Experts worry long layoff could lead to an uptick in injuries
Winter high school sports will resume Tuesday with practices, and games no sooner than Feb. 8 as the state’s the two-month-long pause on team and club sports is expected to expire.
Most athletes have not participated in large-group training, team practices or competitions since early November. For others, it’s been even longer.
With that pause in mind, some medical experts worry the extended layoff could lead to injuries if the athletes’ bodies aren’t prepared for the physical workload of a sports season.
“It’s a huge concern of ours,” said Dr. Alison Crepeau, an orthopedic surgeon and sports medicine physician at Connecticut Children’s Hospital.
“In the pre-COVID world we always advocated for athletes to take a break from their sports. Now we sort of got what we asked for, but a little too much of it.”
Since the state suspended team and club sports on Nov. 19, athletes
have been encouraged to train and condition alone or in groups of four or less. But in some cases it’s been more recommendation than requirement, as high school coaches have been largely separated from their players and resigned to participating in team meetings and any workouts virtually.
The concern of doctors is shared by those working in high school athletics.
“We’ve been so restricted with what we can do with our athletes,” Cheshire athletic director Steve Trifone said. “I’m concerned that bringing them back and having them jump into a season, we really don’t know what kind of condition they’re in.”
There’s precedent for these worries. Crepeau pointed to the NFL, which started after an abbreviated training camp and no preseason games. In one of the earliest weeks of the season, seven players tore their ACLs.
“And those are professional athletes who do nothing else,” Crepeau said. “In one weekend, seven people tore their ACL. It’s incredible the amount of injuries that happened at the beginning of the season, and a lot of people are sort of blaming that on the ramp-up.
“Now you translate down to the high school level, and granted the level of competition and contact isn’t quite the same, but neither are the opportunities for training and conditioning for athletes.”
Crepeau saw a spike after the initial shutdown in the spring as athletes returned to action over the summer and early fall, and overuse injuries followed.
For baseball pitchers, shoulder and elbow injuries occurred. In sports such as girls soccer and basketball, more acute injuries like ACL tears were prevalent.
Dr. Cliff Rios, a sports medicine physician for Hartford Healthcare, saw it in everyday occurrences, too. Seemingly healthy adolescents and people in their early 20s were suffering severe injuries from casual, everyday events, like backyard football with friends.
“Goofing around in the yard used to never cause this injury,” he said. “When you really put them to the test, they really don’t have the balance and coordination they used to have.”
Rios didn’t see much of an uptick in injuries after the initial shutdown last year, but worries it could be coming this time around.
“If we were to get a green light where more things open up more rapidly, I think that spike [in injuries] is potentially coming,” he said.
As much as physical preparation counts, so does mental preparation, said Rios. For the athletes who haven’t played their sport in months, there will be an excitement to be back out on the court, ice or track.
“They may have this mindset ‘Oh, I’m just as good as I was in fall of 2019 — and then they perhaps go out, not being really trained,” said Rios. “And I think it’s going to be a challenge for the coaches, trainers and athletic training staff. I hope the players can be patient in that regard saying ‘Hey, I know you want to get out and do things, but first and foremost, we want to keep you safe.’ ”
There’s responsibility on coaches to take things slow, too. With the winter season shortened (basketball, hockey, gymnastics and swimming will play 12 games, followed by a conference tournament), Crepeau worries there could be more urgency than normal to get kids onto the court, practicing at a full pace to get ready for the abbreviated slate of games.
Crepeau believes winter teams should condition and practice for four weeks before games actually begin.
“My biggest concern is trying to push them back too quickly, or get them into scrimmage and game situations before they’re ready,” she said. “I think everyone is in a rush and we’re going to have this weird shortened season, so that’s one of the things that concerns me, that we’re just going to get on the ice, not do a whole lot of conditioning stuff and then put them in a game situation where they could get injured, because when they’re not in good condition, the injuries can happen when they get tired.”
CIAC executive director Glenn Lungarini said that there is a three-week window built into the winter season’s start so that teams can condition and get back to playing shape before competitions begin.
“For anybody starting after [Tuesday], we have it built in there that you need at least 15 days of conditioning before your first game, and 10 days before your first scrimmage,” he said. “We build that three weeks of conditioning time in regardless of when you start.”
Dr. Stephanie Arlis-Mayor, chief of athletic medicine for Yale Health, pointed out that athletes have been able to train individually
over these past few months. Also the chair of the Connecticut State Medical Society’s sports medicine committee, which advises the CIAC, she said the reason the lead-up time for the winter season is slightly shorter than the fall season is because athletes were not in contact and involved in school activities over the summer.
“They’re not necessarily provided the place or tools to properly train,” Arlis-Mayor said of athletes training individually now. “When we looked at resumption in the summer coming into the fall session, a lot of the delay of getting competitive games up was to allow up to six weeks for training, with real emphasis on starting low and going slow, and recognizing that there’s a lot of weakness physically.
“In the winter venue, we’re looking at doing the same thing. The lead-up time is a little shorter because we feel students have been involved with the school system and had some guidance up until now, so they’re not coming from no intervention.”
Crepeau understands athletes have been hamstrung by lack of facilities to train in, but thinks something as simple as running at a track or interval training could help condition the body before sports return. Arlis-Mayor suggested having athletes train together separately upon the start of the reason, so that regardless of a player’s preparedness, each can progress at their own rate. Rios is advising strength-and-conditioning coaches and athletic trainers to test athletes before the season starts. If a player struggles in a conditioning or balance test, it might be best to hold them out of sports until they are fit.
“Perhaps you can catch the people who are fairly having some difficulty with their balance and coordination, and send them for a more thorough analysis,” Rios said. “It could be the difference between one or two athletes having their ACL torn or labrum torn.”