Noted surgeon Dr. James Andrews wants your young athlete to stay healthy by playing less

Discussion in 'Youth & HS Soccer' started by ObliviousScout, Jun 6, 2013.

  1. ObliviousScout

    ObliviousScout New Member

    Feb 14, 2007
    Washington, DC
    This came across my facebook feed today (even though it's a few months old). Dr Andrews writes, "Almost half of sports injuries in adolescents stem from overuse."
    http://www.cleveland.com/dman/index.ssf/2013/02/noted_surgeon_dr_james_andrews.html

    Thoughts?

    How does this fit into the US Soccer Development Academy mission to reduce the number of total games young players play, increase the ratio of practice to games, eliminate meaningless games, and provide a balanced training program that includes rest for these young athletes.

    Are players [still] playing too many club games? (Is this particularly true of tournaments where players will play as many as six games over a single weekend?)

    Is the high school season too busy? With teams playing games multiple weeknights in a row?

    And what happens when you combine high school and travel clubs, where players are basically playing continuously every day?
     
  2. Beau Dure

    Beau Dure Member+

    May 31, 2000
    Vienna, VA
    Or are they just practicing too much, 10 months a year, with no rest or diversification into other sports?
     
  3. nicklaino

    nicklaino Member+

    Feb 14, 2012
    Brooklyn, NY
    Club:
    Manchester United FC
    I used to scout players for the A league. They train hard 5 days a week. You do that you can easily get over use injuries. Under 16 and over a lot of well know youth coaches think 40 games a season is about right. I am not sure exactly how right that is.
     
  4. rhrh

    rhrh Member

    Mar 5, 2010
    Club:
    AC Milan
    Overuse is far worse because of the dual problem of coaches not subbing and playing not admitting a "minor" injury. Even USSF academies allow all 18 players to play (7 substitutions with no return) - and those kids are supposed to be training for the pros! Yet when I look at the injured players on my son's team, they play full games game in game out. Center mid and center defender always get full games.

    In college, 20 hours per week is the limit. HS soccer would be about 15 hours per week including a few games. Youth soccer has an abysmal training to game ratio: 3 hours per week of training and then go play in a tournament with four games or even more? That would be 3:2 for the players who play full games.

    There is NO reason on this earth that ANY youth soccer team should be playing their players full games every game, let alone high stress positions such as center positions. IMHO, on my son's team, it's just as good as the coach broke the center defender's leg or the center mid's ankle or the goalie's hand.

    The problem is also lack of proper stretching and warming up. How many teams start practice with a light jog?
     
  5. Mirzam

    Mirzam Member

    Jan 21, 2010
    @Dick's
    Club:
    Arsenal FC
    Nat'l Team:
    England
    One of the easiest ways to help our kids stay healthy and injury free is to ensure they are getting optimal nutrition, and most importantly plenty of magnesium.
     
  6. jeremys_dad

    jeremys_dad Member

    NYC Football Club
    Apr 29, 2007
    The Big Easy
    Club:
    Paris Saint Germain FC
    Nat'l Team:
    Germany
    Multi-game same day/next day tourney formats suck the big one. FIFA would likely ban it if it was a problem in the rest of the world if they don't already have rules in place. Kids shouldn't be practicing hard five days a week if they have a game. You need a light practice or day off in front and a recovery day after a game. And about the same 11 for a whole fixture, whats the case with European youth teams now? Anyone know the sub rules generally used in youth leagues and academy fixtures? I feel at some point a kids old enuf to go box to box that full 90, at least at elite level anyway. Our high school does it.
     
  7. rhrh

    rhrh Member

    Mar 5, 2010
    Club:
    AC Milan
    Key factor is not overuse; it is overplaying in games, namely contact. Even teams I have seen that are nationally ranked can never get the level of a practice up to the level of intensity of a game.

    There should be a ban on all kids up to age 14 playing in full games. Of the six kids sitting out from my son's team, five played full games game in game out. That factors into the injuries as well, because they are more likely to play injured if they want to keep their starting spot. Now they sit and watch the subs play full games.
     
  8. Mirzam

    Mirzam Member

    Jan 21, 2010
    @Dick's
    Club:
    Arsenal FC
    Nat'l Team:
    England

    I disagree, the key issue is nutrition, and parents need to understand what optimal nutrition is needed to support a young athlete during high pressure prolonged activity. Now, I don't agree with over playing, but a optimally nournished young athlete should be able to last 70 minutes which is the length of a u14 match.
     
