Monday, June 30, 2008
Twisted ankles, turf burns, torn ACLs, muscle fatigue, and hundreds of other bumps, bruises, and breaks afflict soccer players every year. Most soccer players mercifully avoid major injury, but everyone has run into harm's way while on the pitch. Recently Robbie lost his boot while holding the ball in the corner. Someone stepped hard on his exposed big toe and seriously injured his toenail. He couldn't play for two weeks because the swollen toe prevented him from fitting his foot back into his cleats. During the recuperation, we got treated to daily reports about his toenail – how loose it was and how much it was oozing - and then a demand that we look at it. That's akin to saying ""I think this meat is rotten. Here taste it!"" For most players such nicks and bumps will be the extent of their injury history, for which we can all be grateful. Nevertheless, since injury goes hand in hand with intense physical activity, we parents need to familiarize ourselves with techniques to minimize injury and to treat injury when it occurs.
The most significant way to reduce injury is stretching both before and after activity. Think of joints and muscles like a fine sports car. Despite the tactics of James Bond, most drivers of elite autos know they need to warm the engine up before laying rubber. Likewise the body has its own need to rev up for a spin on the pitch. Joints need gentle activity to loosen up movement and slowly bring them up to a strenuous level rather than suddenly jarring them into a full run. Muscles benefit from the slow increase of temperature and blood flow that a warm-up provides. The warmer the muscles, the more effective they can be in processing the chemicals necessary to produce energy. The heart can't be ignored in this process. It benefits from the slow warming and can more effectively provide blood flow with its rich oxygen supply to the muscles and joints. Following activity joints and muscles need to cool down to resting status. Exercise produces certain toxins in the muscles that can build up and cause pain if not allowed to release. Incrementally ratcheting down the activity allows these toxins to be released slowly without building up again; otherwise they just sit in the muscles. In addition moving from strenuous activity to normal activity without a gradual slow down can have as jarring an effect on the body and heart as can a sudden increase in activity.
Having a physical every one to two years can help detect any problems which might lead to injury. Be honest with the doctor about any problems you have encountered during the intervening time between physicals. This includes joint pains, breathing problems, chest pains, dizziness, neck pain, headaches, and general energy levels. Keep your doctor informed about the level and intensity of activity you participate in for soccer and other sports. Sometimes even medications can interfere with activity and contribute to some weakness of muscles and joints, so your doctor needs to know a complete history to find the most compatible remedy for your lifestyle.
Listening to your body is extremely important in avoiding injury. Pain is the body's way of letting us know to stop doing something. If you touch a hot iron, the body actually retracts your hand instinctively. Chronic joint and muscles pains are the body's same instinctive reaction to inappropriate activity. Only the body can't jerk you away from a soccer match. So you need to recognize the signals and respect them. I'm not suggesting hypochondria as a guard against injury. Rather, I encourage players and parents to simply pay good attention to the signals a body is sending out. Swollen joints or muscles requiring ice after every training and game are probably in need of a doctor's diagnosis. If a player is popping ibuprofen or acetaminophen day after day, that's no good for his or her stomach and signals that the pain isn't transitory. Most problems simply require rest. It's difficult to agree to rest when the big game is coming up or a fun tournament looms just days away. But many injuries occur because players put more stress on their good joints in order to avoid the pain they have in their strained joints. And ignoring the pain can turn an injury requiring only rest into an injury requiring more invasive treatment.
Something as simple as keeping fully hydrated helps muscles and joints maintain both their elasticity and their ability to create energy. The body is technically an electrical machine that requires electro-chemical reactions to produce the runs, kicks and jumps of sports. Cramps are the body's way of saying "I'm out of gas." The muscles don't have enough electrolytes to produce the energy they need to function. When they are weak and poorly functioning they are far more susceptible to injury when as full power.
The best way to keep from getting injured is to be fit in the first place. Those players with the strongest muscles and well-conditioned joints end up with the best protection against the injury inducing stress of strenuous activity. Soccer has the reputation of having one of the lowest incidents of serious injury. While players certainly get their share of bumps, bruises, bloody noses and strains, they get fewer fractures and muscle and ligament damage than other contact sports. A great part of that protection comes from the fitness soccer players aspire to. Another part comes from good training that strengthens players' joints and muscles. Since soccer is a year-round sport, players enjoy the benefit of consistent training. While there is a debate about repetitious stress injuries, the overall effect of regular supervised activity ends up with positive results for players.
If your son or daughter should have the misfortune of an injury requiring medical treatment, be sure to follow the treatment plan completely. Returning to play too soon leaves an injured body part to fend for itself in a weakened condition. That means it can't fully heal, may be susceptible to re-injury, and may never get its full strength back. While it's difficult to sit and observe when you feel fit and fine, the regimen your doctor gives you is not only well-considered but has the authority of experience. Most players who remain plagued with injuries throughout their lives never gave their original injury the opportunity to heal totally. Once a player is strong enough to return to practice and playing, he or she may still need to continue some physical therapy to maintain and build on the strength already achieved.
Occasionally the admonition to play through the pain serves a good purpose: it encourages a player to judge for him- or herself whether or not he or she can continue. And we all know that soccer is a dramatic sport with lots of tumbles to the ground in agony only to have a player spring up Phoenix-like and score the winning goal. So sometimes it's not easy to judge when an injury is serious enough to stop play and seek medical attention. No one expects an injury to occur, so players aren't always capable of judging when enough is enough. Parents, coaches, and referees need to err to the side of caution especially with the youngest players to insure that no one moves from an easily treatable injury to one requiring surgery and long recuperation. The old adage of "an ounce of protection is worth a pound of cure" definitely applies when dealing with soccer injury.