Preventing back injuries in children who participate in flexibility-related sports
Monday, May 04, 2020
Instagram is full of kids and teens showing off their super flexibility — and my daughters seem to follow them all. One thing I’ve pointed out to them is we don’t see posts when they’re injured nor are we privy to how they’re faring 15 or 20 years from now.
The lesson was driven home when my 15-year-old daughter recently elected to drop out of the flexibility number she’d been selected to perform for her youth circus due to lower back pain. She admitted she felt she’d permanently damage her body were she to continue to rehearse in the specialty. When I learned that her teacher’s solution to the problem was abdominal crunches, I decided to do some research.
Fortunately, by taking the precautions that follow, conscientious parents and coaches can help reduce needless injury for young athletes and performers who strive to accomplish phenomenal feats of flexibility.
Mitigate risk with intelligent training
Young performers and those doing sports involving repetitive flexion, extension, and torsion, such as diving, gymnastics and figure skating are particularly susceptible to lower back injury.
“Teachers often trust children's elasticity, as their bodies are developing and their tissues are softer,” explains Silvana Marveggio, who is both a licensed physical therapist and certified yoga teacher. “But this also implies that the damage can be more definitive and permanent.”
Implicit in the concept of high performance is pushing the body beyond its limits, concludes Marveggio. The Olympic gymnast or Cirque du Soleil performer has achieved a level beyond what most human bodies are capable through intense, arduous training. Most youth working towards this level are aware of the risks they’re taking both short and long term — or they should be.
Yet even at the amateur level, Marveggio believes that, at a minimum, a trainer should have a clear understanding of which movements potentially generate injury or postural dysfunction when done repetitively. Knowing this, they work to avoid or compensate for these movements, which for the lower spine may be certain core abdominal exercises.
For example, the lumbar spine has much more range of motion, so many young performers focus their flexibility in this area. Instead, each vertebrae needs to be articulated when arching the back.
The back is not a hinge joint, emphasizes David McAmmond in his teachers’ trainings. His guide, “Yoga Therapy for Backs,” shows how common this error is with photos he’s found published online and in yoga books with models using the lumbar spine nearly exclusively as they demonstrate arching postures.
Recognize and respect limits to elasticity
A big part of the problem according to Marveggio is that kids aren't always aware of their physical limits. Each body is unique with different strengths and limits that a good trainer should know how to safely develop while transmitting that expertise to the athlete. Coaches can help them learn how to listen to their bodies and recognize their personal limits so they’re able to communicate them back to their coaches and trainers when necessary. It’s equally important that such limits are respected.
Coaches can help them learn how to listen to their bodies and communicate what they’re experiencing with their instructor. It’s equally important for teachers to respect those limits. Properly trained coaches should also educate children to know their personal limits.
Unfortunately, Marveggio has heard many cases of teachers continuing to push after the student has said they can go no further and an injury, sometimes permanent, has resulted.
Proper warm-ups and cool-downs can’t be overemphasized, adds Marveggio. Warm-up exercises should begin with shorter stretches to increase circulation in the joints, muscles and in all tissues so they are ready for exercise. After training, cool-down should incorporate longer stretches that allow the muscles to relax and release the lactic acid that has accumulated. This helps prevent cramps and stiffness.
Additionally, it’s critical that they properly balance training with significant time spent stretching while balancing the development of flexibility and strength.
Prevent back pain from snowballing into a major injury
Despite increased education for gymnastics coaches and trainers David Tiley, a doctor of physical therapy and gymnastics coach, reports that he still treats large numbers of gymnasts each week for lower back pain.
“I can tell you firsthand as a physical therapist, a coach, and a former gymnast who suffered from back pain that letting injuries go can progress quickly into bigger issues,” shares Tiley.
In his blog, he provides five screening measures to help coaches detect when back pain warrants referral to a medical professional. As a rule of thumb, when a younger athlete experiences ongoing back pain for three or more days, they should be evaluated by a medical doctor and possibly get imaging to rule out a serious issue.
“I feel by far one of the biggest contributors for things snowballing to big injuries fast is that pain is not screened for and dealt with early enough by coaches, parents, and gymnasts.”
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