  9. rhrh

    rhrh Member

    Mar 5, 2010
    Club:
    AC Milan
    You are of course including proper hydration. I find that the #1 problem in youth soccer players. And yes, a fit U14 player should be able to play a full game without risk of injury, BUT, the coaches seem to assume big = fit and not complaining = not injured.

    To your point, when my son was U10, the A team in his club had pasta dinners the night before every game. They made sure the kids drank a lot of water and/or juice, and packed in the food. They told kids what to eat the day of the game, and when (though it varies for some kids).

    A player who is not getting proper nutrition is not fit, and he's not going to last a game without getting overly fatigued and/or injured. It's all circular. And the trouble is also, there are many levels of fitness, but some coaches ignore fitness even as their team advances in skill and opponent level.
     
  10. Mirzam

    Mirzam Member

    Jan 21, 2010
    @Dick's
    Club:
    Arsenal FC
    Nat'l Team:
    England
    I do mean hydration also. However, optimal nutrition is more than just eating carbs the night before a game. This is a life-long issue that begins as an infant. Do you realize that 54% of US children are chronically sick or obese? Don't you think that affects the performance of our young footballers?
     
  11. nicklaino

    nicklaino Member+

    Feb 14, 2012
    Brooklyn, NY
    Club:
    Manchester United FC
    I go to my nephues HS graduation last week. I live in NYC not many trees here he lives up state NY in the forest :). He is a big kid over 6'5". I brought my camera I thought I would be able to find him easy in tge graduating class him being so tall. Who knew I would be traveling to the land of the giants. Every kid was very tall he looked almost average. The other thing I noticed their we're no fat students there men or women.

    What the hell are they feeding them in this land of the giants?
     
  12. nicklaino

    nicklaino Member+

    Feb 14, 2012
    Brooklyn, NY
    Club:
    Manchester United FC
    Forget where I got this from on hydration its a pretty good Hand Out
    Hydration: Preparation and Warning Signs
    Forget about every other question that you have about nutrition until youâve
    figured out how to stay hydrated. Being smart about hydration can separate
    good performance from great performance.

    You are mostly water. In fact, if you took the water out of a 180-pound lean
    body, there would be about 55 pounds left. Because your muscles, your brain,
    your blood and sweat are mostly water, your body doesnât work like it should
    when it is not properly hydrated. You donât think as clearly, your endurance
    is compromised and your heart works harder.

    When youâre severely dehydrated, sweating stops and your body overheats. The
    result is fatigue, weakness, dizziness, and collapse, or worse. In fact,
    every year, deaths in young healthy athletes are linked to severe dehydration.

    Sweat It Out
    Sometimes you donât even see sweat, like when you swim. But you sweat
    whenever your body heats up from working out. Sweat is your bodyâs cooling
    system. Evaporation of sweat from your skin cools you down.

    When you sweat, you lose fluid from your body. That fluid must be replaced,
    and replacing fluids takes a plan.

    Dehydration: A shortage of fluids in the body.

    Donât Rely on Thirst
    You might be thinking, âWhatâs the big deal? Wonât drinking when Iâm thirsty
    guarantee that Iâm hydrated?â Surprisingly, no. During exercise, for reasons
    not totally understood, humans donât drink enough to prevent dehydration.
    You need to drink before youâre thirsty and keep drinking after you no
    longer feel thirsty.

    Drink It In
    Forget about the old rule of drinking 8 glasses of water per day. You
    probably need more than that on most days. Counting how many glasses you
    drink is only one way of keeping track of what you need. A better way of
    making sure youâre hydrated is to check your body weight before and after
    practice. For accuracy, weigh yourself in minimal clothing if thereâs
    privacy, and afterwards, change out of the sweaty clothing before you weigh.
    The weight lost during practice or competition is not fat, itâs fluid loss.

    One pint of fluid weighs one pound. To replace the fluid, drink one pint of
    fluid (Gatorade or water) for every pound you lost. (One pint = 16 ounces =
    500 ml = ½ liter). It is critical to replace this as quickly as possible.
    Before your next workout, your weight should be back up to normal.

    If you canât check your weight, pay attention to your body for signs of
    dehydration. Your mouth should not be dry. Your urine should be
    lemon-colored most of the time.

    More than one episode of dark yellow urine is a warning sign that you donât
    have much reserve. (Exception: Vitamin supplements can turn your urine
    yellow-orange, even if you are hydrated.) Loss of appetite, stomach aches,
    and muscle cramps can be other warning signals of dehydration.

