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Serious Sports Injuries: See Rehabilitation Specialist First

Surgery Should Be Last Resort

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When a child suffers a serious sports injury, Dr. Sonia Bell, MD, recommends that parents take him to a specialist in sports injury rehabilitation before seeing a surgeon.

Acute youth sports injuries, such as a sprained ankle, or moderate to severe strain, should be seen by your child's primary care physician, who can help you decide if a referral to a sports injury specialist, such as an orthopedist, is required.

If the doctor advises your child to stay out of sports for a period of time, here are the six steps that experts say your child should complete in rehabilitation and treatment of the injury before returning to competition.

  1. Allow healing.While your child is bruised and sore, and perhaps on crutches, or in a cast or splint, he probably will not be tempted to begin exercising the part of his body that is still hurting. If he insists on exercising to stay in shape while the injury heals, make sure he checks with his doctor first to make sure it is an activity, like swimming, that doesn't put stress on the injured area. Sometimes the doctor really wants a kid to do nothing. And even if she approves the exercise, she may want the child to train with a trainer to rehab the non-injured body correctly. This is also a time when you will want to make sure your child eats right.

  2. Restore full range of motion and function in the injured area. Your child should being doing the exercises his doctor or physical therapist has prescribed to restore range of motion (if he isn't, he may never get it back!). Using ankles as example, if your child can move the injured ankle in the same way and as far as his good ankle, he is ready to move on to the next step in the recovery process. No child should be allowed to return to sports if there is any limited motion in a joint.

  3. Regain normal gait. After a leg injury, many people find that they have lost their usual gait (the way the normally walk). When your child appears to you to be walking and jogging normally, she is ready for the next step in coming back from her injury. No child should be allowed to return to sports if he is still limping.

  4. Regain muscle strength. After an injury that has kept your child from exercising for any length of time, he needs to build back the strength in muscles that have been resting. His doctor or trainer should give him weight-training exercises to build up the weakened muscles. A good program: have your child do 3 sets of 10 repetitions ("reps") 3 times a week. In other words, she should lift a weight (preferably a light one) ten times in a row, stop and, when rested, to lift the weight ten times twice more.

    Here's a tip: You don't have to buy special weights. Anything that weighs a couple of pounds (a large can of vegetables, for instance), can serve as the weight. For leg lifts, put the can into one of your old purses, and hang the purse around your child's ankle and have him do reps while sitting in a tall chair or on the kitchen counter.

  5. Regain endurance. Fortunately, most healthy athletes, especially kids, regain their endurance pretty quickly, but your child won't be really ready to play again until he does. It's important that, in building endurance, your child doesn't stress his system. He should activities like swimming, running in the water, biking or rowing. Working out three times a week for 30 minutes each time should be enough.

  6. Regain skills. If your child has been away from her sport for any length of time, her skills (whether it be dribbling and shooting a basketball, hitting a softball, or kicking a soccer ball) won't be as sharp as they were before the injury. She should work in regaining her skills before playing in competition.

Because kids are usually eager to return to play and don't have the discipline to take these steps on their own, and because parents don't have the experience to know when it is safe for their child to progress to the next step, consulting with a certified athletic trainer and/or physical therapist at each step along the way is advised. All take time, patience and your encouragement. Skip any of these six steps, or do them out of order, and your child will risk re-injury and his road to complete recovery will probably be longer.

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