Doctors concerned about injuries — not just COVID
Pediatric orthopedic surgeon thinks return to sports could be risky
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 injuries after such a long layoff?
The time away could lead to an increase in overuse injuries as well as more serious acutetraumatic ones, such as tears to the anterior cruciate ligament, said Dr. Kevin Shea, the Director of Sports Medicine at Stanford Children’s. Dr. Nirav Pandya, a pediatric orthopedic surgeon at UC San Francisco, said injuries would be the “inevitable consequence” of bringing back sports so quickly.
In response, many Bay Area high school football teams have adapted their training routines and taken other measures, such as limits on playing time — steps that could help limit the risk, the doctors agreed.
“I think the concerns are legitimate,” Shea said. “When people ramp up their activity, they’re more likely to have overuse injuries — tendonitis, 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 less than a month away from kickoff.
Players didn’t wear any protective gear besides their helmets until after the first day of practice, Lugo said.
A gradual ramp-up is one of the most effective ways to prevent injury after a long layoff, Pandya said. Pandya said six weeks would be the ideal time to prepare for the season. Instead, most teams will have had about half that time to prepare for the season.
Already, Shea and Pandya said they have noticed an increase in visits to their clinics since the first practices began last month.
In a normal year, Pandya said he operates on about 10 to 15 kids with ACL tears per month but that number fell to only about one every month while sports were down for the past year. Just last week, Pandya had five new pediatric patients come in with ACL tears, he said.
At De La Salle High in Concord, a training staff led by Kent Mercer will be closely monitoring each athlete’s level of conditioning as they prepare for their season opener this weekend. The Spartans plan to limit players to one side of the ball, Mercer said, meaning no one will play on offense and defense in the same game.
As a private school, De La Salle 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. At Saratoga, the football team transported their weight-lifting equipment outside to the softball field.
Without the luxury of extra preparation, 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, and I’ve even already started to see it a little bit.”
In the NFL, more players suffered ACL and MCL injuries during practice prior to the 2020 season than either of the previous two years. But the number of serious knee injuries was about in line with the average since 2012, according to the NFL’s health and safety data.
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 like football, basketball and soccer may be at a higher risk for severe injuries, Pandya and Shea noted, endurance athletes may be more plagued by those of the overuse variety, like stress fractures and tendonitis, that can also derail a season.
However, a growing number of programs are becoming smarter about the way they train, Shea said, which can help reduce the risk.