Parent's Field Guide to Spotting Trouble (and possible injury)

As a parent, my number one job at all times is to make sure my children are safe. Period. 

When they’re young, what we’re looking for as parents is a piece of cake: things like shouting “Look both ways!” as they get ready to cross the street. Or, “have you washed your hands?” before dinner. But, as our children turn into young adults with their physical abilities developing at lightning speed, it can become less obvious to know what to do, say, or ask when you sense *something’s* not right.

At the youth levels (under age 15, especially), coaches are almost always under supported, so waiting on the coach or a member of the medical staff (ha, the team doesn’t have that - you’re it!) to make the call or assessment is likely inefficient.

Get Certified!

Before I dive into my tips, please be sure to take the time to take and/or maintain a current CPR/First Aid course. This is a crucial step helping to identify and respond to emergencies. Having as many people around sporting competitions who are trained in these areas is extremely important and falls under the “it takes a village” category.

Let’s Get to It

Alright, to help with spotting signs of trouble early, below is a field guide of sorts based on the information I’ve gathered over the years. Injury and potential for injury is something that I’ve spent countless hours and many years cataloging as I watched thousands of practices and competitions.

Here’s the thing I want to get across: I’ve learned to greatly appreciate how important it is to put the health of the athlete’s body over all else. As a parent, I’m sure you agree and want you to know that you can and should help.

You may read some of my below recommendations and think: there’s no way my kid is going to get taken out of practice simply because of X, Y, or Z. But, if the consequence of NOT taking action is life altering pain or surgery, would it be worth it?

Here are five things to look out for:

1. Trust your gut. No one knows how your child moves, feels, and responds to questions better than you. If something feels off, you should investigate further.

2. Discuss the realities of injury with your child at a time outside of practice/competition. Explain that your main goal is to keep them safe/healthy and if you notice something you want to know more about that you may pull them aside to find out more. Setting expectations ahead of time can go a long way “in the moment” when they don’t want to answer your questions.

3. Watch locomotor patterns: this is a big one! If your child’s gait becomes visibly abnormal and doesn’t smooth back out after a few minutes, you will need to find out what’s going on. A stride with a visible limp or another compensatory pattern of some kind (leaning to one side, for example) must be addressed.

   1. Possible causes to consider: previous injury, strained muscle(s), stress fracture, growth, stress reaction

      1. If your child is coming back from muscle strain or another known injury, just a brief check in to find out how they’re doing and then reverting to the action plan, as needed

      2. If there is no known injury, ask questions and use your best judgement.

   2. If your child is able to normalize their gait within a few minutes, make a mental note and follow-up afterwards.

4. Repeatedly grabbing a body part after movement: you usually see athletes do this who are working through some kind of discomfort (ex, pitchers and their shoulders or elbows). Use this as a trigger to ask questions.

   1. It is worthwhile to find out where the discomfort is coming from: joint, muscle, or something internal? As this will give you insight on any subsequent actions that need to be taken.

   2. Young athletes will often give a response indicating they’re “working it out” or “a little tight”. From experience, I can tell you that something at least slightly more significant is underlying those answers. Root causes often harken back to a strength deficit and/or overuse.

5. Head impact: this could be a fall to the ground or an impact with another player or object. Head injury should be taken very seriously and always err on the side of caution. If your child was knocked unconscious, seems disoriented, or vomits as a result they need to be removed from practice/competition and evaluated by medical personnel.

A couple other tips to help your kids succeed: keep an eye on hydration (all sports) and temperature (outdoor sports) - climate change is real and exposure to extended periods of extreme heat should be considered and planned for; check out the warm-up - a thorough warm-up is important to reduce injury; have the proper equipment - you don’t have to buy the most expensive options, just be sure shoes, clothing, gloves, etc fit well.

This is a light list of what to watch out for, but in my experience these cover the majority of trouble areas for most sporting activities. If you are a parent reading this, I hope that you feel encouraged and supported to raise the red flag when things are off. Just remember to trust your gut and ask questions.