    When?
    Drink before, during and after working out. Drink a pint or so of fluid a
    few hours before exercise. This will help make sure you are hydrated and
    give you enough time to urinate if you need to beforehand.

    Keep drinking during exercise. And donât worry about getting too much fluid.
    If youâre sweating, your body needs a constant supply. Your stomach might
    gurgle, but your body will absorb and use the fluid. Feeling sick and
    cramping have been blamed on too much water when in fact, stomachaches and
    muscle cramps are usually signs of not drinking enough fluid.

    Drinking fluids after workouts is extremely important. Even when drinking
    fluids during a workout, many athletes become dehydrated. Athletes working
    out in the heat for several hours can lose 10 pounds. Thatâs more than a
    gallon of water.

    Hydration Tip: Keep your hydration source full and in plain sight so you
    remember to drink it.

    What Should I Drink?
    Your body needs water. But remember water comes in all sizes, shapes and
    colors. Milk is 90% water. Juice and most soft drinks are 89% water, sport
    drinks are 94% water, and even pizza is 50% water. And it all counts. Nearly
    everything that passes your lips provides water for your body, and in fact,
    research shows that most hydration happens at meals from the combination of
    food and beverages.

    Research also shows that we tend to drink more if the fluid is flavored and
    if a variety of fluids are available. Gatorade and water are two excellent
    sources for hydration.

    Keys to Hydration
    When you have figured out how to stay hydrated, especially when you sweat
    heavily, you have accomplished the single most important
    performance-enhancing aspect of nutrition.

    Water is your most important nutrient.

    Outline for Heat Illnesses
    Source: USOC Sports Medicine Division

    Heat illnesses are common problems for both athletes and non-athletes in
    hot, humid weather. Heat Cramps, Heat Exhaustion, and Heat Stroke start from
    similar circumstances: poor adjustment to hot weather and relative
    dehydration. These conditions can be severe and need emergency medical
    attention. All are preventable if certain procedures, such as time to adjust
    to heat, adequate fluids, and normal dietary electrolyte intake, are followed.

    Heat Cramps

    Cause
    Inadequate adjustment to hot weather, heavy sweating; decreased blood levels
    of electrolytes; fluids and electrolytes not adequately replaced; unreplaced
    weight loss from previous workout/day.

    Clinical signs and symptoms
    Muscles in arms, legs, and/or abdomen spasm uncontrollably, accompanied by
    heavy sweating.

    Treatment
    Drink fluids; gently stretch and massage cramped muscles; rest in cool
    environment; apply ice to cramped area; watch for breathing or heart problems.

    Prevention
    Maintain adequate fluid intake by replacing sweat losses: 15-30 minutes
    before exercise, drink 16 oz. of fluid; during exercise, drink 8oz. every 15
    minutes; and after exercise drink 16 oz. of water/electrolyte drink (i.e.,
    PowerAde, Gatorade) for every pound of body weight loss; increase fitness;
    wear light colored and/or lightweight (i.e. mesh) clothing; do not use
    alcohol, coffee, caffienated drinks, or soda pop for fluid replacement.

    Heat Exhaustion

    Cause
    Long exposure to hot and/or humid environment; heavy sweating; fluids and
    electrolytes not replaced adequately; unreplaced weight loss from previous
    workout/day.

    Clinical signs and symptoms
    Skin cool, pale and moist; heavy sweating; headache; dizziness; poor
    coordination; mental dullness; enlarged pupils; nausea; vomiting; fatigue;
    weakness; thirsty; small urine volume (bright yellow color); possibility of
    unconsciousness.

    Treatment
    Stop activity; rest in a cool area; sponge with cool water; drink water if
    conscious (replace weight loss with 16 oz of fluid for each pound of body
    weight); watch for breathing or heart problems; refer to physician attention
    if recovery does not occur quickly.

    Prevention
    Maintain adequate fluid intake by replacing sweat losses; 15-30 minutes
    before exercise drink 16 ounces of fluid, during exercise drink 8 ounces
    every 15 minutes, and after exercise drink 16 ounces of water-electrolyte
    drink (i.e. Powerade, Gatorade for every pound of body weight lost; increase
    fitness; wear light colored and/or lightweight (i.e. mesh) clothing; do not
    use alcohol, coffee, caffeinated drinks, or soda pop for fluid replacement;
    allow time for rest and cool down.

    Heatstroke

    Cause
    Bodyâs temperature control system stops working.

    Clinical signs and symptoms
    Hot, dry and red skin; no sweating; rapid pulse; confusion; dizziness;
    unconsciousness; rectal temperature as high as 104°-106° Fahrenheit.

