It is late July in Arizona when the intense heat keeps young athletes indoors, less active and relatively injury free. As a result, sports medicine clinic is a bit light with a few scattered fractures and some lingering knee injuries that have gotten better. I am eagerly anticipating the return of school and fall sports like volleyball, cross country and, of course, football. I have noticed something different in the past couple of years, the sports just never seem to stop. When fall arrives, the clinic is distinctly different than the doldrums of July. The day is packed from 8 AM until the early evening with every sports injury you can imagine. However, there are a few things that seem to be not quite right. I am seeing overuse injuries like tendonitis and stress fractures, but the season has just begun. I am also seeing “baseball” and “softball” injuries in October when the season doesn’t start until March. It got me thinking, so I took a deeper look.
AIA Approves Year-Round Practice
In 2017, the Arizona Interscholastic Association (AIA) approved year-round practice for high school sports. It was a change from a previous restriction on when and how much high school coaches could hold practice throughout the year. Basically, the measure does not put limitations on out-of-season practices except for the use of helmets and shoulder pads not being allowed during football workouts. Needless to say, this seemed to be the proverbial smoking gun. I next had to figure out what does year-round practice actually mean, football was a good place to start.
The Season
In late July and early August, it has become customary for football teams to partake in a preseason camp, just like they do in college and the pros. No doubt a wonderful experience for the kids and coaches alike as they build teamwork and camaraderie. Yet, this is no walk-in-the-park filled with trust falls and roasting marshmallows by the fire. It is intense training, frequently with practice twice a day, with the intention of jump-starting the season. I can understand the benefits and have participated in these myself as a high school athlete. Next come pre-season practices, scrimmages and the much-anticipated football season. These athletes will go hard all the way to the end of October and if they advance in the playoffs up until Thanksgiving. My mental calculator has a tally at 4 months of non-stop work. All the while, Twitter and Instagram are aflutter with highlights and D1 offers; the glory of high school football.
Winter Training
Once the turkey and stuffing have been eaten it's about a week or two off before winter workouts begin. Basically, strength training and conditioning work to get prepared for the next season, the one that is 8 months away. Thankfully winter break comes next with a well-deserved break for these athletes at around the 5-6 month mark, so I thought. One Saturday, as I am enjoying the beautiful Arizona winter I pull out of my neighborhood and the main street is packed, cars everywhere. I slow down to see what is going on at the park and it is the same high school kids I have seen all year doing NFL combine style training. Unbelievable! Well, maybe it's just a one-time thing, nope, every Saturday morning for a few months they are putting in serious work.
Spring Ball
Now on to Spring/Summer, prime time in terms of offseason training. Here is where you want to show what you can do and get your name out there so scouts and coaches know who to look for in the upcoming season. There are passing leagues, camps, 7 v 7 tournaments, and even big-man events. Don’t forget the summer workouts to prepare for these competitions. Now, in case you were keeping score, it's June. Yes, that’s 11 months of straight sports or training with little to no break. We come full circle back in the clinic seeing overuse injuries in the last week of July and soon to be early August with no end in sight. Ordinarily, when we have a lingering injury from the winter or spring we have a few months to get it right. Not anymore, there just isn't time. The irony of it all is that those workouts, competitions, and preparations are the very things causing athletes to be hurt before the season even starts. Heartbreaking to have to sit a kid or not see them reach their full potential, due to misguided enthusiasm to be their best.
Too Much of a Good Thing
I love sports and, yes, sports injuries pay the bills, but that should be even more of reason to heed this warning. Young athletes are doing too much for too long. Neither football nor sports is the villain, its just too much of a good thing. We have arrived at the day when the local newspaper is doing a story on a kid for playing multiple sports because it is so unique. It is really a shame, as it was commonplace 15-20 years ago. It is not just football, I can say the same for most other sports, it is just the best example. I can tell you that the current state of affairs in high school sports is concerning at best and detrimental at worst. Athletes, parents and coaches, young athletes are not super-human, they need breaks just like everyone else. I truly hope this is the start of a conversation, although I know many eager athletes just will not listen. Until they do I will be back at the clinic ready to take care of them.
Randon T Hall, MD
Sports Medicine Physician and Blogger at TheInjurySource.com