By Dr. John R. Mishock, PT, DPT, DC
In the US, there is over 8.6 million sports-related adolescent (age 10-20 years) injuries annually; 42% happen in the lower extremity, 30% in the upper extremity, and 16% in the head and neck. (NHSR, 2016) Many of these are over-use injuries that occur due to excessive intensity, volume, or frequency of the practices or competitions. Many of these injuries are treated in orthopedic physical therapy clinics and chiropractic centers like Mishock PHYSICAL THERAPY & Associates.
Overuse injury is defined as micro traumatic damage to a bone, muscle, or tendon due to repetitive stress without sufficient time to heal or undergo the natural reparative process. (Rosen et al., 2017) The risk of injury is broken down into modifiable and non-modifiable risk factors. Non-modifiable risk factors are things we have no control over, such as; gender, prior injury, age, body size, and maturation. However, we can significantly impact injury potential by manipulating the modifiable risk factors, which include; training, strength, mobility, biomechanics, fitness, psychological readiness, sleep, nutrition, and early sports specialization.
We often overlook sleep as an essential factor in preventing injury. However, those who sleep less than 8 hours per night are 1.7 times more likely to sustain an injury (Milewski, 2014). An athlete who gets> 8 hours of sleep per night has a 61% decreased risk of injury (Von Rosen, 2017). Individuals with a balanced diet that includes adequate amounts of fruits/vegetables, lean meats, and reduced use of ultra-processed and processed foods had a reduced 64% of over-use injuries. (Von Rosen et al., 2017) More than ever, our adolescent athletes experience unprecedented mental stress due to the Covid-19 pandemic, social media, peer and performance pressures, and coach/parent pressures/expectations. Mental stress is strongly associated with injury increasing the risk by 1.5-2 times (Ivarsson et al., 2017). Conversely, psychological interventions such as meditation and cognitive behavior therapy to manage stress can significantly reduce the risk of injury (Kontos, 2004, Ivarsson 2017)
Some people believe that strength training for youth and adolescent athletes can injure growth plates, alter bone development, and increase muscle, ligament, and tendon injury. However, this myth could not be further from the scientific truth. The proper selection of exercise, volume, intensity, and training frequency can significantly reduce injury and improve sports performance. Gaining strength, power, endurance, balance, motor control, and mobility can improve movement mechanics, enhance shock absorption capacity, and optimize force transfer. (Laursen, 2014) These biomechanical and physiological muscle gains will help the athlete run faster, jump higher, throw harder, and hit further while preventing acute and over-use injury. Studies show that appropriate training can reduce injuries by up to 50%. (Lloyd, 2013; Noyes, 2014; Emery, 2003; Meylan, 2014 Sadigursky, 2017)
We, parents, coaches, and trainers, can significantly reduce the injuries in our adolescent athletes by controlling and manipulating the modifiable risk factors mentioned above.
Dr. Mishock is one of only a few clinicians with doctorate level degrees in both physical therapy and chiropractic in the state of Pennsylvania.
He has authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, and “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon.
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