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Crucial for Coaches: Injury management know-how
by Mike Woitalla, October 19th, 2010 5:44PM

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TAGS:  high school boys, high school girls, youth boys, youth girls

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By Mike Woitalla

To coach young children where I live, I had to get licenses from a couple of coaching courses that totaled five days of instruction.

We were taught all sorts of drills -- a few of which resembled soccer-playing -- and were given some useful tips. Like keeping plastic bags in your coaching bag in case you need to pick up dog poo before practice.

The league provided first-aid kits in our coaching bags. But injury management training wasn’t included in the required coaching courses.

So I signed up for an American Red Cross first-aid course. There I spent most of the day becoming intimate with Rescue Annie, learning CPR, and working that wonderful little machine, the defibrillator. (It actually speaks!) But the kind of first-aid I’d most likely encounter at the soccer field was barely covered.

The team I coached at the time had, believe it or not, four parents who were doctors. So whenever one of the little players got hurt, I simply looked down the sideline and picked an MD to attend to the child.

But what if I didn’t have doctors on the sideline?

My response to injured players had been mainly based on what I remember from how the trainers responded to hurt players when I played high school and college ball. Certainly, depending on long-term memory or the odds that there are docs around isn’t a satisfactory approach.

Coaches aren’t expected to be doctors, but they must attend to injured players and make the difficult decision of whether a player is fit to play after suffering an injury.

To help educate coaches on injury management, orthopedic surgeon Dev Mishra has created SidelineSportsDoc.com – “The Coach’s Guide to Youth Sports Injury Management.”

Dr. Mishra has served as a team physician for the University of California, he is currently a team physician for several San Francisco Bay Area high schools, and is a member of the team physician pool with the U.S. Soccer Federation. On a weekly basis at his medical practice he sees youth players with significant injuries that started out as minor injuries.

Extrapolating from what he has witnessed, he figures that the potential number of major secondary injuries -- those injuries that became worse because a young player was returned to play before his or her injury had recovered --  suffered by youth athletes nationally is 1 to 2 million annually.

In other words, much grief and cost could be saved with an informed first response from the sidelines and prudent decision-making in determining when a player should return to action.

One of the components of SidelineSportsDoc.com -- which also offers downloadable MP3 content – is the clear, concise PDF for soccer coaches that covers the most common soccer injuries -- including abrasions, ankles, knees -- and pretty much every other type of injury or ailment that a coach could come across.

The beauty is that it’s not a daunting document. It’s reader-friendly and easily comprehensible. It provides an invaluable four-step guide to on-field injury evaluation applicable for every situation. For all injuries, it includes the crucial advice on what “Red Flags” to look for, how to make the “Play of Sit?” decision, and basic sideline management of the injury.

Also included, of course, is advice on when to call for professional medical personnel.

Reading the PDF or listening to the MP3s -- which run about 5 to 7 minutes per injury -- leaves one feeling much more self-assured about the prospects of attending to a hurt player. And a coach’s confident countenance can go far to settle a child shaken up by an injury.

Shortly after I perused the SidelineSportsDoc PDF, a player on my team suffered a bloody nose. That too had been covered: “To control bleeding, use a clean cloth, paper towels, or gauze, to cover the nose. Firmly pinch the soft part of the nose just beneath the hard bridge of the nose and hold for at least 3-5 minutes …”

As is usually the case, the injury was minor and she soon returned to play. But it sure was nice to be prepared.


“The Coach’s Guide to Youth Sports Injury Management” for soccer is available at SidelineSportsDoc.com.


(Mike Woitalla, the executive editor of Soccer America, coaches youth soccer for Rockridge SC in Oakland, Calif. His youth soccer articles are archived at YouthSoccerFun.com.)



0 comments
  1. Ric Fonseca
    commented on: October 20, 2010 at 11:40 a.m.
    Good article Mike! I do want to say that the national and state coaching associations coaching courses fall way short when it comes to the care and treatment of athletic injuries. For example in a national licensing course, the amount time allotted to cover this topic is insufficient enough and the material potential licensed coaches are expected to learn can be covered in a regular semester long college course, and most of the instruction is not even taught by actual athletic trainers or even an MD! I might point out that this is also the case for state licensing courses. As a retired licensed coach (youth, college and club)& former Athl Dir of a local college, I was fortunate enough to have received some very good training in the care and treatment of athletic injuries while a graduate student volunteer assistant at UCLA (from the famous trainer Ducky Drake) and as an AD, I had two excellent athletic trainers to cover sixteen teams. So what is the remedy for this? The coaching courses MUST expand their offerings simply and because all too often coaches are by far too overwhelmed what with a team of eleven-plus players, parents, game officials, etc., to adequately attend to an injured player, but with adequate training it would certainly help. And while Red Cross courses are very valuable, most do not really cover the perennial care and treatment of athletic-sports injuries. You are indeed lucky to have some MD's on your team, but what about those coaches who do not have that "luxury" such as teams playing in local weekend-unaffiliated AND affiliated leagues?

  1. Amy Tucci
    commented on: October 20, 2010 at 12:18 p.m.
    Dear Mr Fonseca, Thank you for your comments. It has been a concern of mine since my son began soccer at age 8. He is now almost 14 and plays for a MLS pre-academy team, and to my surprise at this level, I have witnessed an unbelievable lack of knowledge and common sense on the sideline by coaches and parents. I am one of those MD parents on the sidelines. I have witnessed probable concussions return to the field of a contact sport many times. I recently witnessed, along with a young ref, a boy get knocked out by a collision with another player. No one worried about it and the coach didn't even worry whether he had lost brief consciousness or could have had a neck injury based on the collision. One of the child's parents made the comment "he does that all the time". I worry about the youth in sports and this mentality. I worry about my own child when I am not there. If someone such as yourself - long involved in sports of the young people - can't figure this out, or get changes made, how can a parent make a difference. I would like any reference to clubs and leagues that require injury assessment/education for coaches.

  1. Michael Cornelison
    commented on: October 20, 2010 at 6:14 p.m.
    Good topic, though I recently faced a challenge that went beyond medical preparation. As a podiatrist (also having gone through advanced life support training) I was actually in good shape to handle a possible cervical spinal injury to one of my players. However, I had no assistant coaches at the game, and as a result I found myself sacrificing my role as coach to 15 very scared 11-year-old girls in order to serve as a first responder to a potentially critical injury. This was an away game 1 hour from home. To my good fortune, an opponent's parent knew that an ER physician lived across the street and summoned him. He took over tending to my player until EMS arrived while I then could tend to my team. Even with the most comprehensive injury training, there are still many peripheral things you may encounter in such an emergency. The fortunate news is that there was no spinal damage, though the player is done for the season as a result of her concussion. This incident has taught me to be better prepared to handle not just an injury but the immediate impact it creates, and of course to expect the unexpected.


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