In the last two weeks, I have seen a significant increase in the number of children in our clinic that are reporting injuries after returning to their sports. Injuries range from a severe quad strain to a patella fracture. The injuries are painful, but most concerning to the athlete, they are preventing the athlete from being able to play at a time when they thought they would finally be able to play. This is devastating to morale and, of course, based on the severity of the injury, could potentially affect future participation.
When I ask the last time the student played or had a formal practice, I am told it has been months. Parents often follow-up with phrases like, “But he plays outside with his brother all the time,” or “but she and our neighbor run around the house all day.” It’s important to understand that while these are technically “activities,” they are not sport-specific activities.
Don’t get me wrong, I would rather hear the kids stayed busy during Covid playing with siblings and neighbors instead sitting playing of video games and eating junk food, but it does not mean the athlete has been adequately prepared to return to his/her sport of choice.
Coaches absolutely need to realize many of these kids have not been training at a level that physically permits them to return to sport at the intensity they were performing at prior to the shutdowns. Practices need to take a gradual approach in frequency, duration, intensity and skill focus. Kids should not be expected to go from zero days per week to 4-5 days per week, 3 hrs per practice with complicated high-level intense drills and scrimmages.
Compounding the issue is the fact that many kids are very excited to be playing again and come out of the gate swinging. Obviously, this appears to be something completely out of the control of coaches, but coaches can help this with endurance activities at the beginning of practice in an attempt to quell unfocused energy prior to other components of practice such as plyo and skill.
What are my recommendations? It’s difficult to generalize since different sports have such varying physical requirements and muscle group emphasis, but here is a good general guideline that can be modified appropriately.
1. Honor the gradual approach. Begin with less frequent, less intense, shorter duration practices and gradually increase each facet over a 4-6 week acclimation period.
2. Frequency. 2-3 times per week during weeks 1 and 2 adding 1 additional day of practice every 2 weeks until desired frequency (5 days/week, max) is met.
3. Duration. Do not exceed 2 hour practices the first two weeks. Before implementing longer duration practices, first consider if frequency is also being increased. It is recommended that during acclimation period, only frequency OR duration be increased each week at a time. For example, if you desire a longer practice at week 3, do not also increase frequency from 3 days per week to 4 days per week.
4. Intensity. Do not encourage kids to practice at full intensity during weeks 1 and 2. It is critical that bodies have to time to remember and develop the appropriate neuro-motor programming needed for proper mechanics, activation and decrease compensatory mechanisms before participating at near max intensity thus reducing the chances of injury.
5. Plyo and skill. Total time spent on these components should be limited and intensity should be closely monitored, particularly during the first two weeks. Long duration or intense plyo and skill training can quickly result in injury including strains and tendinitis, or even more serious injuries such as ACL tears, concussions and fractures. It is best to rotate plyo and skill drills to help reduce overuse, encourage proper mechanics and prevent poor form from burnout.
6. Address all 3 components of fitness – strength, endurance and flexibility. Each of these components can contribute to an athlete’s success, however, not every sport should train each of these, equally. For example, soccer may emphasize endurance more than 100m sprints; gymnastics focuses more on flexibility than football does. That said, all sports should incorporate each component somehow, even if at varying degrees.
7. Other factors – nutrition, hydration, rest and mental health. What athletes do off the field can have just as much of an effect on training as their time and effort on the field. During Covid, it is possible that new habits, perhaps habits that are less than desirable, were formed and may prevent an athlete from reaching his/her full potential. Encourage kids to eat right, create good sleep habits (even if participating in online or hybrid schooling), move regularly during the day and to find a good support system to talk to if the pressure of Covid, school and return to sports is too much to process alone.
The bottom line is to train appropriately. We cannot expect kids to be where they were when restrictions were first implemented and many group activities ceased. Remember that too much too soon, can affect the individual athlete and the entire team. It is in the best interest of all, short-term and long-term, to return to sport with an educated, methodical approach regardless of how excited we are to see sports returning .
Happy training!!
Dr. Y.
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