Listen to the Athletic Trainers
NATA Guidelines for Sports Participation
The National Athletic Trainers Association (NATA) has released new guidelines for children’s sports participation. Athletic trainers are on the front line of the growing youth sports injury battle. Trainers work in the school setting and they see all of the injured children–not just the ones with insurance coverage. More than any other profession, they witness the results of year round, single sports participation. The recommendations from NATA are more stringent than the ones handed down by various physician groups. As a physical therapist that has witnessed an exponential increase in youth overuse athletic injuries, I agree with all of NATA’s suggestions. Go online and read the New York Times article, dated 10/17/19 by Roni Cary Rabin for a well explained review of the NATA guidelines. Presented below are the guidelines I feel parents should follow when the young athlete begins to complain of pain.
At the onset of pain, have the athlete rest for four days. Do not let a minor inflammation evolve into a chronic connective tissue pathology. Do not “play through the pain” in an effort to finish the season, make the playoffs, or win the tournament. The presence of pain alters the neuromotor signals necessary for effortless and graceful athletic performance. Abnormal motor control patterns are often a bigger problem than the initial injury.
Beware the over medicalization of a simple overuse injury. Lots of adults in lab coats talking about ominous anatomical abnormalities can create the fear and anxiety that amplify pain. Young patients frequently express concerns about having to undergo an X-ray, MRI, or bone scan. The push to get youngsters back into the game has led to some questionable medical decisions. Children should not be subjected to injections and surgical interventions.
Really listen to the young athlete. Trainers and physical therapists have the advantage of spending time with these athletes in a relaxed, friendly, low stress setting. It is impossible to use a cell phone while training in the gym so conversation between staff and the other athletes flows. The staff has the opportunity to build rapport and this frequently leads to unguarded comments that bring clarity to the situation.
“How do you feel about missing the tournament this weekend?”– “I’m fine but my Coach gets so upset.”
“What do you like about softball?”– “I liked it better when I wasn’t pitching!”
“Do you miss dancing?”– “My Mom misses me dancing.”
“How is your team doing this year?”– “I hate my team.”
Look for change in team dynamics, a new coach, or a missing teammate. Performance pressure is often difficult for youngsters to manage. Is more expected of the athlete this year? Emotional stress has a profound impact on pain symptoms in everyone. Very often long-standing pain problems quickly resolve with a move to a new team, a change in position, or a simple reduction in the playing schedule.
Parents make the injury management decisions and it is difficult to weigh all of the advice that is provided. From the club coach, the concern is that if an athlete misses six weeks of participation in order to recover from an injured knee, he or she will fall behind all the other twelve year olds. My suggestion is to think long term and endeavor to prevent the knee replacement when the athlete is forty.
The link to the NY Times article is here
Mike O’Hara PT, OCS, CSCS