Introduction
Individuals are increasingly participating in sports as the awareness campaigns on the need for physical fitness abound. Even though the benefits of participating in sports or being an athlete outweigh the risks, athletes in all forms of sports are at risk of injuries. Thus, the literature review will explore different topics from a variety of compiled sources to discuss and flesh out the topic. To this end, the significant areas of discussion include sports injury prevention by the American Academy of Pediatrics, minimizing sports injuries in teens, revamping field safety for athletes, and safety policy changes for saving lives and protecting athletes. Also, the transition from medical to performance care, integration of performance health management and coaching model for elite athletes, the perception of football players regarding injury risk factors and prevention strategies, and fundamentality and rationale for the use of athletic trainers in secondary school athletic programs will be discussed.
Sports Injury Prevention by the American Academy of Pediatrics
More American teens are competing in sports more than ever before. This is because sports helps children and adolescents keep their bodies fit and feel good about themselves. However, the more the contact in sports the significant the risk of traumatic injury even though most of the injuries in teenage athletes are as a result of overuse. Nonetheless, there are several fundamental injury prevention strategies or tips that can aid parents to boost a safe and optimal sports experience for their children. On this accord, the American Academy of Pediatrics (2017) specifies the following strategies in reducing the risk of injuries among the young athletes;
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Young athletes should practice taking a break from training such as taking a day off the week or a month off the year. This practice is to allow the body to recover from the vigorous training, (AAP, 2017).
They should as well be educated on the proper sports technique reinforced during the playing season, (AAP, 2017).
Avoid playing through pain.
Incorporating stretching exercises in the daily training program as well as after games is a fundamental way of increasing the athlete’s flexibility, (AAP, 2017).
Incorporate conditioning exercises which are essential in strengthening the athlete’s muscles, (AAP, 2017).
Always wear the right gear and protective equipment such as helmets, mouthpiece, protective cups, shin guards, etc. relevant to the sport, (AAP, 2017).
Minimizing Sports Injuries in Teens
Sports camps and similar structured activities have increased the tendency of teens to indulge in their preferred sports throughout the year. According to Johns Hopkins Medicine (2019) however, the more time teenagers spend in the field the higher the risk of experiencing sports-related injuries including ACL, meniscus injuries to the knee, injuries to the labrum, or UCL in the elbow and shoulder. R. Jay Lee thus proffers the following injury prevention tips to help keep young athletes on the field rather than on the sidelines, https://www.hopkinsmedicine.org/profiles/results/directory/profile/9882336/rushyuan-lee .
Trainers and coaches need to communicate with the young athletes and maintain an open relationship through which the young athletes can indicate if they are experiencing pain or any other form of injury or discomfort.
Undertake a preseason physical examination to ascertain the fitness of the athlete and asses any areas of concern before engaging in their various sports. This could prevent the aggravation of the underlying injury.
Emphasize a healthy and well-balanced diet that includes fruits and vegetables as well as lean proteins. Furthermore, maintaining a regular eating schedule or pattern is quintessential too.
Emphasize on hydration, especially during hot and humid days to avoid heat-related conditions, http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/pediatrics/heat-related_illnesses_heat_cramps_heat_exhaustion_heat_stroke_90,p01611/ .
Revamping Field Safety for Athletes
According to STMA Information Outreach Committee (2017), compaction which results in the hardening of the playing surface or compression of the soil increases the risk of injury to the athletes. Thus, rotating the location and areas for daily practice is essential in reducing the stress put on one ground by athletes, (STMA Information Outreach Committee, 2017). Also, worn out areas that have less than 75 percent of grass or turf coverage increase the risk of injuries, (STMA Information Outreach Committee, 2017). Therefore, the committee recommends regular seeding with the right species such as the perennial ryegrass.
Moreover, sports equipment such as goal posts and bases also increase the risk of injuries, especially if the sharp edges, screws, and bolts are not secured. Thus, the STMA committee recommends regular facility inspections of the sports equipment. STMA also proffers and specifies the Playing Condition Index (PCI) that could be used by teams to examine and ascertain the playability of their fields, http://www.stma.org/playing-conditions-index-pci . Ultimately, STMA Information Outreach Committee (2017) recommends putting in place a risk management plan which in the case of a crisis implementation of the plan will help mitigate the crisis.