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Thank you! SAPT

Top 5 Reasons Injury is an Opportunity

No athlete ever wants to be injured. But hey, it happens! Once you get past the initial pain and frustration, you'll notice there are huge opportunities that any injury provides. If approached with a positive mindset - one that searches for “the silver lining” - the athlete can exit the recovery process healthier, stronger, fitter, and faster than ever.

Let’s take a look at the top 5 massive reasons injury is an opportunity:

1. Get Bullet-Proof! Well, not literally. But improving an athlete’s injury risk profile is a nice benefit to the time off from regular training. For example, let’s say the injury is a lower-back strain. But in this same athlete, there is also a history of weakness in the hips. That means that the injury is a great time to get Bullet-Proof by addressing the weakness alongside the injury. Hint: most injuries are, eventually, traced back to these weak links.
2. Physical capacities. This is a chance to reset and spend time working on some base level physical capacities like aerobic fitness, total body strength, and overall improvement in physical preparedness.
3. Movement efficiency. Most athletes could use fine-tuning, if not complete overhaul, on things like jumping mechanics, change of direction efficiency, bat swing, shot mechanics, etc. An injury is a great time to rebuild mechanically in areas of need. There is no pressure to perform these skills live, so the ability to practice technique over and over can be extremely productive and refreshing.
4. Psychological and emotional resiliency. I’ve found that when things are NOT going my way that seems to be the best time to see what my current ability is to handle stress. In this case, the injury again affords the athlete time to work on themselves psychologically. This can be with the direct help of a sports psychologist or mental coach or through the learned discipline that comes from showing up to rehab and reconditioning every day only to be challenged and frustrated during the grueling process that IS coming back from injury.
5. Tactical awareness. Take out your play book, fire up YouTube, keep ESPN on, watch practices, etc. Get better at the tactical driven aspects to your sport.

For the hurt athlete, injury should never be viewed as a time to relax and check out. Even if you are a recreational athlete at the middle or high school levels, any injury is serious business that can affect your health for many years to come (or even a lifetime).

Instead of taking a mental and physical vacation, I recommend viewing injury as a brief timeout from regular training and competition and use it to stay focused and double-down on your efforts to improve every aspect of your performance. Then watch as it translates into a fantastic “next season” and shows up positively in other areas of life, too.

Thank you to the book High-Performance Training for Sports for the inspiration and guidance on writing this post.

Sports Are Healthy Right? by Tadashi Updegrove

Continuing from my last post about the do’s and don’ts of an intern, SAPT received someone who exemplified pretty much exactly what I felt a good intern should be.  For the past semester Tadashi has made an impact on SAPT through his knowledge, coaching, and ability to learn and apply.  In his brief time here he became a colleague and a good friend. Unfortunately, his time at SAPT has come to an end and he has decided to take his talents to South Beach and by South Beach I mean College Park, Maryland to pursue an internship with the S & C department.  With that said, here is Tadashi’s final task for completing his time at SAPT.... As a Kinesiology major, I was required to enroll in a “Senior Seminar” class this past semester, where we basically got in a big group and discussed health.  Most discussions were centered around the importance of health, how we can inspire others to be healthy, and the future of health in the United States and the world.  As many of my fellow classmates declared their own personal mission statements to become soldiers in the war against obesity, or how to combat the big tobacco companies, I sat quietly in the corner, hoping I didn’t get called on.  Then I got called on:

“Tadashi, why are you so interested in health?”

After stumbling over my words I finally managed to utter something like “err… I, um... I’m not.”  I went on to explain that health was not my primary interest.  What I was interested in was sports and sports performance.  I wanted to understand how the human body adapts so I could understand how to manipulate the applied stimuli to make someone stronger, jump higher, hit harder, and pick up heavier things.

Then I was approached with a follow up question:

“Well, sports are healthy right?”

I don’t know how I feel about that one.  Sure being physically active and exercising is healthy, but after looking through countless research articles it’s hard to ignore the high percentages of participant injury in sports.  Competitive lifting, both powerlifting and weightlifting, ranks at the low end of participant injury with something between 40%-50% (Yup, ½ of participants getting injured apparently is low compared to other sports).  The NFL is under scrutiny right now because of the concussion rates and the violent nature of the game.  I know the NFL is easy to hate on when discussing health and safety because… well it’s football, and the game involves Hulk-Smashing people against their will.

