Sidelined: Getting young athletes safely back in the game after an injury

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photo courtesy of Billings Clinic
photo courtesy of Billings Clinic

This guest blog is courtesy of Kylie Izzi, MS, ATC/LAT, CSCS, ITAT
Sports Medicine Associate at Billings Clinic

Let’s set the scene: It’s game time.  You sit on the sideline, nervous and proud of the competitor your child has become.  All year long, she’s poured her heart into playing this sport.  Finally, her dedication has paid off, culminating into this very moment: a starting position on the varsity team.  A strong start, and then suddenly, you hear the snap even before you see it.   A knee twist, and she falls to the ground.  Her teammates circle her with concern as she grabs her lower leg, grimacing in pain.  A season lost even before it’s begun.  Now what?

Welcome to sports, where it’s not a matter of if the injuries will happen, it’s a matter of when.  The coaches say they understand and just want your child to get better, but at the end of the day, it’s all about the playing time, right?  Well, sort of.

First let me date myself and build a bit of credibility for you… I was that athlete.  I played competitive soccer – high school, club and an Olympic Development Program – and when Achilles tendonitis began to set in, with pops and clicks accompanying every step I made, I was devastated.  I get it, and it’s why I’ve made it my life’s work to help athletes through just this issue.

We all understand – parents, athletes, coaches – the hours that go into being part of a sports team. With weekends filled with signup fees, tryouts, uniforms, travel fees, and professional training; young athletes can become quite the investment.  Oh – and the shoes…don’t forget about the shoes.

And those are just the parental pressures.  Your young athlete faces tryouts, cuts, pressure to maintain starting position, cliques, practice, missed school days and homework make-ups.  But once it’s all said and done, if your kid makes the team or gets a starting spot, the victory dance in the living room makes it all worth it, am I right?

But the reality is that more playing time can also mean more injury risk.  And if you’re faced with an injury, the hard part has really just begun.  So, now what do we do? If your child cannot walk or put weight on their leg within a few hours after the injury, schedule an appointment with his/her doctor. In most cases, once the emotions and nerves are calmed, your child should be able to start moving around. In this case, an ACE wrap and ice will help control the swelling and some of the pain. The use of anti-inflammatories can be used as instructed on the bottle.

Next, take a deep breath, both of you, and rest for at least 24 hours. (I mean this literally…as in, sit comfortably, sleep, eat natural, nutritious foods and drink plenty of liquids.).  This will allow all the super scientific healing processes to do their job.

Third, identify what CAN be done, and do it.  Identify pain-free range of motion and activities and work within those movements and motions. A small amount of pain is okay, but it shouldn’t bring on the water works. (A quick pearl of wisdom:  I find that once we identify and focus on what can be done, athletes stay mentally engaged.) Continue to gradually increase motion and activities until full motion is reached, and then work to regain muscular strength and endurance.

Additionally, it’s important to keep moving and training parts of the body that aren’t injured.  If the knee is injured, work on the core and upper body (and vice-versa). Instructors should be able to provide options for all exercises, including cardio and warm ups. (Another pearl: keep your child engaged and make them go to practice.) By going to practice and participating in what can be done, step four comes naturally.

Step four is getting back to a pre-injury state. Again, this happens gradually, and every athlete is different.   The use of topical gels can help provide both a physiologic and mental Band-Aid. Because we all want to provide something to help, the use of braces can be very effective, but be sure to speak with someone who knows what they are talking about to ensure the correct fit.

In most non-surgical cases athletes should be back to activity within two weeks. If there is numbness or tingling in the fingers or toes, obvious deformity, and/or no progress being made, schedule a doctor’s appointment. Most importantly, find out what is working and use measureable and attainable goals. (A final pearl:  don’t put specific times or dates on recovery.  This can lead to disappointment.)  Before you know it, your young athlete will be back in the game, and you’ll be back to doing what you do best – cheering him/her on from the sidelines.