THE YOUNG ATHLETE IS NOT A SMALL PROFESSIONAL

By Dev K. Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Young athletes (and their parents) often try to emulate the rapid return to sport after injury that we see in adult professional athletes
  • Due to many factors associated with the unique needs of the young athlete it could be unwise or even dangerous to push the speed of recovery after injury
  • For sports medicine physicians, we will place the long-term health of the young athlete at the top of our priorities when determining a proper recovery process after injury

It’s totally understandable to want your injured son or daughter to be healed and back cwvDm9asA_Lw9YsGTQNy8vW7JoAplaying sports as soon as possible after injury. And since the progress of the professional athlete after injury is chronicled in great detail through social media there’s pressure on the young athlete to get back to play as rapidly as the pros. But the young athlete is not a small professional and in many instances the speed of return could be unrealistic or even harmful to the young athlete.

There are so many factors that make recovery from sports injury different for the young athlete compared to an adult professional. To list just a few: the young athlete may have an injury to a growth plate, thus creating possible problems with future growth with improper care; the psychology of the young athlete will typically be very different from a mature professional; and the adult professional often has access to 24/7 rehabilitative care specifically designed for rapid recovery.

For the young athlete: heavy emphasis on ensuring long-term health

Overall, sports medicine professionals will value the long-term health of the young player above all other factors. This means that sometimes it’s necessary to go a bit slower, to take a bit longer, and even to be a bit more cautious than we would be for an adult professional athlete. The end result is that the young player will occasionally feel ready to return to play before we recommend unrestricted play.

For the adult professional: emphasis on function

In contrast, for the adult professional athlete we will of course arrive at a proper diagnosis and provide detailed information to the athlete about the long-term risks and benefits of various treatment options but there is often a greater emphasis on function and acceptance of playing in some amount of pain. What this means is that as long as it’s reasonable and safe, we’ll work with the athlete and training staff at a pretty rapid clip to determine whether the player can do what’s required for their sport and position.

This also means that in some situations with professional athletes it’s necessary to push the envelope with accelerated treatments. Dr. Brian Cole, team physician for the Chicago Bulls and orthopedic surgeon at Midwest Orthopaedics at Rush put it this way in a recent interview in Wired:

“The decision to push the envelope can be really complex,” says Cole. The player might feel like he needs more time—but the organization, in a situation like the NBA playoffs, will want him back as soon as possible. Or maybe the player is anxious to get back before he is ready, feeling the weight of his or her team and even career. Amid all of this, a team’s physician has to be clear minded and focused on the best interest of the player. “It takes an enormous amount of humility,” says Cole. “You can never be a fan.”

For all players, of all ages, in any sport: physicians must put the player first

SideLineSportsDocThe interesting thing is that regardless of the situation, the sport, the player’s age, or whether they are male or female, the physician approaches sport injury the same way every time. By putting the player’s interests first. Dr. Bert Mandelbaum, the long time national team physician for US Soccer and Advisor to Sideline Sports Doc put it to me this way: “no matter the situation, whether it is a practice with very young players, a club team in a championship, or a professional in the World Cup there’s one thing we must do always: put the player first.”

This means that if you’re a parent or coach of a young player, putting their long-term interests first will give you the best possible chance of ensuring that athlete is good to go for the current season and for the long run.

(Dr. Dev K. Mishra is the creator of the SidelineSportsDoc.com injury management program for coaches. He is a Clinical Assistant Professor of orthopedic surgery at Stanford University. Mishra writes about injury management at SidelineSportsDoc.com Blog, where this article first appeared.)