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Flamin’ hell, give the kids a chance

Nurturing

PUSHING HARD  With many teenagers playing multiple sports, the risk of fatigue and injury is real.

Health

Andrew O'Brien

It has been a long time since I last watched Home and Away, but I’m pretty sure that at some stage during the episode (and every other one besides), Alf Stewart said something like ‘Flamin’ hell, Ailsa, what are those flamin’ mongrel teenagers up to now?’. Alf probably would have had a grumble about the hordes down at the Quay in Westport when the weather was better; ‘They’re hangin’ about and up to no flamin’ good, Ailsa’.
Personally, I’ll admit to being somewhat relieved to see groups of teenagers swimming and having fun once lockdown eased enough to allow it. Lockdown has been tough on everyone, but kids need to be kids.
More worrying for me has been how many injured teenagers I have seen in the clinic since we reopened. Normally, I see a few teenagers each week, mostly with either acute injuries like ankle sprains or growth-related issues. Since lockdown, we’re seeing a few every day. ‘What’s wrong with these flamin’ kids, Ailsa?’.
From talking to them, most of these teenagers were reasonably active during the lockdown period; coaches had set training programmes to have them ready the moment the green light was given. But since training and matches have come back, the intensity and frequency of sessions has gone up several notches. I know of a 15 year old who was recently scheduled to play six matches in nine days.
I should clarify something here; this isn’t a complaint that kids are doing too much. Teenagers are tough; they can, and should, be doing some reasonably strenuous exercise every day. I would rather have a queue of kids who are ‘overactive’ rather than inactive. No, what I’m encouraging here is a little bit of lateral thinking.
Sever’s disease is a growth-related heel pain that is most prevalent in boys aged ten to 15 and, to a lesser extent, girls aged eight to 13. When long bones grow quickly, some kids develop pain at the attachment of the Achilles tendon into the heel bone. It is usually exacerbated by running and jumping sport.
For many, the pain is worst when running in football boots. Why? The flat sole of a football boot means there is even more load on the Achilles tendon. Kids with heel pain should consider doing their non-match running in runners with a bit of a heel to alleviate this load as much as possible.
All sports injuries are more likely to occur with sudden increases in load, as has happened of late. If we can’t change that load, what can we do to mitigate against it?
One simple answer is to ensure adequate sleep. Normally not a problem for teenagers you might say. However, research suggests that most teens get six-and-a-half to seven-and-a-half  hours of sleep per night, rather than the recommended eight to ten hours. On top of that, the research indicates that adolescents who sleep less than eight hours per night have a higher injury risk, with less than six hours sleep increasing the risk by up to 50 percent.
An extension of ensuring sufficient sleep is managing training intensities and recovery, and it’s here that many problems arise.
A lot of the teenagers that I see play at least two sports, and those who are good often play in two or more age groups as well. Some kids end up playing – and training – with four different teams. Anyone who is playing that often is clearly very fit and doesn’t need to train at a high intensity between matches. But the difficulty is that coaches are all volunteers and don’t have the time to individualise sessions based on how many teams each player is involved with, so everyone does every session at full intensity.
I’m not suggesting that the under 16’s GAA coach and under 15’s soccer coach plan their training sessions together, but it would be wise for coaches and parents to keep an eye on players who are involved with several teams. Remember, fatigue and laziness can look very similar. Now that school is back, that will add another layer to the problem.
He might be a grumpy old man, but I’m pretty sure Alf always had a good talk with those flamin’ kids and discovered they’re not all bad. I’ve got to agree with him. Like everyone else, they’re doing their best.

Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.