Fall Sports Injuries...Why and How...

Fall Sports Injuries...Why & How

Phil Hueston, NASM-PES; IYCA-YFS

At the start of fall sports season, many athletes develop "unusual" injuries. These injuries really come as no surprise, considering the number of drastic changes that occur during this transition. Some of these changes are predictable, some less so. Here are some of the changes, along with some of the injuries that often come along with them:

1. Inactivity to activity (or change of activity type and intensity) - many athletes spend the summer "training" for their sport by attending "non-mandatory" practices and informal training sessions to improve their sport-specific skills. Summer leagues, clinics, combines and the like are becoming increasingly common, but often do little to help the athlete to prepare for their sport.

The problem? None of this is true physical conditioning. While skills need to be improved whenever possible and team unity and cohesion are worthy goals, the most important task of the off-season is to prepare the body for the rigors of a long season and the pressure-filled, high-intensity, full-speed sport environment about to be unleashed.

Core strength, systemic strength, speed, agility, quickness, balance, coordination, power, dynamic joint stability and other aspects of the "athletic skill set" must be honed and improved if the athlete expects to perform at a high level throughout the length of the season.

Most skills lessons or clinics are performed at relatively low intensity levels. This is the nature of the learning environment. "Captains Practices" (you know, the "non-mandatory" sessions your young athlete feels compelled to attend) are nearly always poorly organized and too often run by a 17 year old varsity player with little or no knowledge of the kind of science and application that is needed to prepare an athlete for fall sports.

So the athlete has been "training" at low intensity levels in an environment that is focused on production of movement instead of improving the quality of movement. Alternately, they have been working out in an environment that does almost nothing to improve the athletic skill-set. Endurance suffers, as does the ability of the body to resist injury.


Even worse, some athletes spend the summer doing what many of us would love to do - hitting the beach! No workouts, no prep at all. In light of our discussion here, not good.

Add to this the "all at once" nature of the onset of the spring sports season and you have a recipe for injury. Typical injuries of this type include low back pain, joint soreness and muscle strain.

2. Change of surface and/or change of footwear - Many athletes spend the summer in flip-flops, sneakers and only occasionally do they don their cleats or actual playing shoes until it's time to begin practice.  

Grass surfaces have varying degrees of hardness and change drastically with the weather. Turf surfaces vary one from another and also change with the weather. Athletes often are required to move from surface to surface even during the same practice session. When the weather is bad, they may even be moved inside onto wood, tile, sport floor or sometimes even cement floors. This frequent change of surface plays havoc with the ankle, knee and hip joints.

The reason for this is due to the varying degrees of joint stabilization required on various surfaces. Athletes who do not decelerate or who exhibit poor levels of dynamic joint stabilization will feel this more than those who do.

Improving dynamic joint stabilization is not something that "just happens" during summer practices, team sessions or as a result of growth. A coach once looked me in the eye and asserted exactly that - in that fall season, he witnessed 4 ACL tears and 12 other lost-game injuries.

Those injuries could have been prevented if that coach had simply listened to us when we were discussing ways to improve his teams fitness level and their injury resistance levels - all in the same workouts and in
less than 2 hours per week!

Dynamic joint stabilization is improved using a training program that incorporates a stable-to-unstable, slow-to-medium-to-fast and linear-to-multi-directional stimulus progression. In reality, the "systems," if they exist, governing most formal and informal "training sessions" your kids will attend are the chaotic-to-no-plan kind or the run-them-into-the-ground-then-do-drills-til-we-run-out-of-time variety.

Typical injuries associated with this reality include knee injuries, shin splints, ankle injuries and in some cases, hip and low back injuries.

3. Overuse and fatigue-related injuries - Fall sport athletes go from casual, infrequent "practice" sessions to a 6 or even 7 day a week schedule instantly. Hours per week related to sports practice will rise from as few as 2 to 6 hours a week (maybe even none) to as many as 20 hours a week with literally no phasing-in period whatsoever.

It's the equivalent of starting your car and racing out of the driveway at 100 miles per hour without a single second of warm-up time. Combine this with the problems created by poor off-season conditioning and that car is headed for a catastrophic breakdown.

Compounding this issue is the fact that even in the 21
st century, most sports coaches are "old-school," believing that more is better. More practice hours; more time running long distances or useless drills, more time spent pounding on each other and repeating the same activities ad nauseam; more time spent getting cold on the sideline while small numbers of players scrimmage.

Fall athletes also are dealing with the onset of "hip flexion overload." All summer, they've been free to move around at will. Working, going to the beach, going to team sessions and other sports related activities all allow the athlete the freedom to stand upright and move around using the body's biggest and most powerful driver - the glutes! Hip extension is freely expressed and enjoyed by the athlete, even if they're unaware of this particular liberty.

Suddenly, they're shoved into a school desk, with its cramped seat and minimal room to move. They spend 6-8 hours a day sitting with the hips flexed at 90° (
Hip Flexion). Since sitting is the repeated command received by the brain during this time and the hips are flexed at 90°, the brain simply recruits the most available and optimal muscles to maintain the sitting position. In this case, it's the hip flexors, hamstrings and spinal erectors. For the intended purpose, it's a very efficient combination.

The problem? It's nearly the exact
opposite of the muscles the athlete's brain needs to recruit for effective and injury-free sports movements!

Hip extension
is crucial to sports movement. Running, jumping, changing direction and deceleration are all hip extension-driven. When athletes have sufficient levels of hip extension ability, it also helps prevent a myriad of injuries and conditions. Knee, low back, hip and even, to an extent, ankle injuries can be reduced if hip extension is well-developed.

