Prevent Sports Injuries

Caution...

Don’t Let Your Young Athlete Return to Their Sport Too Early Following Injury

WRITTEN BY

DR. ALISON SYNAKOWSKI, DPT

Dr. Alison Synakowski, DPT has been practicing physical therapy for over 12 years in the Capital Region. She practices out of a unique practice, Suarez Sports and Orthopedic Physical Therapy with locations in both Latham and Saratoga. She holds her Orthopedic Specialty (OCS) in PT and has a background in Athletic Training and Strength and Conditioning. She has a strong passion for injury prevention and improving the quality of healthcare. Children, young adults, high school athletes, and college athletes are more often returned to sports much, much too early following injury.

At times, it is gut wrenching how early some are returning or more so, the lack of testing, discussion, education, and preparation for return to playing a sport. More often than I’d like to admit, I see a kid following a second, or third injury — sometimes the injury is to the same body part, other times to a different one (which we tend to think is independent of the first one which is usually not true). I’ll give an example from years ago, although I see this almost every month. A 14-year-old breaks his tibia (lower leg). He is in a cast for 6 weeks, nonweight bearing to allow the fracture to heal. Upon return to get the cast off, he is x-rayed and told the bone has healed beautifully. What happens after the bone has healed is extremely important, the body needs to recover, build strength, and build back better. Confidence needs to improve to not only enhance performance, but to reduce the likelihood of future injuries.

When we do not use a body part for even a few days (think crutches for 2 days after an ankle sprain), there can be a lot of strength lost. The body needs to be strengthened, taught how to work again through movement and progressed back to the level it was at before. But, when returning to sport without properly conditioning, the chances of injury are increased due to being under prepared. A child could “take a bad step” and have another injury and we chalk it up to “bad luck.” Often “we can’t believe this happened,” when in actuality, the ability to reduce the risk of this happening couldn’t be more clear. When we are injured, in a cast, not putting weight through the leg — muscles lose strength, they atrophy. When returning to only jogging following ACL reconstruction (or any leg injury) it is expected the individual can do at least 15 repetitions of a single leg heel raise, 15 hops, 15 single bridges and have adequate strength. To return full to sport the criteria is harder. Kids are resilient thus we think they should just “bounce back” and the pressure of returning to sport is high these days — and the most challenging part — they feel good. When assessed there are so many key components of movement and strength that need to improve to allow full and safe return to sport. When we return anyone too fast to sport — the chances of them needing rehabilitation or treatment again for the same or a different injury are quite high. They are in and out of the doctor or physical therapy or chiropractic care for injury, after injury, after injury — maybe different injuries and we wonder “what is going on, what is wrong with them?” When in actuality, it is just poor decision making and lack of preparation for returning someone to sport. We do need to motivate and encourage kids to return to sports after injury — often they consciously or subconsciously do not have the confidence to return because their movement or strength is not there. If this is their first time injured and coaches, doctors, PTs, parents are saying — “you’re fine, just get out there” — we may be putting them at increased risk. You do not know where they truly are unless you test it. Test strength, test jumping, cutting, assess confidence, and gradually and smartly return them to activity — that is what will give the best picture of readiness. Trying to return kids to sport too quick after injury has a high cost — literally and figuratively. Imagine if the first injury was managed well and took four months to return vs. six weeks. Short term, It’s really hard, but long term, the time out of sport is significantly reduced and many injuries are prevented (and money saved due to medical visits). Please, take a step back when a kid has an injury, question quick returns to sport, be sure they are tested with movement, think about the ramifications and let’s take care of our young athletes so they can keep their social identify, stay healthy, and want to be active for the rest of their lives. SF