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When Can I Go In Coach?
by Dr. Erin A. White
Your best defenceman
twisted her knee in the second period. It is late
in the third period and she wants to play again.
It is late in the
basketball season and your starting centre says he
can play after tearing ankle ligaments one month
ago.
These are just a couple
of scenarios coaches and athletes face every
season. What do you do? Are there guidelines? Are
there legal implications? What would another coach
do?
Fortunately, this topic
has been discussed, researched and studied with much
thought over the years. In today’s litigious
climate, coaches, players and parents should be
aware of the following so that the ultimate goal,
the safety of the athlete, is always remembered.
We all recognize that
injuries are a common occurrence for those who
exercise and compete in sports. Injuries can be
either an overuse condition (i.e. tendonitis, shin
splints) or a sudden, acute injury (i.e. bone
fracture, torn ligament) and many injuries require
restrictions and/or a change in the training/playing
schedule.
Injuries cause some kind
of disruption or dysfunction to the musculoskeletal
system, such as bone, muscles, ligaments, joints,
resulting in pain, swelling, bruising, stiffness and
reduced range of motion, strength and sensation.
Improvement occurs with healing. However, the
tricky part is that improvement in these signs and
symptoms does not necessarily confirm that the
injury has completely healed.
Everyone should remember
the following after an injury has occurred:
1) PROTECT-
Protect the affected area from further injury.
2) REST-
Initial rest will help prevent further injury,
decrease risk of swelling and aid in a rapid
recovery.
3) ICE- Ice
packs on the injured area decreases swelling and
pain and should be used for two-three days
post-injury.
4) COMPRESSION
- Wrapping/bracing helps control swelling and
decreases motion.
5) ELEVATION-
Elevating the injured part (especially above the
heart) helps decrease swelling and pain.
PRICE is the first thing
we should all remember with injury care.
The length of time an
athlete is away from their sport or exercise varies
according to the type and severity of injury, body
part injured and other specific factors.
Of course there are
always exceptions, but healing usually proceeds in
certain stages:
·
24-72 hours post-injury
- swelling/pain decreases
·
7-14 days post-injury -
range of motion increases
·
10-14 days post-injury
- discolouration (bruising) subsides
Proper rehabilitation
with the goal of accelerating healing, pain control,
swelling reduction and increasing range of motion,
strength and coordination is paramount. Attempting
to return to play too early, significantly increases
risk of re-injury or additional injury.
Consultation with a health care provider
knowledgeable in sports injury care will aid in
initial treatment and determination of return to
play.
Please be aware of the
following guidelines for return to play as
recommended by the American College of Sports
Medicine:
-
injured body part should
have full, pain free range of motion
-
at least 90-95% strength
of the opposite side
-
some mild
discomfort/stiffness/swelling during or after
initial return to exercise
-
athlete should be able
to perform specific motions and actions required for
their sport before returning
-
consider a progressive
return to activity, beginning at 50% and progressing
10-15% per week
-
consider cross-training
while healing such as biking/swimming for knee/ankle
injuries
-
ask athlete if they feel
they are ready to return/ensure mental confidence
Appropriate initial care
post-injury and following proper return to play
guidelines will help ensure a safe and fun season.
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