The U.S. Consumer Product Safety Commission reports that four million children seek emergency room treatment for sports injuries each year and estimates that another eight million are treated for such injuries by family physicians. In previous generations pro and college athletes only suffered many of these injuries; now kids are subjected to overuse injuries. What happened?

Dr. Lyle J. Micheli, Director of Sports Medicine at Boston Children's Hospital, answered this question in Newsweek a couple of years ago. "The whole complexion of children's sports has changed," he stated. "Organized sports have replaced free play and the sandlot and have brought on 'overuse' injuries caused by micro trauma to the body's tissues. Growing children are predisposed to overuse injuries because of the softness of their growing bones and the relative tightness of their ligaments, tendons and muscles during growth spurts."

"The fact that most of these injuries are preventable raises troubling questions about children and organized sports. I am especially concerned about the quality of our volunteer coaches who form the backbone of non-school organized sports. Although they are well meaning and committed, most are unaware of the child athlete's vulnerability to injury, especially overuse injury."

"Parents must ensure that their children are enrolled in an organized sports program with a certified coach at the helm and should withhold children from programs where certification is not required. When certification becomes widely mandatory it will be a win, win, win situation. Coaches will win: They'll be better trained and more knowledgeable in fitness principles and injury prevention. Parents will win: They'll know qualified personnel are instructing their children. But the biggest winners will be our kids: They'll be better trained and less likely to be injured."

A number of San Antonio youth sports programs have made certification mandatory for their volunteer coaches through the Kids Sports Network certification program. Effective coaches training programs not only address overuse issues but field, equipment and participation safety as well. Parents can also help by alerting league officials to unsafe conditions and practices that might go unnoticed. Education of parents and coaches will not stop all injuries, but will certainly reduce the numbers considerably. For example, if all baseball and softball programs used the newly developed breakaway bases, the incidence of ankle, foot and knee injuries would be reduced by as much as 90% and save hundreds of millions of dollars in medical costs annually.