Young Athletes Need Time to Heal

By Nancy Justis, Outlier Creative Solutions

In a recent column I mentioned the injury to my 13-year-old grandson who fractured his foot in the first game of a basketball tournament.

Fortunately, the injury did not require surgery but the episode resulted in the end of his spring and summer basketball season, the end of his spring track season and the cancellation of his first football camp of the summer.

The time away from teammates, coaches and the participation in sports was a blow to my grandson and his family.

His doctor described the cause of his fracture was, at least partially, due to overuse. Overuse injuries usually are blamed on sport specialization. They usually occur at an older age. However, overuse injuries are seen more frequently in youth athletes, which is startling to health care providers, according to the Mayo Clinic.

In an article printed by the National Youth Sports Health & Safety Institute, Dr. Andrew Gregory said “approximately half of all injuries evaluated in pediatric sports medicine clinics are associated with overuse. Overuse injuries are chronic injuries that occur with repetitive stress on the musculoskeletal system over the course of time without allowing time for adequate recovery.

“Pediatric athletes are prone to overuse injuries due to stresses placed on the growing bones. External factors that contribute include inappropriate increases in training, hard training surfaces or improper equipment. Internal factors include decreased muscle flexibility and strength or extremely malalignment, such as excessively flat feet.”

The doctor told my grandson’s mother to keep an eye on his flat feet and to wear more supportive shoes.

“All injuries stem from the body’s inability to absorb force,” said Dr. Tommy John, chiropractor and author of the book Minimize Injury, Maximize Performance: A Sports Parent’s Survival Guide.

In an article in stack.com, he said “force is constantly coming into the body (and it) should be absorbed by the muscles. If it’s not fully absorbed by the muscles, it will go into tissues not designed to absorb that amount of force for that amount of time for that amount of reps. That could be a ligament, meniscus, tendon, cartilage, bone, etc. The force comes in and chips away at those areas.”

Gregory said injuries youth sustain are different than those of adults.

“The main reason for this difference is the growing skeleton and its open growth plates,” he said. “The growth plate is made up of cartilage that is becoming bone and as such does not yet have the strength properties of adult bone.”

John said “pain is one of the last things to show up in dysfunction and injury, but the first to go away. And we use it as the greatest marker, which is sad. People aren’t allowed to feel pain anymore. They’re constantly icing, they’re taking anti-inflammatories … ‘You’ve taken two to three weeks off, you’re good.’ Actually, you’re worse off than you were before …

“We’re applying that pro sport mentality to kids, and in addition to many other factors, it’s almost impossible for anyone to heal in the current system of any sport because of the way it’s set up.”

Though my grandson at 13 has not specialized in one sport yet, he is participating in more than one sport at the same time. It’s generally recommended children wait until at least their early teens to start specializing.

In any case, injured athletes need to be monitored closely and should return to intense training gradually. This always takes longer than anyone likes.

“Our entire sports medicine approach has turned into trying to get rid of pain in the shortest amount of time possible at the expense of long-term function,” said John in another article posted by I Love to Watch You Play. “What we fail to realize is that pain is a warning letting us know that there’s damage, inflammation and swelling we feel IS the healing process. Pain is triggering the brain to determine what level of healing is responsible for this event.

“If your son or daughter is experiencing pain from an injury we need to look at things that go well beyond pain, what caused the pain, and how this will affect their foundation for adulthood. Because the fact of the matter is the body remembers every single injury that it sustains and it has a sort of PTSD for that and it becomes the second-most common cause to all injury which is previous injury.”

After two weeks on crutches and four weeks in a boot, my grandson has been able to shed all the “equipment” that has helped him heal. He returned to limited activity and is hopeful he can participate in a football camp in August. He attended his first basketball practice recently.

Hopefully, following doctor’s orders will allow him a successful sport season.

Nancy Justis is a former competitive swimmer and college sports information director. She is a partner with Outlier Creative Solutions and the founder of Iowa Youth Sports Initiative