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Mayo Clinic Q&A: Sports Injury Help | Way of life

DEAR MAYO CLINIC: I am an athletic director at a college and a new school year is almost upon us. I expect to see an increase in sports related injuries from soccer, football, cheerleading, flag football and other activities. Young athletes have lots of bumps and bruises, but how can they avoid injury? Any advice on how long they should sit out before getting back on the court or in the game?

ANSWER: Sport is a fantastic opportunity for young people. Sports not only provide physical health benefits, but also social, emotional, mental and educational benefits. When comparing those who participate in youth sports to those who do not, young athletes have lower rates of anxiety and depression, higher self-esteem, lower substance use , improved life skills, better academic performance, and better overall quality of life.

However, participating in sports comes with potential risks, including injury. Young athletes have different injuries because they are still growing and are more susceptible to injury. Some sports carry the risk of common injuries, but any injury can occur in almost any activity.

Types of injuries include traumatic injuries and overuse injuries.

Traumatic injuries

Traumatic injuries are usually sudden and caused by a twist, a fall or a collision. These injuries usually occur when the player interacts with the sports environment. Common examples are bone fractures, ligament sprains, muscle and tendon strains, and skin cuts or abrasions. Other injuries, such as concussions or those affecting other organ systems, are less common.

Traumatic injuries are more difficult to avoid. For example, some sports, such as football, have many intentional collisions per game, creating an increased risk of injury. Football has fewer collisions, but still has significant potential for body parts to be hit or twisted. This means that athletes are prone to lower extremity, head and neck injuries.

Sometimes these injuries occur simply by walking or running on an uneven surface. Other sports, such as cross-country running, cheerleading and dancing, do not have the same volume of traumatic injuries. But they are at risk of falls and fractures.

Some strategies that may be considered to reduce the risk of traumatic injury include:

— Initiate injury prevention programs. Certain movement patterns or weaknesses can increase the risk of injury. Screening tools can examine movement patterns and attempt to predict injury risk. The programs seek to prevent injuries. For example, several programs seek to prevent ACL tears. A sports medicine professional can direct you to screening and prevention resources. Also consider injury prevention programs at community hospitals and health care organizations.

— Wear the proper gear and make sure it fits properly. Many sports have equipment such as helmets, mouth guards, eye protection, pads, splints and protection. This equipment is designed to protect athletes from injury. If worn incorrectly, this equipment is often ineffective. School athletic coaches, medical professionals, or league officials can help find suitable resources.

— Make sure student-athletes follow the rules of the game. Many sports have rules in place to protect young athletes from injury, including those that prohibit spear-tackle in football or body-checking illegal in hockey. Following the rules and promoting rule changes for safety can reduce the risk of injury.

— Completely rehabilitate previous injuries before starting or resuming sport or activity. Even a simple ankle sprain if not rehabilitated properly can become problematic. It is important for an injured athlete to work with someone knowledgeable in injury rehabilitation before returning to play. Injuries to one part of the body have been shown to increase the risk of injury to other parts of the body, so treat all injuries with caution and be sure to return to sport safely. Look for a professional with athletic experience.

Overuse injuries

Overuse injuries occur gradually over time, often when a certain movement or stress is repeatedly applied to certain structures of the body. This, combined with inadequate rest and recovery, leads to injury. Some examples of this include stress snaps; tendinitis and tendinopathy; and apophysitis, which is a stress injury to the growth centers of bones.

Like traumatic injuries, some sports have a higher risk of overuse injuries than others. Runners have a higher risk of lower extremity overuse injuries, and tennis players, swimmers, and baseball players have a higher risk of upper extremity overuse injuries. Overuse injuries are more preventable, as they are usually the result of errors in training or excessive load or stress placed on a specific part of the body.

Some strategies that can be considered to reduce the risk of overuse injuries include:

— Initiate training before the start of the season. A rapid escalation in training or a sudden change in the type of training can be a risk factor for developing certain injuries. The fabrics have not had enough time to adapt to the new demands and are at risk of injury. Progressive training several weeks before the season can prepare student-athletes for the higher demands of the season.

— Ensure adequate hydration and nutrition. Inadequate energy and hydration are risk factors for injury. For example, in cross country or dance, athletes have high energy expenditures with relatively low energy intakes. This increases the risk of injury, especially stress fractures.

— Follow recommendations for rest and training. Insufficient rest or excessive training increases the risk of injury. More is not always better. Those who play sports all year round or every day of the week are at a higher risk of injury than those who have periods of rest.

— Listen to your body. There is a difference between pain and injury. However, most pains such as muscle aches should improve with time or with rest. Persistent pain is a clue to the body of a more serious injury. Student-athletes may be reluctant to come forward and raise concerns. It is therefore always useful to talk to young people and encourage them to say something if they are not feeling well.

Despite all efforts to reduce risk, injury can still occur.

It can be difficult to tell the difference between pain and injury, but consider these tips, treatment recommendations, and advice when deciding when student-athletes can return to the field of play:

A medical evaluation is required for an injury if:

— Pain is high intensity, does not improve with rest, or worsens over time with activity.

— The injury results in a loss of function, such as the inability to walk, throw, or fully move a part of the body.

— Injuries present with obvious deformity or significant swelling.

— Injuries result in loss of enjoyment of sport or inability to continue training.

After an injury, follow these initial steps:

— Rest and avoid strenuous activities. Allowing the tissue to heal is important.

— Use ice, elevation, compression, and over-the-counter anti-inflammatory medications as needed to manage pain and reduce swelling and inflammation.

— Work to maintain pain-free movement patterns, which prevents stiffness and atrophy. This ultimately helps in a quicker return to sport.

— Talk to a sports medicine specialist about ways to speed up recovery.

Return to play considerations:

Every injury and every athlete will be different, and I always recommend following the advice of a medical professional. However, before athletes return to play, they should feel little or no pain; a full range of motion; be back at full strength; and, most importantly, being able to do specific activities safely and meet the demands of the sport. I also tell my patients: When in doubt, sit down.

Sport can bring many benefits to young athletes. With proper training, reminders and coaching, we hope this school year will lead to fewer injuries. If you have students with significant issues, consider referring them to a sports medicine practice to help them recover and develop in a personalized way. — Dr. David Soma, Pediatric and Adolescent Medicine and Sports Medicine, Mayo Clinic, Rochester, Minnesota


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