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Kids and Sport: When to see a Physiotherapist

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Often parents are unsure when to seek the opinion of a Physiotherapist in dealing with their active kids. Now more than ever, kids and adolescents are getting involved in organised sports, with a multitude of social and health benefits to be gained from their participation. It is not unusual to see kids that are actively competing in several different sports every week, often with once- or twice-daily training sessions and multiple weekend games or competitions. Combine this activity with the demands of growing on a young body and you find the balance is a delicate one: get it right, and the child thrives; push too hard, and it doesn’t take long before niggles and burnout can arise.

Research tells us that sport is the main cause of injury in adolescents (Brukner, 2008). The number of under-15’s seeking medical attention for sporting injuries increased by 60% between 2004 and 2010. This can be attributed to an increase in kids’ participation in organised sports, improved diligence by parents in seeking medical care for their children’s sporting injuries, and higher levels of competitiveness (or skill) in children of younger ages.

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INJURY MANAGEMENT:

We often get asked when is an appropriate time to see a Physiotherapist with respect to a child’s injury or pain. Growing children who are active will often get transient aches and pains that are normal – when these last only a few days and are mild in nature, ie do not stop the child from participating in any activities, then these can be managed without significant interventions. Often rest or a few days off sport will help in these cases. If, however, a child has any of the following, you should seek out a Physiotherapist for diagnosis and treatment:

  • Pain that lasts longer than a few days;
  • Pain that is increasing or sharp in nature;
  • Pain that gets worse with activity – ie it does not “warm up”;
  • Pain that is stopping them from participating;
  • If they are limping/modifying their activity;
  • Pain that is affecting their sleep;
  • Pain that is mild but recurrent in nature;
  • Redness or swelling around the painful area.

A Physiotherapist will be able to diagnose the injury, develop a treatment plan, and work on prevention strategies so that the injury is less likely to reoccur. If scans are required to assist diagnosis, these can be ordered through the Physiotherapist. The earlier treatment is sought, the easier the injury will be to treat and as a general rule, the less treatment sessions that will be required. Don’t feel like your child needs to be in severe pain or unable to participate before you book an appointment – a good Physio will be able to find their diagnosis no matter how “mild” you may think their symptoms are. Keeping a child active and involved in their sports is always a priority and this is much more likely to happen if the injury is seen to at an earlier stage of its progression.

The wonderful thing about children and adolescents is that their bodies have a marvellous capacity to repair and respond to increased training loads (otherwise known as: “kids bounce”). Generally, we can use the same principle in treating injuries that arise: in the majority of cases, kids can continue participating in their chosen sport(s), albeit with a few modifications to unload the injured area and allow it to heal. They are a beautiful example of what we also see in adult athletes: that when we are able to keep the body active through injury, in a safe and supervised way, the body heals faster and is able to bounce back stronger than it was before the injury. Our bodies like to move, and they respond favourably to the increased circulation, muscle mass, and the hormonal response that comes with exercise.

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INJURY PREVENTION:

Physios also play an important role in injury screening and prevention. This has been the case for a long time in sports such as ballet and swimming, where the unique demands of the sport (eg extra flexibility through the shoulders in swimmers, or characteristics of the feet in dancers) mean that the injury risk is higher if the child is not well-prepared and well-suited to the sport (Gamboa, 2008). Typically with these sports we do a Musculoskeletal Screening on young athletes at the start of every year, to flag any strength, growth or flexibility issues and to develop an exercise program to reduce the risk of injury. This process usually requires a one-off musculoskeletal assessment, followed by 1-2 sessions to supervise the implemented intervention and reassess any high-risk measures.   Such programs have been shown to be effective in reducing injury risk (Eils, 2010), and as an added bonus these kids tend to see an improvement in technique and efficiency due to their improved preparedness. Of course, not all injuries can be avoided; traumatic injuries such as those typically seen in contact sports are difficult to prevent, while overuse or growth-related injuries tend to be decreased with the use of screening programs (Emery, 2003). Good candidates for musculoskeletal screening include:

  • Dancers, especially those about to go en pointe;
  • Children and adolescents swimming more than 3 x week;
  • Children who are going through an aggressive growth spurt, or who are likely to be particularly tall;
  • Children with a family history of growth- or overuse-injuries eg older siblings or parents had ongoing knee and ankle pain during growth spurts;
  • Children and Adolescents involved in more than 6 hours of organised sport/training per week;
  • Children and adolescents with a history of recurrent injuries or niggles.

 

 

WHEN NOT TO SEE A PHYSIO:

The following conditions require urgent medical attention and should be assessed by a doctor (usually at a hospital or via ambulance) immediately:

  • Concussion or head trauma;
  • Suspected acute fractures – eg the child has sustained a trauma and is unable to bear weight or move the affected limb;
  • Pains that also involve rashes, fevers, headaches and other systemic symptoms;
  • Traumatic joint injuries eg shoulder and knee dislocations (these will require Physio, however need to be assessed in the acute phase to clear fractures and to get an assessment from an orthopaedic specialist);
  • Pain that is causing vomiting or nausea.

The key point to remember is that early treatment results in less time away from sport, and generally less treatment. Physiotherapists work very closely with other allied health professionals as well as doctors and specialists, ensuring that any patient that requires referral on will be obtaining the best possible care and follow-up.

For more information and advice, contact your local Physiotherapist.

 

Happy Training!

