injury-management

By Dev K. Mishra, M.D.

It’s totally understandable to want your injured son or daughter to be healed and back playing sports as soon as possible after injury.

And sincethe progress of the professional athlete after injury is chronicled in great detail through social media there’s pressure on the young athlete to get back to play as rapidly as the pros. But theyoung athlete is not a small professional and in many instances the speed of return could be unrealistic or even harmful to the young athlete.

There are so many factors that make recovery from sports injurydifferent for the young athlete compared to an adult professional. To list just a few:

• The young athlete may have an injury to a growth plate, thus creating possible problems withfuture growth with improper care.

• The psychology of the young athlete will typically be very different from a mature professional.

• And the adult professional often hasaccess to 24/7 rehabilitative care specifically designed for rapid recovery.

For the young athlete: heavy emphasis on ensuring long-term health

Overall, sports medicineprofessionals will value the long-term health of the young player above all other factors. This means that sometimes it’s necessary to go a bit slower, to take a bit longer, and even to be a bitmore cautious than we would be for an adult professional athlete. The end result is that the young player will occasionally feel ready to return to play before we recommend unrestricted play.

For the adult professional: emphasis on function

In contrast, for the adult professional athlete we will of course arrive at a proper diagnosis and provide detailed information tothe athlete about the long-term risks and benefits of various treatment options but there is often a greater emphasis on function and acceptance of playing in some amount of pain.

What thismeans is that as long as it’s reasonable and safe, we’ll work with the athlete and training staff at a pretty rapid clip to determine whether the player can do what’s required fortheir sport and position.

This also means that in some situations with professional athletes it’s necessary to push the envelope with accelerated treatments. Dr. Brian Cole, teamphysician for the Chicago Bulls and orthopedic surgeon at Midwest Orthopaedics at Rush put it this way in a recent interview in Wired:

“‘The decision to push the envelope can be really complex,’ says Cole. The playermight feel like he needs more time — but the organization, in a situation like the NBA playoffs, will want him back as soon as possible. Or maybe the player is anxious to get back before he is ready,feeling the weight of his or her team and even career. Amid all of this, a team’s physician has to be clear-minded and focused on the best interest of the player. ‘It takes an enormous amount ofhumility,’ says Cole. ‘You can never be a fan.”‘

For all players, of all ages, in any sport: physicians must put the player first

The interesting thing is that regardless of thesituation, the sport, the player’s age, or whether they are male or female, the physician approaches sport injury the same way every time. By putting the player’s interests first.

Dr. Bert Mandelbaum, the longtime national team physician for U.S. Soccer and Advisor to Sideline Sports Doc put it to me this way: “no matter the situation, whether it is apractice with very young players, a club team in a championship, or a professional in the World Cup there’s one thing we must do always: put the player first.”

This means that ifyou’re a parent or coach of a young player, putting their long-term interests first will give you the best possible chance of ensuring that athlete is good to go for the current season and forthe long run.

Key Points:
• Young athletes (and their parents) often try to emulate the rapid return to sport after injury that we see in adult professional athletes
• Due to many factors associated with the unique needs of the young athlete it could be unwise or even dangerous to push the speed of recovery after injury
• For sports medicinephysicians, we will place the long-term health of the young athlete at the top of our priorities when determining a proper recovery process after injury.

(Dr. Dev K. Mishra is the creator of the SidelineSportsDoc.com injury managementprogram for coaches. He is a Clinical Assistant Professor of orthopedic surgery at Stanford University. Mishra writes about injury management at SidelineSportsDoc.com Blog, where this article first appeared.)

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2 Comments

  1. Excellent article. Ankles spring to mind. I don’t know the details, but have had several adult friends over the years with chronic ankle problems that they considered avoidable had they been wiser teens.

  2. Thinking about the athletes first, why do we have these young players participate in tournaments that require them to play 3 to 6 games in 3 or 4 days? They would never, ever expect pros to do that… so why is it ok for the kids to do it? Just wondering…

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