Safety Policy Changes for Saving Lives
According to Adams, Casa, & Drezner (2016), death during sports or physical activity is not only tragic but also unexpected. Among the major causes of sudden death to athletes according to the authors include sudden cardiac arrest (SCA), head injuries, exertional heat stroke (EHS), and exertional sickling. However, reinforcing the National College Athletics Association’s policies, Casa et al. (2012) proffer heat acclimatization guidelines specific to high school athletes in the bid to curb the number of EHS deaths, http://www.natajournals.org/doi/abs/10.4085/1062-6050-44.3.332 . Since the implementation of the mandatory heat-acclimatization policies in 2009 and the subsequent adoption by states, there have been no deaths for fifty consecutive preseasons since 2011 among the states that adopted the guidelines, http://www.natajournals.org/doi/abs/10.4085/1062-6050-47.1.96 . Thus, implementation of the heat acclimatization policies as well as compliance to them is essential in mitigating risks, (Adams, Casa, & Drezner, 2016).
Adams, Casa, & Drezner (2016) ascertain that having the sickle cell trait is a risk factor among athletes tantamount to sudden death as a result of exertional sickling episode. Therefore, the authors recommend a policy change that fosters knowledge regarding SCT status in high-risk athletes. The policy according to Adams et al. should be reinforced with targeted education and tailored precautions that ought to be considered at collegiate levels in the reduction of sudden death for athletes with the sickle cell trait http://www.natajournals.org/doi/abs/10.4085/1062-6050-47.1.96 . Adams, Casa, & Drezner (2016) also assert that cardiac arrest is the leading cause of death among young athletes in sports. Thus, Harmon et al. (2014) posit that early recognition and cardiopulmonary resuscitation CPR, as well as prompt defibrillation, are vital in improving the athletes’ outcome after SCA https://heart.bmj.com/content/100/16/1227.short . This is because, for every delayed minute of defibrillation, the survival chances for the athlete plummet by 10 percent as ascertained by Larsen et al. (1993) https://www.sciencedirect.com/science/article/pii/S0196064405813022 .
Additional research regarding defibrillation by Caffrey et al. (2003) https://www.infona.pl/resource/bwmeta1.element.elsevier-e93aad09-d1aa-34f3-9bd2-e07ad5fd60d5 , Hallstrom et al. (2004) https://www.nejm.org/doi/full/10.1056/NEJMoa040566 , Toresdahl, Harmon, & Drezner (2013) http://www.natajournals.org/doi/abs/10.4085/1062-6050-48.1.20 , Drezner et al. (2009) https://bjsm.bmj.com/content/43/9/702.short , and Drezner et al. (2013) https://bjsm.bmj.com/content/47/18/1179.short has also reiterated and evidenced that survival chances increased with decrease in defibrillation time. On this accord, current consensus standards as proffered by Drezner et al. (2007) and the American Heart Association (2000) recommend ready availability of an AED in athletic settings for use within three minutes after SCA to optimize the chances of survival. https://www.tandfonline.com/doi/abs/10.1080/10903120701204839 and https://www.nejm.org/doi/full/10.1056/NEJM200010263431702 .
Regarding head trauma and injuries, research by Adams et al. has as well shown that proper education tackling aimed at reducing overall head injuries, especially in American Footballers is essential in improving their health outcomes. http://www.natajournals.org/doi/abs/10.4085/1062-6050-51.1.06 . Such education and awareness campaigns should be accompanied by programs such as the “Heads Up Football” program launched in 2012 meant to tackle exertional heat illness and concussions, https://usafootball.com/programs/heads-up-football/
The transition from Medical to Performance Care
Kraemer, Denegar, & Flanagan (2009) assert that the transition of athletes from medical care such as physiotherapy as well as conditioning specialists to strength and conditioning programs in their recovery process is quintessential because medical recovery is significant, but strength, agility speed, power, and endurance are equally salient. Failure to adhere to this transition, athletes, often pay the price in their return-to-play process as Kautz et al. (2007) explain. https://journals.lww.com/hcmrjournal/Abstract/2007/07000/Patient_benefits_from_participating_in_an.11.aspx . However, as Olsen (1996) and Verall, Brukner, & Seward (2006) assert, apart from the athletes, coaching staff and administrative personnel are as well responsible for the recovery of the athlete in terms of providing care at all stages of the rehabilitation stages, especially when funding dictates hiring additional personnel.
