Every 25 seconds, a kid gets injured in sports. About 2 million high
school kids will suffer an injury this year along with 75% of all
college athletes.
As an interventional spine specialist treating athletes, I've seen the
heartbreak and pain these injuries inflict on my patients and their
parents. For some young people, the resulting disappointment discourages
them from other worthwhile pursuits.
Sports accelerate the aging process, especially football, which can
shred tendons and ligaments, bang up joints and break bones.
Yet, NFL quarterback Tom Brady seems to avoid all these injuries and seems to age at a slower rate while continuing to win.
What's his secret for success and how we can translate his methods into a injury prevention program for our children?
First, we have to shift our focus from managing sports injuries to preventing them.
Certain risks of acute injury are unavoidable, but many are preventable.
When we are younger we feel invincible, although our musculoskeletal and nervous systems have not fully matured.
Vulnerability also can arise from the complicated dynamics among young
athletes, parents and coaches. According to a 2013 survey by the
nonprofit advocacy group Safe Kids Worldwide, researchers talked to
thousands of kids, coaches and parents. They found that 42% of young
athletes had downplayed an injury so they could keep playing, while 53%
of coaches said they have felt pressure from parents to put an athlete
back in the game even after they had been injured.
About 54% of kids said they had played injured and of those, 70% said
they did so even after they told their coaches or parents they were
hurt.
This is a real problem.
I've taken care of kids and high-end professional athletes after the
fact for an injury that should have healed in three to four weeks. Most
of the time, the athlete tried to force activity before they were truly
recovered.
This sets off a chain reaction where the body compensates to offset the
painful area. This creates unbalanced, tight muscles, and throws off
proper form along with the gait and posture.
In addition, because these functional changes don't show up on an
anatomical x-ray or MRI, the real diagnosis is missed and subsequently
the medical treatment fails.
I treated a professional baseball pitcher who had a chronic pain issue
with his hip. His prior treatments focused on a diagnosis based on what
was seen on his x-rays. Once we mapped out the true source of his pain
and treated it, the force and accuracy of his pitches dramatically
improved. This reversed the years of compensation and imbalance that was
throwing off his form. He went on a winning streak and achieved
incredible success.
Are we pushing our kids too hard?
Overall, in my clinical experience, the crazed youth sports culture is
good. It teaches team building, self-confidence and physical fitness
habits that hopefully will be followed into adulthood. It combats
obesity and can lead to a healthy self-esteem.
What we have to be vigilant about are two types of sports injuries:
acute ones, such as sprains or ligament tears after a missed step or a
traumatic collision; and overuse injuries, which are caused by
repetitive motion that damages the body over time.
These types of injuries used to be rare in our practice among teens and
children, and were seen mostly in college athletes and high-end
professional athletes. But we have been seeing an alarming increase in
these repetitive use injuries in younger athletes.
Why is this happening?
Overuse and overtraining account for 70% of these injuries. Young
people's training can be intense. They have so many sports events weekly
that there's really no time to recover and grow.
Overtraining keeps you revved up in "survival mode" and releases
cortisol, which is the "stress hormone" and causes a breakdown of the
body's defenses and tissues.
My associate, orthopedic specialist Dr. Jack Jensen, cites the example
of a very young elite gymnast, Dominque Moceanu, who he treated. Because
of the intense year-long Olympic training, she suffered an overuse
stress fracture a few weeks before the 1996 Olympic competition in
Atlanta. She went on to win the Olympic gold medal for the U.S. Women's
Gymnastics Team, but was almost derailed as a consequence of
over-training.
Secrets of NFL quarterback Tom Brady
In football years, Brady is considered to be of advanced age at 39.
Right. Advanced age of 39.
That definitely does not fit my definition of "advanced age," especially as I get older myself.
To understand Tom Brady's unconventional diet and training program, you first have to understand what makes Brady tick.
Brady is ultra-competitive and has an insane drive to be the best.
He has broken down the functional essentials of the athletic
requirements of a quarterback and focused all his energies in an
obsessive way to maximize that potential.
For example, he looks more like a GQ model then the bulkier
quarterbacks we've seen in the past, such as Warren Moon and Joe Namath.
This is on purpose. Brady's diet and training are designed to make him
lighter and quicker, thereby putting less stress on his joints. He tries
to reverse the effects of aging through healthy nutrition and
hydration.
He doesn't plan to have as much muscle mass as a linebacker, for
example, because he has a strong offensive line and he is quick to get
rid of the ball, thereby minimizing the number of times he is tackled.
Where he breaks conventional thinking is in a unique, distinctive Brady
term he calls developing muscle "pliability." For example, when a
muscle is sore, many believe that is because of muscle weakness. As a
result, the focus becomes on building dense muscle, which actually
sometimes contracts the muscle, making it shorter and more prone to
injury.
Brady works on building muscle "pliability," and flexibility to reduce injury and maximize functional ability.
Brady keeps his muscles elongated, flexible and soft.
Traditionalists will question the keeping muscles "soft" part as there
is nothing wrong with building strong muscle. Brady gets some heat for
that, but I believe what he is referring to is that by keeping the
muscles long and relaxed, they will be less prone to injury. Remember
the familiar term "you have to roll with the punches."
Maybe that's the reason drunken drivers don't generally get as severely
injured as the people they crash into. Because of the alcohol, their
muscles are unusually relaxed and bend to the force of the crash,
whereas the people they hit reflexively tense up.
When I take my 8-year-old nephew to karate practice, I've felt my heart
skip a beat when I've seen him take a hard hit. Parents will understand
that feeling of helplessness at watching their child suffer.
Now, we can do something about it.
In my opinion and in our practice, the most important part of your
injury prevention program involves not overtraining, having adequate
recovery, keeping muscles flexible, focusing on having your muscle and
joints go through the full range of motion, maintaining the ideal
length-tension relationship in the muscles, and making sure the flexor
and extensors muscles are balanced and in a relaxed state.
Tight muscles lead to injury. Hydration, rest and balanced nutrition round out a proactive injury prevention program.
Dr. Pawan Grover, M.D. (inovospine.net),
is an interventional specialist who prides himself on being an advocate
for patients. He believes in pulling back the medical curtain to
explain how Big Medicine works, so patients can take the power of health
care back into their own hands. Dr. Grover has more than 20 years of
experience as a medical doctor, and has served as a medical
correspondent for CNN, NBC, CBS and PBS. Dr. Grover is a graduate of the
UMDNJ-Robert Wood Johnson Medical School (Rutgers Medical School). He
completed his residency at the Texas Medical Center, and did a special
fellowship in Sydney, Australia, with professor Michael Cousins, who is
considered the father of regional blockade and pain management for
cancer and non-cancer pain. Dr. Grover has worked extensively with top
neurosurgeons from MD Anderson Hospital in the Texas Medical center for
cancer pain management.
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