When we get hurt on the field of play or in the game of life
there are several strategies (icing, massage, muscle activation, nutrition) we
can use that help the body recover. [1] [2] But how do you know when it’s time
to “get back on the horse” and return to action, is it simply when the pain
goes away?
Keep in my mind that I am referring to soft tissue injuries
that are mild in nature.
Addressing the protocol of return from a more traumatic injury such as a
surgery or broken bone is beyond the scope of this article.
In professional sports and even most college and high school
athletic programs an athlete has to be cleared by a trainer or coach before
they are deemed suitable for return to play. An athlete will take part in some type of agility test
to determine if the are favoring the injured area. The trainer/coach will carefully watch for subtle
compensations that the athlete may be using to avoid stressing the previously
injured area. If the athlete
is not able to move the way they did pre-injury they most likely won’t and
should not be cleared to play.
If an athlete lacks the confidence to run aggressively and
then stop quickly to make a change in direction it may be an indication that
the injured area is not strong enough yet or the athlete may be fearful of
re-injury. This “mental” block can
be quite a substantial one to overcome particularly for younger athletes with a
first time injury. In their
attempt to avoid pain they may start to develop poor movement habits that could
lead to a more serious injury while also hindering their long-term athletic
development.
When an athlete doesn’t play reflexively and is overly
cautious they tend to move in a very choppy almost robotic manner. This alters their body awareness and
balance and could leave them vulnerable to a “big” hit because they lack that sixth sense to avoid collisions. That aspect is often overlooked but
body awareness and coordination may be an athlete’s best shield against
on-field injury.
As is often the case the middle school aged children are
often neglected in this regard.
Most middle schools do not have access to an athletic trainer that can
test an athlete to ensure they are ready for return to play. This is why it’s important that coaches
and parents carefully monitor the way their young athletes move at all times,
even when they are healthy? You
need to have some type of baseline to compare their return from injury status
to. Complicating the challenge for
this age group is the pain, discomfort and disruption to body control that
accompanies the adolescent growth spurt.
It should also be noted that even though an athlete passes a
return to play test with flying colors the real test comes during game
play. Even a well designed agility
test and the keen eye of a seasoned coach won’t be able to make up for the
speed of the game.
Game action is the real test for the athlete returning from
an injury. Everything happens much
faster in the game, it’s chaos and in this environment the athlete must be
mentally sharp and confident that there body will be able to answer their every
call instinctively without delay.
As parents and coaches we need to ensure that we keep a
watchful eye on our young athletes at all times and just as importantly we must
foster an environment that encourages non-judgmental communication.
We should be aware of the child who may seem timid and is
not able to regain the “intensity” or “aggressiveness” they displayed before an
injury that very likely left a painful memory.
Consider the following scenarios:
"It still
hurts"
The first factor could quite simply be that the child still
experiences pain as they are trying to play. If the young athlete feels
empowered as a member of their own re-habilitation team, they will be more
likely to let you know that "it still hurts". The fix here is simple;
go back to the doctor or get a second opinion.
"I'm all
done"
This factor is a little more difficult to rule out. In our
efforts to promote our children through sport we sometimes forget that they are
not little adults. Their likes and dislikes are fickle at best as they move
through development and maturation. Today's favorite activity may be tomorrow's
memory. Your child/athlete may be trying to let you know that they have simply
lost interest in this sport and don't know how to tell you for fear that they
will let you down.
As leaders of young athletes we need to create an
environment where they feel like they can speak up on their behalf and be open
about what they are feeling. Coaches and parents need to affirm the child’s
feelings by letting them know that they are rational and normal. Then
we need to guide them along with a return to play strategy (progressive goal
setting) that honors each child’s unique situation understanding that sometimes
the emotional and mental healing requires more time than the physical healing.
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