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Dear parents and coaches:

Relax, back off, chill, give the kids a break, before they break. 
Many of us are pushing too hard and the kids suffer. The kids are not indestructible. Mentally, physically, and emotionally they can suffer, be hurt without telling anyone, and get injured permanently because we, the adults, are too focused on our own goals being attained through the athletic accomplishments of our children.

Parents want the best for their children as do Coaches, but sometimes the need of wins, traveling teams, all-conference teams, “club teams,” scholar-ships, “making the pros” and “the big bucks” creates too much ugly pressure on everyone involved.

I am writing this from three perspectives. Most objectively, I am a practicing physical therapist, treating adolescent injuries for 31 years. I am a parent of a teenager and I have also been a community league coach.

The problem is getting worse… not better. 
Overuse and fatigue injuries are my primary concern. Recently, the violence of our society has been illustrated in our own community youth basketball league – the adults, not the kids. Remember the NBA riot.

Training intensity these days is incredible. Twelve months a year or you don’t make the team. Multi-sport athletes are really in jeopardy of fatigue, because they not only go from sport to sport, but are being asked to play “club” in one sport, in addition to the school team in either the same sport of a different sport.

I am all for cross training to avoid injury, but not full-time training and competition in one sport and then add practice and competition of another sport during the same time period.

Dance and gymnastics are much the same if not worse. They get away with it because people think of the beauty, think again.

The research is out there and is too plentiful to mention in this letter. Teen females are particularly at risk with a rate of six-fold more knee injuries that their counterparts. Injury rates and psychological burnout increase with too busy a training schedule. Other parts of a balance life and education are also excluded. Family time, vacations, and simple playtime are missed.

Why all the drugs, caffeine and performance enhancements? Do you think it starts in elementary school? You bet!

So chill, back off. One sport at a time! One team at a time. Have an ice cream. Miss a practice when they have a virus!

Rest creates improved performance. Stop the competitive juices once in a while. It helps! Taper before competition. Be realistic.

How many of our beautiful children have played in the NBA, NFL, Major Leagues or Olympics since 1980?
One!

How many get hurt and don’t heal properly, because we push them too hard?
Plenty.

I see them and so do surgeons, pediatricians and family practice doctors.

Walt Abbey (published in the Union newspaper)

Professional athletes have back pain even though they are very fit. It even happens to quite knowledgeable Physical Therapists. March 12, 2009 I herniated a disc and have sciatica that will resolve without surgery. WHY? It starts with our anatomy. The design allows for motion, and good strength, but to put ligaments, cushioning discs, muscles, nerves, small joints, spinal cord and vertebral bodies in a very tight space is a delicate balance. Large accidents and small daily incorrect movements and postures create wear and tear that eventually get us in trouble.

PREVENTION is a combination of good lifting mechanics, knowing your limits, trunk stabilization, leg flexibility, use of carts and other assistive lifting devices, good nutrition and health habits. Practice avoidance of reaching, twisting, and bending at the waist even if all you are lifting are dishes or small garden items or one piece of firewood. Always face the item and move your feet and bend your knees to accomplish your tasks. Learn how to properly stabilize your trunk before lifting. Abdominal tone helps but the old health club crunches are not the answer. Call a physical therapist for body mechanics and exercises.

Good nutrition is not rocket science. Eat fresh foods, fruits, vegetables, lean protein, and whole grains. Limit alcoholic beverages to 1-2 per day because they dehydrate you and your spine. Too much refined sugar compromises bone and cartilage metabolism. Nicotine/tobacco chewed or smoked greatly reduces oxygen and circulation to the spinal tissues and is an irritation to the nervous system and therefore increases pain. Tobacco dehydrates your discs and speeds up the aging process. Keep excess weight off. We Americans are killing ourselves and ruining our joints because we are the most obese country in the world.

If you hurt your back seriously call your doctor get their evaluation and get some anti-inflammatory and pain medication to help you. Leg nerve pain means you have a more serious injury and you need immediate help. Lie down flat, rest, and walk if possible. Avoid sitting. I will be sharing more advice in the future about the most common injuries I see based on my 35 years of experience and the latest medical information.

This can be a devastating injury that takes over 1 year to return to 100 percent of performance and agility. It also sets up the athlete for early onset of arthritis. Coaches, parents, and young female athletes can learn these training techniques and should definitely make them part of their training regimen. These exercises do 2 things. They actually reduce ACL injuries and the byproduct is they improve the females jumping and agility skills. I will give brief instructions later.

ACL tears usually occur without any physical contact in females. In females the injury generally is a cutting, landing, and quick change of direction injury on the defensive side of the game. Soccer, basketball, and volleyball come to mind. There is a gender biological bias due to risk factors and most of this information comes from the NCAA injury surveillance program. These injuries start at 12-13 years of age as the female moves into puberty. Risk factors are: Females perform athletic activities with improper technique that predisposes them to injury. Females have poorer muscle strength and control in their legs, at this age. Because of the widening female pelvis, the knees are asked to function with more inward angle. The female hormone levels of estrogen fluctuate and affect changes in flexibility.

Training technique and strength can control of 2 of these 4 factors and has proved locally and nationally to decrease female knee injuries and improve performance. Females jumping technique risk is due to that they tend to allow the knees to come together and be inside the foot position when changing direction and landing from a jump. In other words, avoid the “knock knee” position at all times. The other technique flaw is that females tend to land flat footed and with knees straight, so they don’t absorb the shock well. We videotaped this on Nevada Union girls' basketball team 6 years ago. 80 % and even the star players had bad technique. The solution, practice change of direction and jumping with the knees in a position away from each other and in line with hips. It is great in practice and before a game for part of the warm up drill.

Strength training is done much the same with three or 4 jump activities. The 3 jumps are simply calf jumps, like jumping rope. Do 30-50. Then squat half way and then jump bringing knees up to waist. Do 10-20. For the thrust jump, which is next, start in a full squat and explode all the way up throwing your arms up like you are grabbing a rebound. Do 10, if you can. The important things are technique while jumping and landing. Start with fewer jumps if you have to in order to maintain quality. Knees are out slightly and absorb shock with landing on toes and bending the knees. When the youngsters are strong enough add lunging jumps or straddle jumps, knees out slightly.

Do this training and improved jumping and reduced injuries will be your result. The first year Coach Ganskie did this training he had Zero injuries and one girl improved her jump 3-4 inches. The previous seven years all had at least one injury. All youth and school coaches should train this and 75% of all female knee injuries would be prevented. Just a thought, better rebounding means more victories. Start this with 10 year olds and when they get to13-14 they will already be trained and jumping correctly. Call us at A&A Physical Therapy and we will train the coaches or parents or athletes. We will go to the schools and coach's meetings.