 

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REFERENCES

  • Brukner, P., Kahn, K. Clinical Sports Medicine. Revised Second Edition. (2008). McGraw-Hill Australia Pty Ltd.
  • Eils, E., Schroder, R., Schroder, M., Gerss, J., Rosenbaum, D. Multistation proprioceptive exercise program prevents ankle injuries in basketball. Med Sci Sports Exerc 2010; 42:2098-2105
  • Emery, C.A. Risk Factors for injury in child and adolescent sport: A systematic review of the literature. Clin J Sports Med 2003; 13:256-268
  • FIFA 11+ Webpage: http://f-marc.com/11plus/home/
  • Gamboa, J., Roberts, L., Maring, J., Fergus, A. Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics. J of Ortho & Sports Phys Therapy 2008; 38(3) 126-136

6 Things You Didn’t Know About Exercise Physiologists

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1. The qualification matters.

Exercise Physiologists (EPs) are not just glorified personal trainers.  At the moment in Australia, it takes a minimum of 4 years of University training to earn a degree in Clinical Exercise Physiology, which includes over 400 hours of practical clinical experience.  This then permits the individual to apply for accreditation as an Exercise Physiologist with ESSA, the Australian body for Exercise Science.  This allows the EP to have the relevant insurance, professional contacts and medical referrals such as Medicare.  To maintain their accreditation, they much invest a significant amount of time and money annually into professional development courses around the country. 

 

 

 

 

2. There are Different Specialty Areas within Exercise Physiology.

 

Just like within Physiotherapy and medicine, an EP by law must graduate with qualifications and competency in all areas of Exercise Physiology, but will generally choose one or two specialty areas to base their career on.

 

These specialties include:

 

 

– Cardiac Testing (eg ECG stress testing in hospitals);

– Cardiac Rehabilitation (eg in-hospital following a heart attack);

– Clinical Pilates;

– Coaching (from kids through to elite level);

– Neurological Rehabilitation (eg following a stroke or Parkinson’s Disease diagnosis)

– Mental Health;

– Musculoskeletal Rehabilitation (eg strengthening after acute sports injuries, or for injury prevention);

– Chronic Pain Management (eg Low Back Pain);

– Research (typically university-based); and

– Public Health (eg weight management and disease prevention, education).

 

 

3. They are the future of our Health System.

In the last 5 years doctors globally have started to recognise the key role of exercise and weight management in prevention of increasingly common chronic diseases such as diabetes, high blood pressure, depression & anxiety, osteoporosis, cancers and so on.   With a health system that is currently in crisis (in terms of both costs and resources), EPs will be at the forefront of health care in the coming decades.  Take home message: don’t be surprised next time you see your GP and they prescribe 60 minutes of physical activity a day and 5 visits to an Exercise Physiologist instead of medication and a handful of tests!

 

4. A good training program may seem easy at first.

The Commando off The Biggest Loser will scream at you until you finish 50 chin-ups in your first session.  A “Bootcamp” instructor may demand you flip ridiculously huge tyres, regardless of your injury history.  An EP will not.  Every person has a unique set of challenges to work with, and it is imperative that both the EP and the client have clear and common goals established from the first session so that an individual program can be developed that will work for the long term.  The research tells us over and over that the quick-fix programs not only do not work, but tend to make the problem (whether it be weight, injuries or pain) worse in the long term.  Be patient, trust in the fact that you are in the best and most qualified hands, and acknowledge the relationship with your EP as the worthwhile investment into your health that it is.  Think of it like this: you can put in the time and money to be healthy now, or you can put in the time and money being sick later.  Both are hard.  You choose.

 

5. The best trainer in the world cannot make up for a shitty diet.

In this day and age I would find it hard to believe that anyone genuinely does not know that being sedentary, eating processed foods, and smoking are bad for your health.  But we still have the issue of increasing obesity and chronic disease.  Hence, we know that simply educating people is not the whole picture, and that is where an EP comes into the equation by helping you to create the best possible health and lifestyle plan for you and your family.

 

But here’s the catch: simply “buying into your health” by seeing an EP for exercise sessions and an eating plan won’t make you healthier – you have to actually put in the hard yards and stick to it.  If you are not meeting your weight loss goals and are working out every single day with your trainer while eating cereal, sandwiches, candy, soda, and other crap – don’t blame the trainer. Your weight, the way your body looks and your health are predominantly a function of what you put in your mouth. Exercise can positively alter what your body does with the food that you eat, in addition to the phenomenal emotional, physical, and mental benefits it offers.

 

The human body is an amazing machine and the knowledge that you can gain from working with an EP is an incredibly powerful tool; embrace it, and discover how good life can be when you achieve optimal health.

 

6. I am yet to meet a person who cannot benefit from a few sessions with an Exercise Physiologist.

Where most other health professionals are limited to fairly specific areas, an EP is truly is the “jack of all trades”.  They work with clients of every age, from healthy to sick, from elite athlete to chronically ill, from families to individuals.  They can: make you fitter; stronger; more injury proof; reduce your pain; improve your posture; improve your flexibility; make your spine stronger; rehabilitate your body (from toe injuries to hip replacements to heart attacks!); assist with weight loss – or weight gain; muscle sculpting; power; help to reverse chronic diseases (from depression to diabetes); even keep you fit during pregnancy and immediately after.  If you have ever wanted to improve any aspect of your body, health or happiness, then you could benefit from seeing an EP.

 

Exercise Physiology sessions can be expensive for many people, so to get the most out of your sessions, do some prep work beforehand.  Spend some time thinking about your goals, your main limitations, your strengths and weaknesses.  Write them down, along with any questions you may have.  Turn up on time, and listen to every word, and don’t be afraid to write notes!

What are you waiting for?!

 

– Kristy Shannon

B.Appl.Sc(HMS); M.PHTY

Kristy has a degree in Exercise Physiology from the University of Queensland and a Master’s Degree in Physiotherapy from Griffith University.  

 

An accredited EP can assist with safe rehabilitation from injury through to full fitness

An accredited EP can assist with safe rehabilitation from injury through to full fitness