Teenage sports injuries: prevention and management

Overview

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One of the greatest things about being a teenager is that you can run, jump, bend and reach in the ways we can only wish for as we get much older.  But having such a high performance machine requires high performance maintenance and care.

Furthermore, without the necessary care and maintenance, teenagers can be prone to injuries keeping them away from sport – from nagging niggles to more demoralising and chronic debilitating injuries.

Fear not! Armed with the right knowledge, injury risk can be minimised and should the worst happen and you do develop a problem, knowing how to manage your way back to sport can be a useful skill and can better your performance in the long run.

In this blog, Richard Game, one of our team of Sports Physios talks about types of injuries and issues, why teenagers might get them, how they can be managed and more importantly, what to do to prevent them occurring where possible. Richard has three teenage boys of his own and two are particularly sporty – so he speaks from a place of experience!

Introduction

The key to best managing sports injuries in older children, teenagers and young adults is the appreciation that they ARE NOT the same as adults.  The physiological properties of their body tissues, their various stages of growth and their growth rate can all vary hugely and all require careful consideration when assessing and treating them.

teenage skeletonThere are 2 main growth spurts in children and teenagers, coinciding with hormonal changes, as the child progresses from infant to child.

The first occurs at 6 or 7, but most relevant for this discussion is when puberty occurs. The timing of this spurt varies between girls and boys with girls being slightly earlier at 8-13 years and boys at 10-15 years.

The hormonal driven changes cause increased activity in the area of bones where growth occurs which is called the ‘growth plate’.  The rate of this can vary greatly – with some adolescents growing relatively slowly over longer periods, whilst others seem to shoot up almost overnight!

Therefore, it is really important that teenagers with musculoskeletal pain are suitably assessed and, here at Physio on the River, we have several team members who have a lot of experience working with sporting teenagers and understand the various challenges and issues this cohort bring with them.

Types of sports injuries

These can be broadly split into two types:

  1. Traumatic injuries – these most commonly happen in competition or training and includes things such as sprained ligaments, torn muscles, fractures, tendon injuries and haematomas (large bleeds into a muscle).
  2. Overuse injuries – these can build overtime or suddenly become evident by causing pain, swelling, strength loss and a reduction in sporting performance. Examples of these include conditions such as: Chondromalacia patella and Osgood Schlatter’s disease in the knee, Pars defects in the spine, Severs disease of the heel, shin splints and tendonitis.

Prevention

There are several different aspects to injury prevention in younger sports people.  Most importantly to say right away, is that if you think you have a problem and it’s either not improving or your problem is distressing because of pain, then it’s essential that you see either your physiotherapist or doctor to have a thorough assessment.

It’s not ‘normal’ to have pain other than perhaps post exercise muscular fatigue and pain could be indicating something else that needs medical attention.

Common Issues Physio Solutions
Over training – Too high a volume of training/competing, too heavy loading of tissues, lack of variety in movements and loading Training smarter – Your physio can help you develop a training program that enables optimal performance AND minimises injury risks from over-use.
Growth related issues – ‘growing pains’ can be very real, can prevent full movement and function and severely limit sporting activities Understanding your body – We can help you understand what are growing pains, what are training pains that are normal and what may be an injury or overload AND advise you how to manage this
Poor technique – inefficient movements or poor technique causing overload of tissues and increased stress and strain on the tissues Doing it right – Making sure you are performing techniques correctly, reduces excessive lading of tissues AND will enhance efficiency and help you perform at your best
Inadequate/wrong equipment – often adapting movements to accommodate adult equipment that is too big The right stuff – We are able to advise you on equipment from footwear to bikes and taping to padding.

And finally a brief word on weight training…

It is very ‘fashionable’ in society at large to engage in weight training – whether that’s a 50-year-old Mum doing 70 kg dead lifts at the gym, a 25 year old sculpting their body for social media posts or a young sportsperson trying to get stronger for their sport. What is important is that teenagers respect the level of maturity of their skeleton and load it accordingly.

teenage rugby playersFor example: let’s look at 14-year-old rugby players Ollie and Billy. Ollie is 6’1”, weighs 78 kg and is just about the same height as his father but 30 kilos lighter.

Billy, on the other hand, is 5’3”, weighs 46 kg and is 7” shorter than his father and 45 kg lighter.

They are both in the A team for rugby in their school year.  Clearly the boys are similar in age and level of sport being played, BUT they are not at all the same in their physical development.

As physios we would help Ollie develop a strengthening program using free weights, lifting heavy weights and ensuring technique is correct. We would not however encourage such an approach for Billy who is presently less physically mature. We would  perhaps use resistance bands and body weight exercises and maybe light weights instead, as he would be at far greater risk of injury.

It is this evidence based and reasoned approach to managing sports injuries and performance in teenagers that allows us to achieve great results.  We are always happy to screen teenage sports players and can advise on training regimes that are tailor made for them at their unique stage of development.

Next steps

If you would like to find out more or want to discuss your teenager’s injury with Richard or one of our team of Physios, just:

Call the clinic on 020 8876 5690

Email us here

Book an appointment online

Or pop in to the clinic for a chat!

Hear how Physio Dave helped a keen runner with persistent Achilles Tendinopathy

I recently caught up with one of our keen running clients, Patrick, who came to the clinic complaining of chronic Achilles Tendinopathy. Read on to find out how Physio, Dave Burnett, helped Patrick recover so that he could return to distance running again.

Hi Patrick- tell us a bit about yourself and what sport and exercise you do?

As a retired rugby player and triathlete my body has taken a bit of a battering over the years. Nowadays I cycle as my main sport but still enjoy running and swimming.

How and when did you develop your running Injury?

