Training “too much, too fast, too soon” has been called the “terrible toos” for as long as I can remember, because it’s a great formula to create an injury. But one of the problems with this line of thinking is that it can be very difficult when you’re in the moment to understand whether you are in fact doing something “too much, too fast, or too soon”.
We often don’t know whether an athlete has over trained until they come in to the doctor’s office with an injury. We then work backwards and if we’re lucky we can point to specific training errors as the likely cause of the injury. Is there a way we can monitor training loads going forward to avoid exceeding the thresholds for overtraining? Wearable activity trackers may be the answer.
Sports medicine specialists and team physicians want to see all of our athletes succeed to the best of each of their abilities. But we’re also in a position to see the many things that unfortunately go wrong for younger athletes, including overuse injuries, burnout, and psychological stress.
It’s believed that two of the main causative factors in the above problems are early sport specialization and high intensity training at a very young age. For the younger athletes it’s believed that sport specialization hampers the opportunity to develop proper neuromuscular skills and general fitness.
A recently published study showed that young athletes interested in a baseball career at the highest professional level can minimize the risk of overuse injuries and have the potential for greater future longevity by participating in multiple sports during high school.
During the recent US Club Soccer webinar I participated in, I was asked this question by the host:
“What advice would you give to a parent of a youth soccer player regarding being proactive or reactive to injuries and overall health?”
The question above was specific to soccer but the point I make here is applicable to all sports. By far and away the area where we can have the greatest impact with a sport that’s in-season is in monitoring for overuse injuries.
Today’s post is directed towards coaches, but parents can benefit from these tips too. Maybe your sport is football, or soccer, or cross-country. Whatever it is, you’re thick in to your fall season, focusing on practices, competition and hopefully aiming for playoffs. In spite of everything you’re busy with there are still some important steps you can take now to make sure you’re performing at your best. I recently participated in a webinar with US Club Soccer, and adapted here for any sport are five areas to revisit now:
Monitor your players’ training loads
Be aware of weather safety, especially lightning and cold weather
Take 15 minutes to review your on-field injury recognition protocols
Make sure you’re up to speed on concussion evaluation
Use a good dynamic warmup, and if you’re a soccer team start using the FIFA 11+
There are a number of factors that appear to be correlated with an increased risk of youth sports overuse injuries:
Single sport specialization prior to the age of 14
Playing that single sport more than eight months out of the year
Practicing and playing a combined number of hours per week more than your age in years
Conversely it appears that free unstructured play rather than organized sport lowers a child’s risk of overuse injury. Appropriate periods of rest from sport as well as limitation in participation hours per week also appear to reduce injury risk. Is it possible that children from wealthier households are at higher risk of developing overuse injuries than children from poor households? One recently published study suggests that household wealth may be correlated with overuse injury risk.
The female athlete triad is a potentially serious health condition typically affecting teenage girls and young women. It’s made up
of three key components (“the triad”):
Low energy availability, sometimes associated with an eating disorder
Abnormalities in the menstrual cycle
Low bone mineral density, sometimes leading to stress fractures or osteoporosis
As sports medicine doctors, we will often find that a young athlete first comes in to see us when she’s developed a stress fracture. The typical teenage athlete may hide conditions such as an eating disorder or abnormalities in her menstrual cycle from her friends, family, and coaches, so the stress fracture is often the thing that requires her to seek medical care.
The end of summer and early fall are some of the busiest times of the year for outdoor sports participation, and unfortunately this is also the time of year with the highest number of cloud-to-ground lightning strikes. According to data from the National Oceanic and Atmospheric Administrationthere are about 25 million cloud-to-ground lightning flashes each year. The highest number occurs in southeast Florida and decreases towards the western United States.
Absolutely no practice or games outdoors during active lightning storms.
“When the thunder roars, go indoors”. Play should not resume until at least 30 minutes after the last sound of thunder or flash of lightning.
By Dev Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: Overuse injuries to the elbow are common in young baseball players, and prevention programs are needed to reduce injury risk A recently published scientific study highlighted the potential benefit of a stretching program called the Yokohama Baseball-9,…
By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: Specific basketball warmup programs focusing on balance and agility show reductions in lower extremity injury rates These warmup programs are attractive because they can become part of your normal pre-practice and pregame warmup I’m a fan…
By Dev K. Mishra, M.D. President, Sideline Sports Doc Clinical Assistant Professor of Orthopedic Surgery, Stanford University Key Points: A skilled athletic trainer (ATC) is an invaluable part of the student-athlete’s sports injury care Schools with ATCs will consistently have healthier athletes and lower rates of recurring injuries than those without an ATC I’d strongly…