseball and golf, and increased for football, soccer, cheerleading and many other sports.

About one third of reported injuries were strains or sprains, and fractures or contusions were also common. During the study period, internal organ injury increased from 2.5 percent of the total to almost six percent by 2013. Concussion diagnoses also increased from 2 percent to 4.6 percent of injuries.

Awareness of head injuries and the importance of being examined by a doctor has increased dramatically since 2001, Bell said.

Ice hockey, rugby and golf accounted for the highest proportions of total internal organ injuries - with more than 9 percent of all internal injuries coming from hockey and more than 8 percent each from rugby and golf.

Ice hockey, rugby and lacrosse contributed the highest proportion of concussions, with about 6 percent to 9.5 percent each, according to the results in Injury Prevention.

More than a third of injuries among kids ages five to 10 years were head or neck injuries, a higher proportion than for older kids.

"We're seeing more severe injuries in the youngest age group," Bell said. "One thing that might explain that is sports becoming more competitive and less emphasis on injury prevention.

"We know that more kids are vying for scholarships or starting younger, that might be something future researchers can look at," she said.

Judging criteria for sports like ice skating and gymnastics have gotten more advanced over time, she added.

"For the most part, increasing trends in sports injury correspond with increasing trends in American sports participation, and that is a very good thing," said Dr. Andrew W. Gottschalk, a sports medicine expert at Ochsner Health System in Harahan, Louisiana, who was not part of the new study.

"The best medicine is education, and for more athletes and parents to be aware of sports injuries - and appropriate treatment of those injuries - is also a very good thing," he said.

The change in public thinking about concussions results in more emergency room visits, but more importantly keeps pediatric athletes safer, Gottschalk told Reuters Health by email.

"Parents and coaches should seek out good sports medicine doctors to educate families, coaches, and athletes as to safe playing conditions and safe sports techniques," Gottschalk said. "The best treatment of injury is preventing the injury in the first place."

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