Join Now | 
HomeAboutContact UsPrivacy & SecurityAdvertise
Soccer America DailySoccer World DailySpecial EditionAround The NetSoccer Business InsiderCollege Soccer ReporterYouth Soccer ReporterSoccer on TVSoccer America ClassifiedsGame Report
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
License-mania -- aggrandizing the coach in a player's game    
It's not easy to become a USSF-licensed elite soccer coach. Indeed, it's tougher to become a ...
Dutchman completes U.S. Soccer's slate of coaches on boys side     
U.S. Soccer has appointed Dave van den Bergh, who came to the USA from his native ...
Youth soccer factions united in frustration with U.S. Soccer Federation    
The USA has so many organizations involved in youth soccer the term "turf war" often comes ...
Girls vs. Boys: U.S. Soccer's Development Academy dilemma    
Generalizing about genders is a precarious venture, especially when one side is making assumptions about the ...
France routs USA at U-19 tourney    
After opening the Copa del Atlantico tournament in the Canary Islands with a 1-0 loss to ...
U.S. Soccer Development Academy adds 56 clubs for U-12 division     
Fifty-six clubs will join the U.S. Soccer Development Academy at the U-12 level, which the DA ...
Birth-year registration: The transition is upon us    
Will my child be changing teams? Will she be playing "up" if she stays with her ...
Three 14-year-olds picked for U.S. quest to reach U-17 Women's World Cup    
Seven Californians were named by Coach B.J. Snow to the USA's 20-player roster for the 2016 ...
Reffing in foreign languages: Even a few words can make a difference    
Unfortunately, English is the only language that I speak fluently. Immigration from Spanish-speaking countries has grown ...
U.S. Soccer's slate of coaches on boys side almost complete    
Shaun Tsakiris, previously U.S. Soccer Development Academy coach at Northern California club De Anza Force, has ...
>> Youth Soccer Insider Archives