We are in an unprecedented and unique time in the world’s history, and certainly sports injuries are not top of mind. Yet, there is a worthwhile discussion to be had; a new perspective to be gained as we are all sidelined in a time of crisis. As a pediatric sports medicine physician, the majority of decisions I make on a daily basis involve optimizing return back to sports. Needless to say, that part of the job is non-existent these days. Normally, no visit is complete without the inevitable, “Doc, how long will it be until I am able to play?”. As a result of injury, there are countless visits filled with tears over missed seasons, playing time or even practice for that matter. Well...how will things turn out for the youth sports machine after an essentially complete shutdown?
It may not be soon, but youth sports will return and my sense is that both physicians and athletes will be enlightened. We will realize that even when workouts are postponed, championships are cancelled, or an entire season is lost, the athlete will endure. We will understand that athletes can still be elite and scholarships can still be earned in the absence of relentless pursuit of perfection. We will understand that the pressure to return from injury is manufactured and based on mythical stories of athletes past. Do we really need the unrelenting hours of practice and barrage of multi-game tournaments?
Ultimately, we will see that even when the worst occurs for an athlete, they will endure.
It is my belief that rest and recovery actually make the athlete better than they would have been had they “pushed through the pain” or “gutted it out” to return early, only to be at less than 100%. Somehow we have moved to an era where the notion of missing a week or a month of training is permanently detrimental to the success of an athlete. The present crisis and stay-at-home orders have forced our young athletes to rest, and the result will be illuminative. If sports return this spring, track athletes will still put up blazing times and rested pitchers will be throwing with remarkable velocity and accuracy. Competitive cheer routines will still be remarkably precise. Athletes will soon realize that this unsolicited rest hasn’t eroded their skill; it has allowed it to flourish while being rested and rejuvenated. In the end, athletes will realize this is a watershed moment in injury management and return to sports.
One of the most prominent and devastating injuries in sports is tearing an ACL. The road to recovery is long, in fact, data shows the physical and psychological recovery is more arduous than anticipated. In an era where the race to return from ACL has passed, the door is now open for all physicians to definitively move away from the classic 6 months return. In light of recent events, athletes, therapists and providers will see that an additional 3 months restriction doesn’t mean a lost career. It will force them to be more in line with the evidence and more consistent with a 9 or 12 month return that is based on function. The ACL is just one example among many injuries, where involuntary sports restriction will show us improved outcomes without significant loss of skill or future success.
Of course, in youth sports we all want the best for our athletes, whether provider, family or coach. However, at one point in time we have all been blinded by the hype of returning an athlete back to sports.
We all need to stop for just a second and realize the moment we have before us. A moment where we can convincingly show everyone with interest in youth sports that a simple respite is more valuable than we might imagine.
We have an opportunity to literally change the game. An awakening that young athletes can rest without irreparable harm to their athletic career. The only question that remains is will we take advantage of this chance to protect our athletes or will we quickly forget once all returns back to normal?
Randon Hall, MD
Comments