Youth athletes: Training around injuries

In many ways, youth athletes are similar to adult athletes when it comes to rehabbing injuries. Regress away from movements that cause pain, build tissue capacity over time, then slowly progress to full return to play. 
However, unlike adults, youth athletes are not in full control of their rehab process. They receive instructions from coaches, parents, and health care professionals, and too often, there is disagreement on what their plan of care and return to play should look like. 
A common solution to an injury is to tell the athlete to sit out and rest for a few weeks, which can be harmful to a child both mentally and physically. Most kids play sports because they love them, and if an athlete is forced to stop playing and practicing their sport completely, an important social and physical component of their life has been taken away. 
Many injured athletes are so desperate to play their sport that they will force themselves back into full training too soon, leading to further injury. Therefore, when it comes to a plan of care, a multidisciplinary approach is critical, and it is vital for health care professionals to communicate with coaches to involve their injured athlete in practices and games as much as the rehab plan allows.
There are few reasons for an athlete to ever take complete rest from a sport. As health care practitioners, it’s important to have conversations with the athletes and coaches about pain and explain to them it’s OK to play and practice with pain, as long as it stays under a 3-4/10 — meaning the pain level should not be above a 3 or 4 on a 10 point scale. This is a subjective measure of pain, but as long as the pain isn’t sharp and as long as it stays below this level, the athlete should be allowed to continue playing/practicing/training. 
Some athletes will have a good amount of fear of pain and need lots of encouragement to get back fully to their sport, while others will need to be held back from aggressively jumping back into play. The rehab process should be explained to the athlete and applied to the sport so that they will see value in it and participate to the fullest. 
In addition to letting the injured athlete participate in their sport as much as possible while healing, injuries should be viewed as an opportunity for the athlete to work on improving her cardiorespiratory conditioning or strength. Frequently, youth athletes train all year round for a sport, without any off-season to work on increasing their tissue capacity and load tolerance by strength training. This is of particular importance for young athletes, as they haven’t ingrained enough repetitions of common movement patterns to be good
at necessary motions for sport, such as squatting, jumping or running. They need strength training to create a base of athletic movement and potentially reduce their risk of injury. 
Dr. Nate Jones, PT, is with Made 2 Move Physical Therapy on Daniel Island. His intern, Rebecca Angles, SPT, a doctor of physical therapy student at the Medical University of South Carolina in Charleston, contributed to this article. For more information, call 843-640-5244 or go to

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