Following proper exercise and sports safety rules and regulations can greatly reduce a child’s risk of injury while participating in sports and activities. A coach, trainer or other fitness professional can help explain the proper techniques, regulations and safety procedures for a particular sport or activity.

Children with chronic health problems or disabilities also need to participate in some form of physical activity. Some activities (e.g., walking, swimming) may be better suited for these children, and others may need to be modified or adapted to the child’s needs. In addition, children with medical conditions may require medications or monitoring. For example, children with diabetes require blood sugar (glucose) monitoring during exercise, while children with exercise-induced asthma may need to take preventive medications before exercising.

Although fitness and exercise are very important, so is moderation. Too much exercise can cause injuries and other problems. There are many reasons why children or adolescents may overdo it when it comes to fitness. Some signs of exercising too much include pain during or after a workout, amenorrhea (absent menstruation) in girls and being below normal weight for age and height.

Proper equipment and equipment fit is essential to fitness safety. If the equipment does not fit, it will not work properly. Major types of sports and fitness safety equipment include:

• Helmets. There are many types of helmets and it is important for the helmet to be appropriate for the sport or activity. For example, a bicycle helmet must have a sticker from the Consumer Product Safety Commission that specifies that it meets the safety standards for bicycling. Helmets must fit snugly but comfortably and should not tilt when worn. A helmet is only good for one impact. A helmet involved in a crash will not offer the same level of protection as before and should be replaced, even if there is no apparent damage.
  
  
• Eye protection. May include face masks, polycarbonate (plastic) guards or shields, or goggles. Regular eyeglasses should not be worn when playing most sports. Prescription goggles are available. Eye protection must fit securely, with cushions above the eyebrows and over the bridge of the nose.
  
  
• Mouth guards. Guards that protect the mouth, teeth and tongue. They are necessary for contact sports, such as hockey and football. These can be purchased at sporting goods stores or fitted by a dentist. Retainers should not be worn when playing most sports.
  
  
• Wrist, knee and elbow guards. Guards that help to prevent fractures, cuts and breaks. These are important for sports that involve risks of such injuries, such as bicycling and roller skating.

  

• Pads. Provide cushioning against blows and falls. These are necessary for contact sports, such as football. There are a variety of different pads, including shin, knee, elbow, wrist, chest, shoulder, hip and thigh pads.
  
  
• Bras, cups and athletic supporters. Bras support the breasts for girls during exercise. Cups and athletic supporters protect the genital area for boys. Cups provide protection during contact sports and athletic supporters provide support during running.
  
  
• Footwear. Helps to maintain a good grip on the ground and prevent tripping and falling. Different sports need different types of footwear. For example, a tennis shoe and a running shoe provide different amounts of support in different areas of the foot and ankle. Footwear that is worn out or no longer supportive needs to be replaced.

It is important to prepare the muscles and joints by warming up before and cooling down after strenuous exercise. This includes stretching exercises and light aerobics (e.g., jumping jacks, brisk walking). Similar exercises are used to cool down after a workout.

Some children may wish to participate in strength training, although pediatric strength training is not the same as adult strength training. The National Association for Sport and Physical Education has established guidelines for strength training in children. A ratio of at least one instructor for every 10 children is recommended. The instructor must have experience with both children and strength training and must supervise the children closely. Children can participate in two or three training sessions per week and should not train two days in a row.

Practicing helps children to hone the muscles in preparation for athletic activity. It also increases overall physical condition and improves coordination (including teamwork). All of these benefits help to prevent injuries. It is important to follow the sport’s rules and regulations and to learn and use the proper techniques. These improve safety for the individual, other participants and spectators.

Certain competitive sports or activities focus on adolescent participants (e.g., gymnastics, dancing). Children participating in these activities may be susceptible to injuries caused by repetition and overuse (e.g., shoulder and back injuries). Highly qualified programs and trainers along with appropriate medical care can help prevent injuries in young athletes.

Children should never exercise or participate in a sport or activity while injured or with an illness without consulting a physician. This can result in re-injury, inattentiveness, and complications to current conditions or injuries. It is recommended that individuals seek medical assistance when in moderate to severe pain, the injured area begins to swell, or the pain, injury or illness interferes with sleep or daily activity.

In recent years, the use of anabolic steroids or other performance-enhancing drugs among high school athletes has become controversial. About 6 percent of all high school athletes surveyed in the United States admitted to using steroids to enhance their performance, according to the Centers for Disease Control and Prevention. Abuse of steroids has been linked to liver cancer, heart attacks and increased cholesterol levels. In addition, steroids can interfere with the lengthening of bones in adolescents, stunting growth.