Stemming the Rising Tide of Student Sports Injuries

By Mike Palmisano, MS, ATC

For more than 48 million student athletes each year, the back-to-school routine includes a trip the emergency room for the treatment of a sports injury, leading to time on the bench, and often a more permanent injury that can keep them out of sports altogether.

But that doesn't have to be the case. Years of sports studies have shown that injury rates can be decreased by 20 percent or more if student athletes participate in strength, endurance and agility training several weeks before their sports season starts. Also, during the season, the proper of use protective equipment can reduce the risk of injury.

"Kids are so eager to play, they jump right in after a long period of inactivity over the summer, practicing too long or using the training equipment improperly," said Sarah Becker, M.S., director of KORT sports training center. "They'll develop bad habits when they run, jump or turn, which will set them up for injuries during the season. But the errors are so small, no one notices until it's too late," she added.

Sports training centers can help athletes as young as 9 or 10 improve their performance and reduce their risk of injury. They offer personally tailored training programs to help them run faster and with correct form, jump higher and turn quicker. Strength training of students' core torso muscles helps with overall agility and balance - key skills for bodies that are growing and changing so quickly neurologically, Becker said.

TRAINING CONSIDERATIONS

With so much at stake, how can a parent tell when a student athlete is at an increased risk for injury?

• Excessive fatigue - If a student athlete shows unusual tiredness, loss of appetite and dropping performance, even in spite of an active schedule, overtraining may be the culprit. In girls, delayed puberty or a cessation of periods is a red flag for dangerous overtraining.
• Poor form - This varies widely by sport and by gender. For girls, it often means swinging the elbows across the chest while running or putting the knees together while jumping. Girls are statistically much more prone to knee injuries because of bad form, and the number of girls receiving surgery for torn knee ligaments has become a major problem in the U.S., according a recent report from USA Today . For boys, poor form can mean improper turning or over-explosive running starts. This general awkwardness comes from learning bad habits or weak muscles, but is also a symptom of kids physically compensating for their growning limbs. Learning proper technique, however, will create good habits that are in the athlete's "muscle memory" for a lifetime.
• Muscle stiffness - Some studies show that athletes who are aggressive, tense and compulsive have a higher risk of injury than their relaxed peers. Tension makes muscles and tendons more taut, increasing the risk of harm during workouts. Stiffness can also be caused by not doing enough stretching before sports play, or from not developing muscles properly in the back and core through strength training.
• Trigger points - These are thick knots in the muscles, often swollen and sore to the touch, taking a day or more to go away. Sports massages can help alleviate the pain of a trigger point, but only an analysis of the player's form and targeted training to help correct the bad habit will keep the problem from coming back.
• Muscle imbalances - Many athletes favor one leg or arm over the other and can unconsciously create a muscle imbalance. Having one side of the body that is much stronger than the other creates a ripe opportunity for sports injury.

"If you look closely, it's easy to see the problems that lead up to sports injury and stop them before they start," Becker said.

While sports training for the very young player is unnecessary, pre-season training can really help a student athlete even in the pre-teen years, Becker said. "We have a lot of very serious and fit high school and college athletes who come here looking to trim seconds from their running times or increase their standing jump heights. But we also see a lot of out-of-shape pre-teens who really want to play sports, but don't yet have the muscle strength. We see pre-teens who are just starting to play sports seriously, but who aren't performing well, because neurologically they haven't developed the muscle control to have a winning style. Pre-season training can help all these kids," Becker said.

PROTECTIVE EQUIPMENT

In addition to proper training, the proper use of protective equipment can go a long way to keep young athletes safe. Ankle braces, knee supports, mouthpieces and helmets are just a few items used to prevent injuries.

Football can leave players bruised and battered. Like other contact sports, it is important for players to have the proper equipment that fits correctly in order to remain injury free.

Mike Stammerman, a coach and trainer for the Male High School football team, said, "I advise the kids who have or have had an ankle sprain to get an ankle brace and, if need be, I will both tape them and have them use the brace for better support and stability."

Stammerman says that knee supports are also important in protecting players. Knee braces help to stabilize the knee and prevent it from bending in the wrong direction following a tackle or hit, he said.

A mouthpiece is essential in protecting the teeth and gums from permanent injury. In a sport like football, where players are knocked down and hit from side to side, proper-fitting mouth pieces or guards and helmets go a long way in protecting athletes from head injuries.

While proper training and use of protective equipment cannot prevent all injuries, it can lessen the severity of the injury, making recovery time faster. And any athlete will tell you they'd rather be on the field than on the bench.

Mike Palmisano is the co-director of sports medicine for Caritas Rehab Services and KORT Physical Therapy. He provides dedicated sports medicine services to Louisville Collegiate School, the Louisville FIRE Arena 2 Football, and Male High School's football program.