‘Inevitable consequence’ as sports returns? Injuries
Many high school coaches have adapted training routines to help reduce the risk
Beyond the masks, the disinfectant, the logistical nightmares of this shortened spring season, there’s one more thing weighing on the minds of many high school coaches in California. How will they protect their players from injury after such a long layoff?
Injuries will be the “inevitable consequence” of returning to action too quickly after a yearlong hiatus, said Dr. Nirav Pandya, a pediatric orthopedic surgeon at UC San Francisco. There could be an increase in all manner of injuries, from those caused by overuse to those more serious, such as ACL and MCL tears in the knee, said Dr. Kevin Shea, the director of sports medicine at Stanford Children’s Health.
In response, many Bay Area high school football coaches have adjusted their training routines and taken other measures, such as putting limits on playing time — steps that could help reduce the risk, the doctors agreed.
“I think the concerns are legit
“If kids aren’t ready to respond in real-game speed, that’s where the risk occurs . ... We’re going to start seeing those traumatic injuries.” — Dr. Nirav Pandya, a pediatric orthopedic surgeon at UC San Francisco
imate,” Shea said. “When people ramp up their activity, they’re more likely to have overuse injuries — tendinitis, aches, pains, other things . ... but also acute injuries, things that are more likely to be more severe.”
When the Saratoga Falcons took the field for the first time last week, coach Tim Lugo said it looked more like a spring practice than one in preparation for the season opener.
“The first couple days, we’re just getting kids used to wearing a helmet again and putting a mouthpiece in their mouth,” Lugo said. “I treat this like traditional spring practice . ... The only problem is in May, we have two-and-a-half months before we play. Now, we have two-and-a-half weeks.”
A gradual ramp-up is one of the most effective ways to prevent injury after a long layoff, Pandya said. Six weeks, he suggested, would be the ideal preparation time for the season. Instead, most teams will have had three or four weeks.
At De La Salle High in Concord, a training staff led by Kent Mercer has been closely monitoring each player’s conditioning level as they prepare for the season opener Saturday night against St. Mary’s of Stockton. Typically, De La Salle has a number of two-way players, guys who play offense and defense, but there will be none of that Saturday night, Mercer said.
De La Salle, a private school, has been in session since October. Players have been able to lift weights in a converted batting cage and hold conditioning workouts since the summer, Mercer said.
Without the extra preparation time, Mercer said he would have reservations about such an accelerated timeline to play.
“If we were just starting up, I wouldn’t feel comfortable sending kids out there to play a sport like football,” Mercer said. “The sport doesn’t change. You have to make sure the kids are ready. There are challenges with that. It’s a short season, and we want to give them as much as we can, but we also have to make sure they’re safe.”
Even for athletes who have been able to train throughout the pandemic, some aspects of the game can’t be replicated, Pandya cautioned. Not every public school has a dedicated athletic trainer, either.
“If kids aren’t ready to respond in real-game speed, that’s where the risk occurs,” Pandya said. “One thing we do know is when you suffer these injuries is when your muscles aren’t strong enough and they get fatigued . ... Your form breaks down and you twist or you lose that balance in your leg and you tear your ACL. We’re going to start seeing those traumatic injuries.”
In the NFL, more players suffered ACL and MCL injuries during practice leading up to the 2020 season than either of the previous two years.
Certain exercises can reduce an athlete’s risk of harmful knee injuries by as much as 50%, said Dr. Andrew Pearle, who specializes in ACL injuries as the chief of sports medicine at the Hospital for Special Surgery in New York City. Getting coaches to convince kids to adopt the time-consuming and tedious routine is the challenge.
“We can prevent half these injuries, almost like a vaccine can prevent a virus,” Pearle said. “But people don’t take the vaccine (just as) people don’t do the exercises.”
Planks, squats, hamstring curls — with proper form — can all help minimize the risk of injury by strengthening the core and the hips as well as improving balance. All of that helps with the mechanics of sharp cuts and awkward landings, Pearle said, two motions that commonly lead to ACL tears.
At Hillsdale High in San Mateo, coach Mike Parodi said some players have already taken time off to nurse tight hamstrings, though, “knock on wood,” he added, “I think it’s just a normal start to the season.”
After a year away from the practice field, Parodi said he wasn’t in peak form either.
“Shoot, my voice is cracking all the time,” he joked. “I’m not used to coaching on a full field.”
While athletes in sports such as football, basketball and soccer might be at a higher risk for severe injuries, athletes in endurance sports such as track and cross-country will be more vulnerable to overuse injuries such as stress fractures and tendinitis.
For all of its benefits, psychological and otherwise, the return of high school sports in California also carries risk — the risk of injury, the risk of COVID-19. Pandya is more concerned with one than the other.
“If you think about the high school athlete, they’ve had really no access to training. They haven’t had contact with their coaches, for the most part,” the UCSF doctor said. “As long as they’re doing the right stuff outside of the game, the injury risk is much higher than the COVID risk.”