YOUTH ATHLETE SIG

JULY NEWSLETTER & CSM WRAP UP

The mission of the Youth Athlete Special Interest Group of the American Academy of Sports Physical Therapy, as a component of the American Physical Therapy Association, is to promote excellence in the practice, research, education, and professional development in the physical therapy care of the youth athlete.

PAST EVENT

Thank you all for attending the “Many Faces of Youth Sports PT: Networking With Your SIG Leadership!” We were thrilled with the turnout and are looking forward to more networking events in the near future.​

UPCOMING EVENTS

Call for CSM 2021 Poster and Platform Abstracts:
The deadline for poster and platform abstracts has been extended to July 27, 2020.

“Load Management and Strategies for Returning Young Athletes to Sport”
When: Tuesday, August 18, 2020, from 7:00 PM-8:30 PM EDT
Why: Research related to load management and training principles within youth athletes have been evolving over the past several years. This session will provide physical therapists who work with youth athletes up to date information regarding these principles and integrate them into practice.
Contact: Elliot Greenberg at greenberge@email.chop.edu

RETURNING TO SPORTS POST-PANDEMIC

As we move into the summer and restrictions continue to be lifted, we all hope we’re closer to playing and watching sports again. Throughout this transition to higher activity levels, it’s important for therapists to understand the concept of load management and be able to educate parents and coaches on strategies to help decrease the risk of injuries.

Benefits of Sports Participation
Perhaps the thing we all miss the most about sports right now is a reason to get out of the house and socialize with others. As physical therapists, we know how important sports participation is to a child’s development. Sports bring with them a platform for developing friendships and teamwork skills, as well as physical literacy with the fostering of movement competency and confidence.  Being active with greater than 60 minutes of activity each day is now widely accepted for children to optimize health outcomes. However, with exercise and sports participation comes the risk of injury. To reduce the risk of injury it is important to make sure our patients, families, and coaches don’t jump in too quickly.

Understanding Load Management
The biggest concern with the return of sports is athletes being expected to be in mid-season form when they return. Without the appropriate physical preparation, the likelihood of sustaining an injury will increase. The general process of guiding activity increases to reduce the risk of an injury is known as Load Management.

Generally speaking, Load Management is intuitive to a physical therapist. We would never recommend someone to run a full 26.2-mile marathon next week if they’re starting training tomorrow – it doesn’t make sense. This would be a massive spike in running activity. Inevitably, something on their body would break down due to a lack of adaptation to the load requirements of a marathon. Instead, we would recommend beginning with shorter distance runs and gradually increasing their running volume over time. The more challenging problem is how to progress their volume (“Load”) while reducing the chance of sustaining an injury.

In higher-level sports, limitations on activity levels are often based on activity data. This can range from GPS tracked running mileage or sprint speed, to the number of balls tossed in baseball or pitch velocity. Using this data, we can carefully allow an athlete to return to an activity while trying to reduce their risk of injury by avoiding spikes and integrating rest periods.

Youth sports typically don’t have access to high-tech equipment. However, that may not be necessary in order to monitor the loading of a youth athlete. The monitoring number of throws, distance run, or time of activity may be sufficient. Educating coaches and parents on the basics of Load Management and to avoid large spikes in activity could help prevent some injuries from occurring.

Getting Back to Sports
Just as we wouldn’t run a marathon without training, we shouldn’t let kids go back to high amounts of activity without an on-ramping period. When looking at the professional teams who are attempting to resume their seasons this summer, they have all built-in several weeks of on-ramping training prior to competitive play. These training weeks are designed to develop skills and build up load capacity.

A common perception is that kids are much more physically resilient than adults and can take on a lot more activity without negative consequences. Although there is some truth to this (the body doesn’t recover at 30 like it used to!), kids and adolescents are susceptible to various types of overuse injuries that adults are not. A youth athlete’s level of physical development and the sport they play may set them up for various types of injuries. For example, youth baseball players with open growth plates in the upper extremities are at risk of developing Little Leaguer’s Elbow or Shoulder, while a youth soccer player or cross country runner may be at a higher risk of developing Sever’s Disease or Osgood Schlatter’s. Stress fractures and patellofemoral pain syndrome are common among youth athletes as well. By slowly increasing activity levels, the likelihood of these injuries may be decreased.

For parents or coaches who are less versed in injuries that a youth athlete is susceptible to, it may be very tempting to jump straight into mid-season volumes and make up for lost time. Instead, a general rule of thumb is to start activity levels at between 25-50% of their typical “pre-isolation” volume of activity and increase activity levels by around 20% per week until they get back to their goal volume. This rule can be applied to things like throws in baseball and distance covered in swimming and running.

For example, if the goal for a junior high cross-country runner is to run 25 miles/week, a good starting distance may be 12 miles the first week and 15 miles the next. Within about 1 month they will be at their target volume. Another example is a dancer who, under normal circumstances, practices 20 hours per week over 5-6 practices. A good starting volume may be between 5 to 10 hours per week with a greater focus on technique and less on jumping volume, and progress both intensity and total volume slowly from there. This may help decrease the risk of sustaining an injury and having to take time away from their sport again later.

ABOUT THE AUTHOR: GRANT POSTON, DPT
Grant Poston, DPT, is a physical therapist in the Division of Occupational Therapy and Physical Therapy at Cincinnati Children’s. He specializes in sports physical therapy with special interests in ACL and knee injuries, Blood Flow Restriction training, weightlifting, and load management.

YOUTH ATHLETE SIG MENTORING PROGRAM

The American Academy of Sports Physical Therapy Youth Athlete SIG is excited to announce its official mentoring program!  The Youth Athlete SIG recently completed a 14-month pilot mentoring program.  The pilot program placed 3 mentees with 3 mentors with a structured guideline to help foster development of clinical practice and/or research in the area of sports physical therapy for the youth athlete.  Valuable learning occurred for the mentees and the mentors!  While Covid-19 has delayed our ability to start this new official program, it has given the leadership of the Youth Athlete SIG time to carefully integrate these valuable lessons learned into building a bigger and better mentoring program for our membership.  We have set a tentative date of accepting applications on December 1, 2020, with having acceptance and matches created for a program start date of CSM 2021.  Please watch our future newsletter and our Youth Athlete SIG mobilize site for application announcements and more details in the upcoming months.

If you are interested in learning more about the structure of this mentorship program, please reach out to Marc Sherry at MSherry@uwhealth.org for the full details!

RESEARCH ASSISTANCE: THE IMPACT OF HIP INJURIES ON THE HEALTH OF YOUNG ATHLETES

The purpose of the study is to determine the impact that a previous hip injury has on self-reported hip function, health-related quality of life, and activity level in a cohort of youth and adolescent athletes. The study has been approved by the UW HS-IRB with Dr. Erin Hammer as the principal investigator.

To take part in the study, we are asking for youth and adolescent athletes to complete a short (5 – 10-minute survey) online survey for us. The survey starts with questions about the athlete's age as well as the types and the volume of the sports they play. The second part of the survey asks whether they have had a previous hip injury or surgery. The final section includes questions about how both of their hips feel while doing daily or sports-related activities and questions about their general health.

Eligible participants include young athletes (ages: 8 – 18) who participate in any youth, club, or school sport. They do not need to have had a previous injury to fill out the survey.  It’s important for us to hear from young athletes regardless of whether they have had a hip injury. 

Please pass this information to your medical provider colleagues as well as any athletes, parents and coaches you have worked with recently.

Let us know if you have any questions!

Thanks,
Timothy A. McGuine PhD  ATC

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