Pre-Season Care Should Involve a Visit to the Physical Therapist
Updated: Aug 3
If your child plays a middle or high school state-sanctioned sport, chances are he or she needs to have a current physical on file to participate. It’s a good thing: the general physical conducted by an MD guards again severe illness (heart abnormalities, scoliosis, etc.) and ensures that your child can hear and see while participating. Included in these physicals is a general orthopedic component, usually involving moving the arms above the head, bending over to touch the toes, and squatting down. If your child, like any regular teenager, can do this, then check! he or she is cleared to play his sport.
My training is in orthopedics and the musculoskeletal system, but am I the only one wondering why this orthopedic assessment is so archaic and rudimentary when we are asking our children to run, jump, and throw hundreds of times throughout the course of their season? What is missing out of this orthopedic screen? My good senses tell me a lot. After all, a friend of mine had been officially diagnosed by a specialist with a completely torn ACL prior to her physical, yet she was still able to “pass” the orthopedic section of her sports physical. Yikes.
Let me hit you with some statistics (based on individual studies in select populations):
46% Football players will suffer an ACL injury
40% of Soccer players will experience hip pain
50% of Cross Country runners will complain of knee pain
23% Volleyball players will sustain an ankle injury
47% Tennis players will experience a shoulder injury
Certainly, not every injury can be prevented. There is a lot happening during a game, and impact is unpredictable. The point is: We can prevent the overuse injuries, and since we can, then we should. My job as a doctor of physical therapy is to look for asymmetries and less-than-optimal movement patterns. Simply stated, where there is asymmetry from left to right in joint mobility, muscle flexibility, and/or muscle strength, there is increased opportunity for injury to occur. Additionally, physical therapists know what good movement patterns look like and why poor movement patterns put the athlete at risk. As a long jump coach this past track season, I (alarmingly) noticed that one of my best jumpers was landing in such a way that put her ACLs at risk for injury. I explained to her why her form posed a danger and proceeded to give her three simple exercises to perform at home “for life” (or for as long as she did anything athletic).
I have long surmised that the athletes that make it to the collegiate level (and even more so the elite level) are the ones who have a decent amount of talent but mostly the ability to stave off injury for as long as possible. What if all it took to make sure your child did not experience knee pain this cross country season was some corrective hip exercises now? What if your volleyball player never experienced a torn rotator cuff because she did shoulder blade strengthening now?
Let up help! We are trained in special tests to screen for susceptibility to the injuries listed above as well as all other common sport-related injuries. We can educate you on your level of susceptibility as well as provide you with exercise and movement strategies for decreasing risk so that all of our local athletes can be their best this season.
Barzilai P, Brady E. Knee injuries worry NFL players more than concussions. 2014. https://www.usatoday.com.
Caine DJ, Maffulli N. Epidemiology of Pediatric Sports Injuries. Individual Sports. Med Sport Sci. Basel, Karger, 2005;48: 120–137.
Doyle K. Heavy soccer playing before age 12 tied to later hip deformities. 2015. https://www.reuters.com.
Gallo RA, Plakke M, Silvis ML. Common Leg Injuries of Long Distance Runners: Anatomical and Biomechanical Approach. Sports Health. 2012;4(6):485-495.
Jadhav KG, Deshmukh PN, Tuppekar RP, Sinku SK. A Survey of Injury Prevalence in Varsity Volleyball Players. J Exercise Science and Phys. 2010; 6(2): 102-105.