"We started with high school-age athletes," said Holly Silvers, a member of U.S. Soccer men's and women's national medical team, who along with the Santa Monica Sports Medicine Foundation's Dr. Bert. R. Mandelbaum helped develop the PEP Program and the 11+ injury prevention warm-up. "We realized that was probably a little too late. Bio-mechanically, when we look at these young kids developing, we noticed that are real deficiencies we can identify even as early as 8 and 9 years old.
"We made some modifications to the program because what’s
applicable to a 14-year-old is not pertinent to an 8-year-old, so we’ve modified some of the programs, like the PEP
Program, and there’s a kids’ version to the FIFA 11-plus program. You can implement this as early as 8 and 9. The idea is to basically create a vaccination of sorts. If we can prevent some of these deficits
from being entrenched from a motor learning perspective, early on, that we can mitigate risk going forward."
Further reading: FIFA 11+ For Kids Manual and FIFA 11+ For Kids Poster
Silvers was on the Webinar panel, hosted by ECNL President Christian Lavers, along with orthopedic surgeon Dev Mishra (Sideline Sports Doc), sports scientist, coach and coach educator John Cone (Fit for 90), Tyrre Burks (Players' Health) and former U.S. national team player Danielle Slaton (Positive Coaching Alliance).
• Mishra on overuse injuries and low-back stress fractures: "As a coach, you’re going to typically
be the first one to evaluate an injury, or you’ll be the one to notice a change in a player’s performance. One area that is incredibly common in young soccer players and really all young
athletes is overuse injuries. It’s become an epidemic in some sports. I’m seeing a rise in lower-back stress fractures in soccer, lacrosse, gymnastics, tennis and lifting sports. We can
catch this early on, and maybe when it’s just a muscle issue, it might be just a couple weeks off from play. But if a player keeps trying to push through this, those stresses get transferred to
the bone, eventually the bone can crack, and that results in a stress fracture. Average return to play after spine stress fracture is around six months, some never heal."
Further reading: Low Back Pain In The High School Athlete: Early Intervention Is The Key
• Slaton on a culture of trust: "What kind of environment as a coach can we create
so you are having the communication, the open channel, the culture of trust so that if an athlete feels something in their lower back or some other injury, how as a coach are you creating that
environment so an athlete can come to you and mention it -- so it’s not only on the coach to recognize this thing? Are you demonstrating ways that you value your players not just for their
performance on the field, but in other ways. How are you building that culture of trust over time, learning about your players, who they are as people, so you can understand the differences and
nuances with the players. That's huge piece when it comes to injury prevention. ... As a coach understanding the climate of pressure that a lot of these young athletes are under. ... There’s
this fear, "What if I lose my spot. What if I can’t play in that one game where these college people are watching."
Further reading: Positive Coaching Alliance Resource Center
• Cone on reducing injury risk on multiple-game days and weekends: "Manage the fitness load ... tapering the week before the players are going to play multiple matches. ... We need to effectively rotate the roster as much as possible. While we want to win, it should never be at the risk of injury and the well-being of the player. We have to effectively manage the players, so that we're not getting this accumulation of minutes, accumulation of game load over the course of the weekend, or we're minimizing it as much as possible. So we're giving each player the greatest chance of not just success on the weekend, but success over time. When we come out of those weekends, the next piece is allowing the players time to recover. We have a big stimulus on the weekend, if we give them ample time to recover and adapt from the training load of the games, they will bounce back and be at a higher level than when we entered it.
"How are we micromanaging that window of time outside of the game? Mobility work after the game. Pool recovery I've found to be very beneficial. Nutrition. Hydration. Sleep. It takes a comprehensive approach to survive these weekends ...
• Cone on college recruiting at tournaments: "There's a lot of college recruiting going on at these events. I think we have to be especially aware of how driven the kids are in all these games. If we look at the data coming out of these weekends, we can see the fatigue that's occurring in those later games, but there's still college coaches lining up on the side of the fields, and that's pushing the kids well beyond -- because their motivation is so high. Maybe we need to articulate to the college coaches, don't come to the last day of the tournament. It's additional stress on the kids. We know they're not performing to their best potential. ... There are a lot of things that go into successfully managing these windows of time that we know are too much and hopefully in the end we can start to move away from the current norm to increase the likelihood of success for each individual athlete."