I’m a School Nurse and My Advice on Preventing Injuries May Surprise You—Here’s Why

Injury Prevention in Children
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As a certified school nurse and mother of two toddler boys, treating wipe-outs, split chins, and rolled ankles is part of my daily life. Now that my boys have reached the ages of 2 and 4, we spend countless hours at our local parks and forest preserves. There is one new playground that seems to be the favorite, even pulling in kids from neighboring towns. It has enticing features such as a two-story tower, a zip line, a giant rope course, and wobbly bridges galore! The playground encourages kids to test their limits at greater heights and speeds, while testing parents’ anxiety and stamina as they feel compelled to stick to their kids like glue to prevent them from getting hurt.   

“No spinning on that!” “Slow down!” “Don’t climb that!” are phrases I often overhear at the park as parents hover over their toddlers. Being a school nurse, parents have asked me if the playground makes me worried. And what I often want to say is that no, actually, it’s the kids that are not allowed to play here that I worry about most. Those are the kids I fear are not being given the opportunity to develop the skills necessary to one day, in third grade for example, make it across the monkey bars without falling and breaking their arm. 

 

My Advice on Injury Prevention in Children

Research shows that the skills young children develop through free play—coordination, balance, and body awareness to name a few—serve as key building blocks for maintaining lifelong physical health and safety. It may seem like our kids are trying to test our limits by jumping off the swings, but their engagement in these “risky” types of play is truly about the kids testing their own limits in very necessary ways. 

While I understand the protectiveness—the fear our child will get hurt—I think it may be worth considering if by trying to prevent an immediate (minor) injury, we may in fact be increasing their chances of sustaining potentially more serious injuries down the road. To put it bluntly, my piece of advice is this: Get out of the way and let the kids—and their developing body systems—do their thing.  

 

Get out of the way and let the kids—and their developing body systems—do their thing.  

 

To help drive the point home, I reached out to Sara Zielinski, MS, OTR/L, Director of Occupational Therapy Services at HLC Therapy Group, whose fifteen years of focus in child-led, play-based, pediatric occupational therapy have worked to increase children’s independence and self-regulatory skills.

“I don’t know if all parents realize that all of the little successes, the motor skills that we obtain even in utero, in infancy moving around on the floor, are all the little steps that develop the competence to do things like the zipline successfully,” Zielinski said.  

 

preventing injuries in children

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Play Helps Kids’ Sensory Systems Develop 

Zielinski highlighted two crucial sensory systems that require frequent and varying types of play to develop properly: the proprioceptive system and the vestibular system.

 

The Proprioceptive System: Body Awareness

The proprioceptive system, which is how we establish body awareness, has receptors located in the muscles and joints. When children stress their muscles and joints—think tug of war, lifting heavy objects, jumping down—those receptors receive different inputs which in turn strengthens that mind-body connection. “The development of this system is why we can perceive to lift our foot a little higher to get over a step,” Zielinski said. 

 

The Vestibular System: Balance

The vestibular system is responsible for balance, by way of fluid in our inner ear canals moving and sending signals to our brain. The more our kids are rolling, spinning, and hanging upside down, the more that fluid in the inner ear gets to move. And the more opportunity there is to develop those neural pathways in the brain. “Kids who have developed a strong sense of balance are more competent and less likely to get seriously injured,” Zielinski said.

 

How Parents Can Resist Stepping In

Beyond stopping our kids in the moment, Zielinski, like me, is concerned about the societal trend toward less and less “free time” for kids to enjoy self-directed play. “Nowadays, toddlers and kindergarteners are confined to their desks for much longer. It’s another example of reducing the opportunity for these developments to happen.” Zielinski pointed out, “So much of their day is monopolized by sitting in a classroom, moving between stations, even PE is structured. As parents, we can be aware of this, and carve out time for free play. Give them the opportunity to move in the way that they need to, in a way that challenges them.” 

 

child hanging on a tree

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Trust That They’re Learning

Through the lens of development, it’s remarkable that we don’t have to instruct our kids to spin, jump or climb—they just do it. We must foster that intrinsic motivation, believing in the internal processes happening, and that they are building—step by step—all these important systems and skills at their own pace.

 

Even a fall is an incredible learning experience.

 

Zielinski agrees. “We need to trust them…that their bodies are seeking out the input it needs. We need to trust that they can learn these skills. And that even if they are not successful, they can learn from that experience and decide whether they want to try again or not.” Zielinski pointed out that even a fall is an incredible learning experience. It enables thought processes such as “Can I motor plan to get down next time, can I problem solve, can I communicate and ask for help?”

 

Make Time for Child-Led Free Play

It’s easy to overschedule our young kids because there are so many clubs, teams and lessons that are now available for two-, three- and four-year-olds. However, in the name of healthy development—and safety!—I encourage you to carve out some regular, child-led free time and allow your child to engage in the type of movement their bodies crave.

As they climb higher, you can calmly move in closer but remain confident knowing that there is real magic, real important development happening at that very moment. As Zielinski emphasized at the end of our conversation, “You cannot count the amount of learning that happens through free play. Motor, sensory, communication, problem-solving… There is so much learning that happens. Kids don’t get enough play.”  

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