Kraemer, Deneger, & Flanagan (2009) also corroborate with Jarvinen et al. (2007) and Baechle & Earle (2000) by asserting that resistance training is vital to the resolution of impairment and the recovery of function. This concept essentially helps in the transition from injury resolution to performance resumption supervised by physiotherapists or athletic trainers, (Kraemer, Deneger, & Flanagan, 2009). Therefore, Kraemer, Deneger, & Flanagan (2009) postulate that periodization, which incorporates care and proper progression with conventional rigorous resistance training programs is central in the recovery process of an athlete. All in all, to ensure complete and total recovery process, Coris et al. (2007) and Lee et al. (2008) posit that medical providers and coaches must be assured and confident that injured tissues are capable of withstanding the demands of sports and that muscle and joint impairments have been resolved sufficiently. https://journals.humankinetics.com/doi/abs/10.1123/jsr.16.3.260 and https://www.sciencedirect.com/science/article/pii/S0749806307007931 .
Integrated Performance Health Management and Coaching Model for Elite Athletes
Contrast to the traditional model where the physician was often the primary contact of the athlete (Brukner, 2012), the current SEM model proposed by (Dijsktra et al. 2014) is an improvement on the traditional one where the multidisciplinary nature of athlete’s primary professional contact is recognized http://www.softtissuetherapyonline.com/wp-content/uploads/2009/10/FreeChapter.pdf . Here, the professional contact could be a physiotherapist, a sports physician, general practitioner, team doctor, soft tissue therapist, orthopedic surgeon, nutritionist, physiologist, etc. (Dijsktra et al., 2014). Thus, from the results of the study, Dijsktra et al. (2014) find that the new SEM model takes into account the best medical evidence as well as athlete’s performance preference where decisions are not made in isolation. In essence, the authors conclude that the integrated model takes on the performance-focused approach regarding the athlete’s health which coaches, athletes, clinicians, and managers can adhere to, (Dijsktra et al., 2014).
Football Players’ Perception Regarding Injury Risk Factors and Prevention Strategies
Zech and Wellmann (2017) posit that while current research and approaches focus on injury prevention through the transfer of evidence into daily practice, influencing the attitudes and beliefs of players is more significant and promising. Thus according to a study by Adams, Caiozzo, & Baldwin (2003), football has the highest number of injuries per game of any sport, https://doi.org/10.1152/japplphysiol.00346.2003 . Moreover, Van et al. (2008) and Soligard et al. (2010) assert that the compliance of athletes to the preventive measures is a central facet in the successful implementation of effective strategies in sports practice. https://doi.org/10.1136/bjsm.2008.04644 and https://doi.org/10.1136/bjsm.2009.070672 .
The rationale for the Use of Athletic Trainers in Secondary School Athletic Programs
Clines et al. (2018) assert that secondary school student-athletes lack appropriate medical care during school-sponsored sport participation; thus, athletic trainers can bridge the gap. In essence, while most injuries in school are not fatal or life threatening, current literature, and research by Casa et al. (2012), Drezner et al. (2007), and McDermott et al. (2009) indicates that many of the risks associated with sports can be alleviated with proper prevention, assessment, and treatment by a qualified healthcare provider. http://www.natajournals.org/doi/abs/10.4085/1062-6050-47.1.96 , https://www.tandfonline.com/doi/abs/10.1080/10903120701204839 , and https://natajournals.org/doi/pdf/10.4085/1062-6050-44.1.84 . Inferring from their research findings, Clines et al. (2012) resolve that specialized training by ATs was perceived to increase safety and reduce liability.
Conclusion
Drawing from the review, it can be deduced that even though injuries range from minor to severe, what is constant is the need for prevention and mitigation. Among the significant mitigation strategies is the use of ATs, proffering approaches that are generally accepted and perceived to be beneficial by the athletes, availability of AEDs in athletics setting, as well as reducing the amount of time for defibrillation are essential in curbing athletes’ injuries. Thus, this literature review implicates healthcare providers, athletes, medical practitioners, coaches, therapists, nutritionist, and other sports-related institutions and individuals in sensitizing the need to alleviate athletes’ injuries. To this end, the recommendations and strategies presented in this review are quintessential in achieving this objective, and the implicated individuals and institutions are encouraged to analyze and research further for a complete understanding on the best approaches towards ensuring safety.
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