Achilles tendinopathyIt was probably a combination of not warming up properly, pushing too hard and the uneven surface that must have aggravated my Achilles tendon problem. When you are only a short distance out the tendency is to keep going to the end which probably just aggravated the situation even further.

What did your physiotherapy involve and how did you find it useful?

Dave at Physio on the River was great! Things were made easier as I was being treated by him for a shoulder injury at the time and he saw me hobble in and immediately diagnosed the issue – which was a Chronic Achilles Tendinopathy. So, after a couple of sessions of manual therapy treatment and stretching exercises for the calf, hamstrings and glutes (buttocks) we started the Shockwave treatment.

Describe your experience of shockwave therapy?

Shockwave for the achilles tendonI had 4 sessions of Shockwave which involved getting hammered by metal pads 100 times a second! It hurts the first time, although I think this was psychological and then after that it became quite therapeutic!

Whilst you mustn’t run immediately after the treatment, you can stretch and it’s important to do loaded strengthening exercises.

Every week I felt some progress. Once we had finished the Shockwave sessions we were able to progress to more explosive “plyometric” exercises. Apart from a blip when I may have done too much too soon, I was able to gradually build up the time and distance I was running and eventually the pace.

I am making great progress now. The important thing is to listen to your body and take your time. When you get injured after 50, it’s about managing the condition. The shoulder injury also helped as it forced me to go swimming and I was able to do more rigorous plyometrics in the pool. The positive benefits of swimming are extensive!

How are you getting on now and have you achieved your goals?

I’m in a good place now and am hopeful of continuing Park Run regularly and getting to that all important 22-minute milestone. My ultimate aim is to get back to half marathons.

What’s your brief understanding of how to manage your Achilles tendon problem in the long-term?

Should it return I should first  reduce the load, gradually re-load, add plyometric exercises and load even more -with marginal increments and take my time! Thanks very much Dave!

Thanks, Patrick, for sharing your story and illustrating so nicely how we treat and help people manage chronic tendon problems like yours.

Next steps….

If this has struck a chord with you and you’re suffering with a tendon problem, to make an appointment with Dave just:

Book online

Call 020 8876 5690

Email us here

Or pop in for a chat!

12 top tips for avoiding a skiing injury this Spring!

At Physio on the River we work closely with the Orthopaedic Consultants at Wimbledon Clinics (at Parkside Hospital) who are specialists in managing skiing injuries. They are experienced and keen skiers themselves so understand the sport completely. If you are unlucky enough to get injured this Christmas or Spring we can refer you quickly to their fast track clinic for injured skiers.

However, prevention is so much better than cure!

We run a Get Fit to Ski class to help you prepare for the slopes and we will be continuing this class in the New Year to help those preparing for the half term or Easter holiday break. The class is Physio led and covers all aspects of fitness, flexibility, strength and conditioning and balance to get you in tip top condition. It’s also a great way to shed those extra pounds put on during the festive period!

Jonathan Bell from Wimbledon Clinics has written this excellent top 12 tips for avoiding injury, which I would like to share with you in this blog.

1. Take lessons

The better your technique, the less chance you’ll put undue strain on your joints.

2. Get the right kit

Have your ski or board bindings set up by a pro because, if your bindings are incorrectly adjusted, or you borrow a friend’s skis, you’re more likely to injure your knees. In the hire shop, provide an accurate weight and estimate of your ability and don’t use boards or skis that are too short or long.

3. Have a rest day

Ignore the “first lift / last lift” banter and take a break. You’re likely to get more from your holiday. Why? Because the highest risk of an accident is after 3pm on day three of your holiday as muscle fatigue reaches its peak 48 hours after you hit the slopes.

4. Take the lift at the end of the day!

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Later in the day, you’ll be tired, the pistes may be icy and crowded, and there will possibly be bare patches in the snow – all of which are risk factors for injury. So take the lift!

5. Control your weight

Good advice for life is to maintain a healthy weight. It’s also good to prevent injuries. The heavier you are, the more strain you put on your knees and the harder you fall.

6. Keep within your comfort zone

Control is good, bravado is bad, and icy moguls – especially if you already have any damage to your knees – are a menace. Mogul falls can result in serious injury, especially to the shoulder in
firm conditions.

7. Minimise alcohol at lunchtime

Alcohol slows your reactions and makes you more reckless.

8. Be careful getting off the chairlift

It’s easy to fall when trying to get off a chairlift. And, while it might be funny, it can be serious. We also see many people who’ve ruptured their knee ligaments when the person next to them
falls across their skis.

9. Ski off-peak

The quieter the slopes, the less danger there’ll be of being called on to take sudden evasive action. If your ability allows, learn to ski off-piste where it’s often quieter. Do make sure you learn about the risks before going off-piste and have the correct equipment and insurance.

10. Don’t wear a knee brace but do wear wrist guards if you snowboard

We recommend knee braces only for a small number of people. These include skiers returning to the sport with an old or partially healed ligament injury (they might want to use a hinged brace) or
those with mild arthritis (who might benefit from a neoprene sleeve).

Otherwise, skiing without a brace improves the ability of the muscles around the knee to respond effectively to the different stresses and strains. Wrist guards for snowboarding are useful and
significantly reduce incidents of wrist fractures.

11. Seek advice immediately after injury

Clinics in ski resorts are versed in treating ski injuries. Above all, do not ski with an injury – get it checked out. Even though it might be tempting to carry on skiing through an injury, ignoring it may result in a longer lay-off. Then, once you are home, speak to your physio about a referral to Wimbledon Clinics.

12. Wear a helmet

Helmets can reduce the severity of mild to moderate head injuries.

If you are interested in joining our Get Fit to Ski class or giving a loved one a voucher just:

Call us on 0203 916 0286

Email us by clicking here

Or simply pop by for a chat!

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