But football players aren’t the only ones getting hurt.  Even the concussion rates in girls’ lacrosse are high enough to raise concerns about helmet requirements.  Take a look at ACL injuries and you’ll find that the overwhelming majority of ACL tears occur because of non-contact situations.  ACLs tend to rupture during a sprint, a jump landing, decelerating, or change-of-direction task.  Athletes in sports that demand a high volume of these tasks are placed at a higher risk of injury.  Think soccer, volleyball, basketball, etc.

During my experience working with the SAPT coaches and athletes, I began to realize more and more that training for performance is training for health. Learning to squat with the knees out and the hips back makes you more of a beast because you get more recruitment of the glutes and your legs are placed in a structurally ideal position to produce force into the ground.  This also happens to be the healthiest position for your knee joint by reducing the load to the medial compartment.  Bracing the midsection during a lift will increase performance because of an improved transfer of force between the upper and lower body.  This ability to create a rigid torso also happens to be the best way to keep your spine from folding in half under load.  Similar performance and health benefits can be said about keeping the scapulae retracted during rows or tucking the elbows during a pushup.

I played lacrosse and ran track in high school, and now compete in Brazilian Jiu Jitsu/submission grappling, and like many athletes in other sports, have come to understand that injuries are just part of the game.  Most athletes can expect to get banged up here and there.  Sometimes, unfortunately, they’ll get hit with a more serious injury that takes them out for a length of time that really puts their patience (and sanity) to the test.  For me it was a back injury that occurred during a grappling session which required surgery last September.  Looking back it’s easy to say I should have done more soft tissue work, anterior core exercises, mobility drills, and gotten more rest but… hindsight’s always 20/20.  What is it going to take for me to get healthy?  Strengthening the right muscles, mobilizing the right joints, and training the neuromuscular system appropriately.  Sounds eerily like training for performance...

I realize now that I am interested in health (specifically musculoskeletal health), because it goes hand in hand in optimizing athletic performance, but I still have to disagree with a blanket statement like “sports are healthy.”

Even a sport like distance running boasts a participant injury rate upwards of 70%!  The next time you watch a baseball or softball game watch the pitcher’s shoulder as he/she pitches.  Try and convince me that they throw this way to improve their health.

However, despite the risk of injury there are many reasons why I believe sports are awesome, and most of these reasons are not necessarily health related.  Growing up my Dad always told me that I would learn more from playing sports than I would learn in the classroom, and I’m pretty sure he was right (but I went to class too…).  I learned what it meant to work hard towards a goal, work with others, and make sacrifices for the benefit of the team.  Not to mention it’s FUN, and I’ve had some of my most memorable moments on a lacrosse field or a grappling mat.

Mid-Point Goals

I want to give a few personal updates on my training these days. I am just over the half-way point with this pregnancy (21 weeks) and last week we found out we're having a boy (yay!). Since I've already been through this process once before I know that the next 20 or so weeks can become quite physically trying. So, I've reassessed my progress to this point and have created some new goals.

First 20-weeks goals:

1. Build a solid aerobic base ahead of time - ACCOMPLISHED. With Arabella I had NO IDEA how important aerobic exercise would be for my day-to-day tasks. I ended up having to play "catch-up." You'd think this would happen late in the pregnancy when you've gained a bunch of weight... surprise! It doesn't! It happens very quickly as the result of increased blood volume. The aerobic training helps your body adapt more quickly. For Baby #2 I began a conditioning program (geared towards 800m runners) about 1 month before we started trying to "get pregnant" - it has worked wonders. Weight gain has been slower and I've felt much better.
2. Address my body's areas of breakdown ahead of time - ACCOMPLISHED. I've learned that, while pregnant, I need to take special care of my lower back via simple strength movements like the bird-dog, address calf weakness and overall foot health, and can train with more vigor than I did with Arabella (again, I realized this about half-way through with her). The result is that while my back flares up from time-to-time, it is under control and overall I feel much more like myself in terms of strength and health. Regarding foot health, I won't know if I've been successful until after the baby is born.

