Avoiding Injury in the Year Round Athlete

As a parent, you want to provide your child with the opportunities to grow and succeed, mentally, physically, and socially. One of the best ways to do this is through physical activity, and for many parents and kids, that means playing sports. Numerous studies have well documented evidence that physical activity benefits brain structure and function, which positively effects cognition, school and academic achievement, behavior, and psychosocial function. The question then becomes how can my child gain these positive benefits while avoiding some of the more commonly associated harmful orthopedic side effects of sport such as sprained ankles, dislocated shoulders, and injured knees.
Working as a physical therapist in a large sports medicine facility allows for a unique insight into injury rates and prevalence, common injury themes, and specific mechanisms of injury. Working in a large sports medicine facility in North Texas provides for an even better insight into how the aforementioned factors can affect youth athletes. So how do you keep your kid safe while still get the benefits from play and sport? Highlighted below are some of the most important injury prevention practices that I have found.
One of the most common reasons that we see young children in our clinic is from overuse and early specialization. The National Athletic Trainers’ Association recommends delaying sport specialization in youth athletes. Participating in multiple sports and unstructured playtime allows for more variation in movement, resulting in a decrease in repetitive movements, and improved general fitness and motor control. For further supporting evidence, in the 2016 NFL draft, 28 of the 31 picks played multiple sports in high school.
Overuse injuries, such as stress fractures or tendonitis, are the result of repetitive stress to the bone, ligament, muscle, etc., which weaken and inflame these structures. Children are particularly vulnerable to overuse injuries because their bodies are still developing and are unable to handle these repetitive stressors as well as a skeletally mature adult. In addition, children may have poor body mechanics during sport movements, which place abnormal stresses on their bodies.
A 2016 study of youth baseball players with elbow pain identified year-round play and working with a private coach as risk factors for developing an elbow injury.
Coaching tips - Skills practice should focus on proper body mechanics prior to addressing speed, power, etc. Following volume restrictions, such as playing time or pitch count, should be strictly followed to prevent repetitive microtrauma.
To assess proper mechanics and readiness for sport, a pre-participation examination by a physical therapist can identify weak links in the athlete’s body structures or movement pattern. Once risk factors are identified, corrective training and/or activity modification can be implemented to prevent injury from occurring.
A proper warm-up and cool-down should be integrated into each practice and competition. A warm-up should include 5-10 minutes of light aerobic activity, dynamic flexibility activities, and low-intensity skills practice. A cool-down should include gradually decreasing levels of aerobic activity and flexibility training.
At the beginning of the season or following time off due to injury, a gradual increase in training load, intensity, and volume is recommended to prevent injury/re-injury.
Participation volume (time spent training and competing) guidelines are currently being developed, with a general recommendation of 16-20 hours/week limit on sport and conditioning activities in the youth athlete. Rest is important for injury prevention, avoidance of burnout, and performance enhancement. The National Athletic Training Association recommends 1-2 days off per week to allow the body to recover from training and competition. For youth athletes participating in baseball, throwing guidelines can be found here: http://m.mlb.com/pitchsmart/pitching-guidelines/
Read more article from EXOS, Texas experts:
Dry Needling the Pediatric Population - Safely & Applicability

Trey Kunz, PT, DPT, ATC, CSCS
Trey is a physical therapist and athletic trainer working at EXOS in Frisco, TX. He enjoys working with athletes and patients from youth to professional, and everything in between.
Call: 214-618-3246
REFERENCES
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Mcleod TCV, Decoster LC, Loud KJ, et al. National Athletic Trainers' Association Position Statement: Prevention of Pediatric Overuse Injuries. Journal of Athletic Training. 2011;46(2):206-220.
Multi-sport athletes dominate first round of 2016 NFL Draft. Youth Football. http://usafootball.com/blogs/americas-game/post/12009/multi-sport-athletes-dominate-first-round-of-2016-nfl-draft.
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Pennock AT, Pytiak A, Stearns P, et al. Preseason Assessment of Radiographic Abnormalities in Elbows of Little League Baseball Players. The Journal of Bone & Joint Surgery. 2016;98(9):761-767.
Pontifex MB, Saliba BJ, Raine LB, Picchietti DL, Hillman CH. Exercise Improves Behavioral, Neurocognitive, and Scholastic Performance in Children with Attention-Deficit/Hyperactivity Disorder. The Journal of Pediatrics. 2013;162(3):543-551.
Voss M, Chaddock L, Kim J, et al. Aerobic fitness is associated with greater efficiency of the network underlying cognitive control in preadolescent children. Neuroscience. 2011
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