Join Now | 
HomeAboutContact UsPrivacy & SecurityAdvertise
Soccer America DailySoccer World DailySpecial EditionAround The NetSoccer Business InsiderCollege Soccer ReporterYouth Soccer ReporterSoccer on TVSoccer America Classifieds
Paul Gardner: SoccerTalkSoccer America ConfidentialYouth Soccer InsiderWorld Cup Watch
RSS FeedsArchivesManage SubscriptionsSubscribe
Order Current IssueSubscribeManage My SubscriptionRenew My SubscriptionGift Subscription
My AccountJoin Now
Tournament CalendarCamps & AcademiesSoccer GlossaryClassifieds
Injury management: The return-to-play decision
by Mike Woitalla, November 22nd, 2010 5:54PM

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

MOST COMMENTED

Interview by Mike Woitalla

One of the toughest decisions in youth soccer is determining when a player who has suffered an injury is ready to return to action. Dr. Dev K. Mishra, who has served as team doctor at the professional, national team, college and high school level, is the founder of SidelineSportsDoc.com. We asked Dr. Mishra for advice on making the return-to-play decision.

SOCCER AMERICA: What’s the most important thing to keep in mind when determining if a player is fit to return to action?
DR. DEV MISHRA:
The emphasis on the sideline has to always be directed toward athlete or child safety. The emphasis is always on erring on the side of caution.

SA: Because a premature return can lead to a more serious injury?
DR. MISHRA:
Yes. In my clinical practice over the last 15 years I see one or two kids each week with a significant injury that started out as some kind of minor injury. For whatever reason they kept playing and that minor injury turned into something more significant.

Sometimes it was because they were put back in the game too soon. Sometimes it was because they failed to report it to the coach.

If you think a kid’s not really ready, it’s better to sit them – maybe lose them for a few days – rather than to let them get back in before they’re ready and lose them for weeks or months.

SA: What’s the optimal approach to take in making a decision?
DR. MISHRA:
What I’d love to see is that the real decisions on return to play – if it’s a significant injury – is not in the hands of the coach, it has to be in the hands of a trainer or physician – someone who’s really trained and qualified to make that decision.

But there are settings where someone who is professionally qualified isn’t there to make a remove-from-play or return-to-play decision. In that case, it’s really going to come down to the coach. It has to be the coach who has the knowledge to be able to intervene.

SA: What if a young player insists she or he is ready to play?
DR. MISHRA:
This is where the decision becomes really tough. You really need to be their advocate -- to be their voice.

As the kids gets older, they’re going to have better reasoning abilities. They’re also going to have other motivations to stay in the game – and perhaps not tell you stuff. That’s when you really have to have some judgment and the decision can be very difficult.

SA: We hear about pros playing with injuries all the time …
DR. MISHRA:
That’s a totally different setting. Those are not minors. They can undergo treatment with informed consent. It’s completely different for a kid.

With kids, you have to make the tough decision for their own good. What if you’re at an away tournament? What if it’s your star player? What if you have to play a man-down? You still always want to err on the side of safety.

SA: Are there any rules of thumb, such as looking for a limp?
DR. MISHRA:
In soccer, we’re mostly talking about lower extremities – hip, knee, ankle, foot.

The safest thing to do is confirm that the kid is really pain free. If you’re deciding on return-to-play, it’s really a black-and-white approach.

If the kid is pain-free, no swelling, normal ability to jog, cut, sprint and jump with normal strength – they can return to play. That’s basically saying if a kid gets back to “normal” – they can play.

But there are subtleties that make it complicated, which is why it is always advised to consult a medical professional when there is any doubt.

(Dev K. Mishra, the founder of SidelineSportsDoc.com, is an orthopedic surgeon in private practice, Burlingame, Calif. He is a member of the team physician pool with the U.S. Soccer Federation and has served as team physician at the University of California, Berkeley.)


(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.)



No comments yet.

Sign in to leave a comment. Don't have an account? Join Now




AUTHORS

ARCHIVES
FOLLOW SOCCERAMERICA

Recent Youth Soccer Insider
Is it OK to play in pain?     
"What's the difference between discomfort and pain? And is it OK for me to keep playing ...
The benefits of pool play vs. traditional leagues for U-10s     
The Youth Soccer Insider asked Sam Snow, Technical Director of U.S. Youth Soccer, to explain the ...
Ref Watch: Why three is so much better than one     
When I moved to Florida for business 27 years ago, I lived and worked in Orlando ...
Tab Ramos auditions new talent for U-20 World Cup     
Coach Tab Ramos has called up three players to the U.S. U-20 national team, which is ...
George Altirs boosts New Jersey-area youth ball     
As a boy, George Altirs spent his free time playing as much soccer as possible in ...
Are tire crumbs on fields a cancer threat?    
Some environmental and health advocacy groups have claimed that the crumb rubber infill, used in artificial ...
A World Cup for Richie Williams, better late than never     
Richie Williams might just be the USA's most successful player who never played in a World ...
USA avoids debacle in U-17 World Cup qualifying    
Ultimately, the USA's quest to qualify for the 2015 Under-17 World Cup hinged on shots from ...
Americans down to one last chance at U-17 World Cup qualifying    
One of the U.S. national team program's consistencies for nearly three decades was that the USA ...
Video Games vs. Youth Soccer, the mismatch    
In an article by John O'Sullivan, founder of Changing the Game Project, he writes that three ...
>> Youth Soccer Insider Archives