    Treatment: Medical Emergency!
    Immediate emergency cooling (e.g. cool room, put body in tub of ice water,
    ice cloths with a fan blowing on skin) and transport immediately to
    hospital; check temperature; watch for breathing or heart problems (may need
    CPR)

    Prevention
    Maintain adequate fluid intake by replacing sweat losses; 15-30 minutes
    before exercise drink 16 ounces of fluid, during exercise drink 8 ounces
    every 15 minutes, and after exercise drink 16 ounces of water/electrolyte
    drink (i.e. mesh) clothing; do not use alcohol, coffee, caffeinated drinks,
    or soda pop for fluid replacement; allow time for rest and cool down.

    Sources: ICSN, International Center for Sports Nutrition
    USOC, United States Olympic Committee â Sports Medicine Division
    USSF, United States Soccer Federation â Sports Medicine Committee

    (Thanks to Mark Stein, ATC, for his help with this project.)
    1991 United States Olympic Committee (revised November 1999)

    Water Content of Common Foods and Drinks


    Item Water content, approximate
    Diet soft drinks, tea, coffee 99%
    Sports drinks (Gatorade) 94%
    Milk 90%
    Soup 90%
    Soft Drinks, soda pop, juice 89%
    Yogurt 80%
    Corn 76%
    Baked potato 74%
    Cooked rice 73%
    Cooked pasta 66%
    Taco 59%
    Chicken 54%
    Ground beef 53%
    Pizza 50%




    Prepared by the U.S. Olympic Sports Medicine Division and the International
    Center for Sports Nutrition.1999 U.S. Olympic Committee

    USOC Medical Emergency Procedures
    Heat Illness Guidelines

    Recognition
    Heat Cramps
    Musculature spasm of extremity and abdomen
    Heavy sweating
    Core temperature normal or slightly elevated

    Heat Exhaustion
    Cool, moist, pale or flushed skin
    Headache and dizziness
    Strong, slow pulse
    Weakness, confusion, and fatigue
    Nausea, vomiting

    Heat Stroke
    Usually, hot, dry, flushed skin
    Headache and dizziness
    Strong, slow pulse
    Heavy sweating, thirst
    Fluid and electrolyte depletion
    Enlarged pupils
    Possible unconsciousness

    Management
    Heat Cramps
    Cease activity and remove from heat
    Rest and drink cool fluids
    Monitor for change in symptoms

    Heat Exhaustion
    Cease activity and remove from heat
    Sponge with cool water
    Slowly administer cool fluids orally if conscious
    Monitor for change in symptoms

    Heat Stroke
    Activate EMS
    Remove wet clothing and sponge with cold water
    Monitor symptoms
    Remove from heat

    Referral
    Heat Cramp/Heat Exhaustion
    Contact consulting physician if complications occur or symptoms do not resolve

    Heat Stroke
    Activate EMS

    Follow Up
    Heat Cramp/Heat Exhaustion
    Maintain adequate fluid intake, adequate rest and cooling periods,
    acclimatize to environment, physician release if indicated

    Heat Stroke
    Physician release to activity
    Maintain adequate fluid intake
    Adequate rest and cooling periods
    Acclimatize to environment

    Notify Head ATC or designee and appraise of situation

    Notify the emergency contact of the patient if they are a minor
     
  13. nicklaino

    nicklaino Member+

    Feb 14, 2012
    Brooklyn, NY
    Club:
    Manchester United FC
    Eating for soccer
    Carb load for three to four days before a match, then eat lots of protein for three or four days after a match. Get lots of calcium, and eat lots of veggies and fruits to get valuable vitamins and minerals....... that is not just a health-freak, tree hugger thing, it will help tons in injury prevention.
     
  14. HeloBubba

    HeloBubba New Member

    Jun 20, 2013
    Club:
    FC Barcelona
    I concur on the hydration and nutrition piece. I think that we need less games and more training but the idea of limiting training because of over use is suspect. I think the problem is repative tasks that cause muscle imbalances especially in girls. In other words if your kid is only running and playing soccer but not doing strengthening exercises like core work, lunges, squats and plyometrics then you will have problems with knee and muscle injuries.

    My daughters current team is seeing alot of sore/strained muscles because the girls came into the season out of shape too. You cant spend the summer at the beach not running/practicing and expect to show up to practices ready to go. I would like to see less advice from orthopedic/pediatrics and more from sports trainers/sport physiology people.
     

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