As if that's not enough, the weather conspires to make things worse. When practice starts, it's relatively warm; by the time it's over, temps have dropped 20 or even 30 degrees. Most of our kids dress for the beginning of practice and are shivering, tight and hurting by the end.

Overuse/fatigue injuries often include shoulder, elbow, back, neck, hip and knee pain or injuries. Many times, fatigue and overuse manifest as a general malaise with symptoms much like those of a mild, lingering flu: muscle aches, joint pain, occasional fever and sniffles or cough.

4. Plain old bad coaching - The onset of the digital generation has made it hard for abusive coaches who run or play their players into the ground to keep their jobs, but a few surely have snuck under the radar somehow.

Your kids may be suffering at the hands of an abusive or just bad coach if they have to attend long (3-4 hour or more in some cases) practices where they get little coaching attention and little or no opportunity to improve their skills, if the coach uses physical activity (running, push-ups or other exercise) as punishment for every infraction, real or imagined or if the coach allows hazing to go on without interruption by the coaching staff.

While not all these behaviors will lead directly to an injury, they are symptoms of an overall attitude of indifference, inattentiveness and selfishness that will lead to an environment in which injury is more likely to occur.

So I got hurt. Now what?

If you have already suffered an injury, your next move depends on the nature of the injury and how severe it is. Here are some basic guidelines:

  • Is the injury "chronic" or "acute?"
    • Acute injuries include things like a sprained ankle, strained back, or fractured hand and occur suddenly during activity. Signs of an acute injury include the following:
    • Sudden, severe pain
    • Swelling
    • Inability to place weight on a lower limb
    • Extreme tenderness in an upper limb
    • Inability to move a joint through its full range of motion
    • Extreme limb weakness
    • Visible dislocation or break of a bone.

Chronic injuries usually result from overusing one area of the body while playing a sport or exercising over a long period. The following are signs of a chronic injury:

  • Pain when performing an activity
  • A dull ache when at rest
  • Swelling.

Either way, there is no reason to "work through" an injury. Continuing to play on an injury will almost certainly led to a more severe injury.

Should I see the doctor or go to a hospital?

See a doctor or medical professional if:

  • Your injury causes severe pain, numbness or swelling.
  • You can't tolerate or support weight on the area or joint.
  • The pain or dull ache of an old injury is accompanied by increased swelling or joint abnormality or instability.

If you don't have any of the above symptoms, it's probably safe to treat the injury at home-at least at first. If pain or other symptoms worsen, it's best to check with your health care provider. Use the RICE method to relieve pain and inflammation and speed healing. Follow these four steps immediately after injury and continue for at least 48 hours:

  • Rest. Reduce regular exercise or activities of daily living as needed. If you cannot put weight on ankle or knee, crutches may help. If you use a cane or one crutch for an ankle injury, use it on the uninjured side to help you lean away and relieve weight on the injured ankle.
  • Ice. Apply an ice pack to the injured area for 20 minutes at a time, four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. To avoid cold injury and frostbite, do not apply the ice for more than 20 minutes. (Note: Do not use heat immediately after an injury. This tends to increase internal bleeding or swelling. Heat can be used later on to relieve muscle tension and promote relaxation.)
  • Compression. Compression of the injured area may help reduce swelling. Compression can be achieved with elastic wraps, special boots, air casts, and splints. Ask your health care provider for advice on which one to use.
  • Elevation. If possible, keep the injured ankle, knee, elbow, or wrist elevated on a pillow, above the level of the heart, to help decrease swelling.

This may get me in hot water with my friends in the physical therapy community, but I'm going to suggest some things I've been recommending to my athletes for many years in response to certain, specific injuries. Mind you, these are only intended for the injuries indicated and only in cases where a trained professional has indicated they are acceptable.

  • Ankle injuries - If the ankle sprain is mild (that is, it doesn't meet the symptoms requiring a doctor visit) don't sit around! I recommend my athletes try to walk on the ankle before removing the shoe, if they can put weight on it. If it supports weight, a few ginger steps are in order. If that is tolerable and there is a modicum of stability, walking with support or help for a minute or so seems to help with blood flow in the area. While this idea is usually frowned upon, we've seen good results with it when it's followed later with the R-I-C-E protocol.
  • Shoulder injuries - Athletes often "bang up" their shoulders. Left alone, these events often lead to stiffness, limitations in ROM and lingering pain. After insuring that no structural damage has occurred, it is advisable to get the joint moving - slowly! Assisted ROM activities will help prevent the inflammation that can often lead to temporary impingement of the shoulder after contact injuries.
  • Muscle contusions and deep bruises - These can hurt - badly. Any athlete who has ever had a deep bruise on the quad can tell you how much fun it is - NOT! One of the best things you can do for this is move the muscle in question before you ice it. Partner-resisted movements increase blood flow to the area in the immediate term and seems to help "clear out" dead tissue and other fluids that can make the bruise worse.

Remember, if you are not comfortable or there is no sports fitness professional available who is familiar with these techniques and ideas, do not attempt them. These are techniques that we have used with our athletes, with whom we are very familiar.

Prevention of injury is the key to a long, healthy athletic career. Avoiding the kinds of activities that undermine the development of the athletic skill-set will go a long way to lengthening a career.

Working with Sports Fitness and Performance Prep Professionals who understand the link between injury prevention and performance training will help make that same career both lengthy AND successful!

All-Star Sports Academy can help. Contact us here for your 5 Point Movement Assessment and Quick Start Trial today!