There is a difference between playing when you are injured and playing when you are sore. Both may be painful, but playing with an injury is likely to make that injury worse and take longer to heal. For youth athlete, learning to identify the difference is an essential part of their sporting journey. Every athlete will be sore at some point. Many will suffer an injury.
In January 2017, Green Bay Packers receiver, Jordy Nelson, played with two broken ribs and caught six passes in the NFC Conference Championship. He was an adult, had full medical supervision, wore body armor, and knew that it would help his team win (they lost against the Atlanta Falcons). He knew that he would have the entire off-season to heal and get better.
Telling a 9-year-old to play through such an injury is irresponsible and should not happen. Their health and well-being are more important than any sports match at their level.
What Is An Injury?
According to the International Olympic Committee (IOC) manual of sports injuries (2012), a sports injury may be defined as “damage to the tissues of the body that occurs as a result of sport or exercise.”
This includes everything from a blister on the palm of a weightlifter to the fractured spine of an alpine skier. The IOC definition could be extended to almost all physical training that causes an improvement in fitness: the usual overload and recovery cycle that takes place to allow the muscular, vascular and respiratory systems to adapt to the new workload. But that does not help us define an injury.
My son’s shins are covered in bruises: not from his football training, gymnastics, or athletics. They are from his playground games at lunchtime. They must have hurt, but he gets back into the mix. He decides to do that.
Tender Loving Care: TLC
A 10-year old gymnast that I coach cut his heel in training this week. There was a tiny amount of blood. We took him out of training, put a plaster on it, asked if he was okay, and went back on the mat. He sustained a sports injury in training and carried on.
Another girl was out of breath, said her tummy was aching after rolling, and wanted to stop. I asked, ‘is it sore or just tired?’
‘Just tired,’ she said. She sipped water and got back on the mat.
In neither case did I ignore the athlete nor force them to go back into training. However, we want them to train when tired and get used to some fatigue so that they adapt and get fitter.
The girl could have strained a muscle. The boy could have sustained a fracture underneath the cut: as coaches, we can not pretend to know the injury. If the child is in distress, we need to let them sit out. But, bumps and bruises happen all the time in sport, and children need to take a moment out before resuming their play. This ‘time-out’ will allow them to compose themselves and see if they are hurt or temporarily sore. A little bit of TLC with an assistant or parent helper goes a long way to making them feel better.
Time To Stop
I have seen three boys fracture their wrists when vaulting. All about 11 years old and going through growth spurts. Each time they tried to carry on, and I had to pull them out. I didn’t know they had fractures at the time. They just said their arm hurt. I could see by the way that they held it that something was wrong. Tough kids who wanted to carry on, but I pulled them out before they did further harm.
If continuing training is likely to cause further harm or damage, then it is time to stop or do an alternative activity (if appropriate). Even a blister can be very painful, as anyone who has had one on their heel and tried to walk will know. Carrying on in a soccer match could cause further skin damage, and then the child will be unable, or unwilling, to play in the next match.
Children who complain about sore shins should be taken out of the training: stress fractures are common and are linked to overuse. In an athletics club, that child could try a throwing event for the next few sessions and gradually return to running. That is a sensible precaution and keeps the child active and involved. If the shins are sore when throwing, then the child might have to cycle or swim: non-weight-bearing activities. The athletics coach might like to revisit their training program and see how it balances with the child’s other activities: they might be doing a lot in school PE or play another sport like lacrosse with a lot of running in it. Being told to ‘tough it out on the track would be negligent in this case.
Not all injuries require cessation of activity. Some need a short time-out, some an alternative activity. Some need a day’s rest. But, some require immediate medical attention. The main rule is: if carrying on is likely to cause further harm or damage, then STOP. Even if you think a child is ‘faking it,’ there is a reason they are doing that. TLC and giving an option to carry on is an excellent place to start. The coach shows empathy and compassion, and the athlete will respond accordingly.