Interview by Mike Woitalla
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 about injury trends he has observed in youth soccer; whether there are different injury patterns between boys and girls; and what coaches can do to help keep their players healthy ...
SOCCER AMERICA: What trends have you seen in the past years in youth soccer injuries?
DR. DEV MISHRA: There’s two things that we’ve seen that have really risen dramatically.
One is that it seems that for whatever reason we’re seeing a much larger number of overuse injuries than we used to see even 10 years ago.
These would be things like tendonitis, stress fractures, things that result from repetitive usage of an extremity. That’s No. 1.
No. 2. We’re seeing a rise in certain traumatic injuries at a much earlier age than we used to. For soccer players it’s principally ACL tears.
There seem to be many factors involved in that. Whether it’s more kids playing, different style of play, different surface, or mechanical issues like muscle weakness.
But we’re seeing ACL tears in children as young as 12 and 13 years old – which used to be really quite rare 15 years ago.
SA: Are there different injury patterns for boys and girls?
DR. MISHRA: Girls tend to become physically mature earlier than boys do and certain injuries such as ACL tears happen at a younger age in girls than they do in boys.
We see adult-type injuries a little earlier for girls than we do for boys.
There’s also growing, very solid evidence that shows that girls respond differently to a concussion than a boy does. Girls tend to have symptoms that last longer and perhaps are a little more severe than one would see in a boy. There’s some strong scientific evidence of that coming out of the University of Pittsburgh.
SA: For years there have been reports of higher rates of ACL injuries in females. What should coaches do with this in mind?
DR. MISHRA: There’s a lot of effort in trying to improve training for girls to reduce ACL injuries.
Dr. Bert Mandelbaum’s group has been key in developing some of those methods. He and physiotherapist Holly Silvers have done a great job of identifying a simple warm-up that helps to improve the landing characteristics when you’re landing from a jump, and improving the mechanical ability to cut and pivot.
And they’ve shown that they do have reductions in ACL injury rates for teams that follow these protocols.
(Editor’s note: For more on the Prevent injury, Enhance Performance (PEP) Program, click HERE.)
SA: What else can coaches do to help prevent injuries?
DR. MISHRA: Good training courses should include in their training age-specific methods that help coaches recognize and provide basic management for injuries.
As the kids get older and into adolescence there’s more of an emphasis on proper warm-up, flexibility, jump training, and other preventive measures.
Early on, the game should really be about fun and less about tactical awareness. It’s amazing that when we take tactical awareness and that type of thing out of the game -- and it becomes more play than game -- we see far fewer injuries than we do otherwise in a structured environment.
SA: How can coaches prepare to respond when injuries do happen?
DR. MISHRA: Coaches should use whatever resources are available to educate themselves about injury management .
Our premise, with SidelineSportsDoc.com, is to teach people a method they can use every time. Learn how to take care of the six to eight key injuries that happen. They’re going to be a little different for soccer than they are for baseball and hockey.
If you have resources available in your local community, take advantage of them. Perhaps your club has an injury management curriculum as part of your coaching certification course. Make yourself aware of a method and make yourself aware of the most common injuries, how to look for the red flags and manage that properly on the sidelines. Knowing those basic things will allow a coach to respond with confidence when an injury occurs.
(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/East Bay United in Oakland, Calif. His youth soccer articles are archived at YouthSoccerFun.com.)