Second 20-week Goals:

1. Continue to prioritize low- to moderate-level conditioning but without laying the foundation for wicked plantar fasciitis. I'm shifting towards Prowler sled pushes 2x/week, stepper or bike or smililar low impact activity 2x/week, and 1 or 2x/week of actual running. Believe it or not, with Arabella I ran 3-4x/week (with low impact on off days) up until I was 38 weeks pregnant. For my Prowler pushes I will do a "trip" for every week pregnant I am - today I did 21. Took about 30 min.
2. Keep up with lower leg pre-hab to keep my feet and calves strong enough to safely continue to propel my heavy(er) body when I'm running.
3. Maintain pullups and chinups in my training regime. Sadly, these will not be body weight. BUT, on the upside, they can be called "Banded + 25lbs Pullups" by the due date - I'm sure somewhere in there things even out. With Arabella the stretch placed on my torso from the hang position was too uncomfortable/borderline painful to keep in (even banded). So, I'm hoping to keep them in throughout, if possible. Same approach as the Prowler: 1 rep for every week pregnant.
4. Lastly - and, okay, I recognize this borders on the ridiculous - but, if everything goes smoothly and all the variables line up in the best possible way. Then my goal is to beat my time in "active" labor. Arabella took 55 minutes. I'm after a PR with this little guy.

One final note is that I'm not entirely a crazy person, I do certainly understand the limits of my body and the safety of the baby comes first. So, as with #1, I know when to dial things down if my body isn't feeling quite right. And, the above is by NO MEANS my recommendation to pregnant women looking to stay active throughout their pregnancies. Rather, this is the by-product of a body (mine) which has been trained consistently at a very high level for about a decade.

I categorized this post under "Awesome" and "Chest Thumping" because, well, staying active throughout a pregnancy is really, really tough. So, anyone who manages that feat should feel it is both awesome and a serious point of pride!

Strength Training In-Season & Cirque Video

For most of our readers this is a "preaching to the choir" study I found: "Effects of complex training on explosive strength in adolescent male basketball players." But, I thought it was worth posting for those few of our readers who may not be fully sold on in-season training:

The purpose of this study was to evaluate the effects of a complex training program, a combined practice of weighttraining and plyometrics, on explosive strength development of young basketball players. Twenty-five young male athletes, aged 14-15 years old, were assessed using squat jump (SJ), countermovement jump (CMJ), Abalakov test (ABA), depth jump (DJ), mechanical power (MP), and medicine ball throw (MBT), before and after a 10-week in-season training program. Both the control group (CG; n = 10) and the experimental group (EG; n = 15) kept up their regular sports practice; additionally, the EG performed 2 sessions per week of a complex training program. The EG significantly improved in the SJ, CMJ, ABA, and MBT values (p < 0.05). The CG significantly decreased the values (p < 0.05) of CMJ, ABA, and MP, while significantly increasing the MBT values (p < 0.05). Our results support the use of complex training to improve the upper and lower body explosivity levels in young basketball players. In conclusion, this study showed that more strength conditioning is needed during the sport practice season. Furthermore, we also conclude that complex training is a useful working tool for coaches, innovative in this strength-training domain, equally contributing to a better time-efficient training.

As a college strength and conditioning coach and the owner of SAPT, I've seen countless times how important strength training is for athletes to remain strong, fast, and free of injury during the practice and in-season time frame. I always get a chuckle out of athletes (or their parents) who only "need" 4-6 weeks of preparation before their respective tryouts begin.

Check out this nonsense someone sent to me (and by nonsense, I mean this is absolutely so amazing that it is ridiculous):

Lastly, Ryan and I are expecting a new bambino or bambina at the end of May! Have you ever heard the term "Irish twins?" I hadn't... apparently, it refers to siblings born in close succession. It originated in the 1800's and was a derogatory term used to describe the reproductive tendencies of Irish immigrants. Someone suggested yesterday I will have Irish twins with baby #2. Technically, I think they would need to be born closer to 12 months apart... our kids will be 23 months apart, thank you very much.