Keeping Young Athletes Healthy: Injury Prevention Guide with Paul Ness

One research in Australia showed that only one in three children, and one in ten young people, meet the current (Australia’s) physical activity guidelines for children of 60 minutes of physical activity every day. Furthermore, fewer than one in three children and young people are meeting the guideline for “no more than two hours of screen-based entertainment” every day.
Result is decline in children’s fundamental movement skills. What can be done to change this negative trend, which can be seen all around the Globe?

It is interesting that today we have more access to physical fitness facilities, playing fields, organised sports team and also more knowledge about how important physical activity is, yet we are not meeting the recommended goals. With cost of living pressures resulting in more parents having to work we have become “time poor” meaning there is less time directing children to play sport. On top of this, computer games have become so exciting and interactive they are very appealing to many (not just children). Continued public education is required to educate parents and children about the benefits of exercise and some focus will be needed to make it fun so it is not a chore.  Perhaps some school education could include exercise in inventive ways that will incorporate learning and movement. I think it probably needs to be government driven via public education and programs to have the widest impact.

Regarding the first question, should not therefore the role of physiotherapists in young athletes development be much more emphasized? Otherwise many deficiencies (incorrect walking patterns, poor posture, …) in young athletes often go unnoticed.

I am not sure there is ever likely to be the scope or budget to have physiotherapists involved full time at lower levels of sport unfortunately. I think it could be best for coaches to be trained better so they can recognise that something doesn’t look right and can then refer appropriately. Certainly, trained professionals such as physiotherapists have a lot to offer and hopefully they can become more involved over time.

In your opinion, what benefits can youth athletes gain from participating in multiple sports rather than specializing in just one from an early age?

I am a believer that sport should be fun at an early age and playing multiple sports can be fun for children. There are possibly cross benefits of playing different sports such as a variety of movement patterns and different conditioning. Of course, there is also the load problem of children playing too many sports!

What should an effective injury prevention program for youth athletes include?

There needs to be a much greater education and emphasis about load management for young athletes. So many injuries are caused by overload. If athletes are taught to measure their own load in the form of a training diary, they will be able to see patterns and avoid pitfalls such as sudden overload. For example, if an athlete is used to practising 2 hours, 5 times a week (which is quite a lot), and during their Easter break they go and play in a carnival where there are multiple games/matches in a day and they play day after day (often resulting in that 10 hours of normal weekly play occurring over a 3 day weekend), it should be no surprise they are likely to suffer from injury.

With respect to strength, mobility and movement control, each athlete needs to be assessed individually to have a program set up for them. There can be some general exercise programs that are effective, but it is highly likely there will also be a need for specific plans for an individual.

Good nutrition and good sleep are also immensely important. Athletes need to fuel their bodies adequately to prevent breakdown. Sleep has been proven to be one of the most important recovery tools there is.

What indicators or signs should one look for to identify when a young player may be at risk of overtraining or burnout?

One common measure some people like is to measure resting heart rate each morning.  An athlete can work out their baseline and then if there is an increase in normal the body may be under too much stress. Recovery should then be prioritised, even if the athlete wants to keep pushing themselves.

Measuring performance is also a good indicator of over training.  For this naturally you need a reliable measure of performance. Coaches are ideally placed to recognise a drop in performance and should be educated as to what this might mean.

What challenges do junior players on the Tour face and what advices do they hear from you?

Tennis at the top level is extremely physically demanding.  Many players take years for their bodies to gradually develop. They need to have a plan that is broken down in to long- and short-term goals. If they have achievable short term goals, they will be able to see progress and maintain their course.

How do you see the necessity for the Coach education programs regarding the guidelines on proper young athlete development in order to prevent injuries at an early stage in their careers?

There are many coaches’ programs set up around the world which aim to educate coaches in best practice. Much is left to sporting governing bodies to fund education which obviously means not all coaches have equal access. Professional sport is only a relatively recent phenomenon (50 years) and in the early days there was not much money in coaching. This has changed over the years so that coaches are well paid and professional, but at the lower levels education is just starting to evolve and help younger athletes. As this education evolves, coaches will be more rounded and more knowledgeable and as a result will manage athletes better with respect to injury prevention.