How A Rise in Adolescent Sports Injuries Has Prompted a Change in Athletic Trainers

More than 90 percent of student athletes suffer some form of injury. Here’s how local health centers are handling it.



A recent physical-therapy session at Nemours’ Center for Sports Medicine in Glen Mills

Tim Duer was running out of bones to break. By the end of high school, he’d fractured 15. “Ankles, wrists, my nose more than once, a back fracture—and one stressed mother,” Duer says. 

All of that came from playing typical contact sports: football, baseball and basketball. Given his tendency to fracture, doctors wondered if Duer had an underlying medical condition. He was tested for everything. The results were negative. “Nothing was wrong with me,” he says, “except that I was really unlucky and really active.”

Something positive did come from all of that pain. Duer is now a physical therapist and a certified strength-and-conditioning specialist, managing therapy services at Nemours/Alfred I. duPont Hospital for Children in Wilmington and all of its satellite locations in New Jersey and Pennsylvania, including Nemours’ new Center for Sports Medicine in Glen Mills. The facility has state-of-the-art sports-rehabilitation equipment, along with concussion, occupational and developmental therapies for children with learning differences and those on the autism spectrum. 

Duer oversees it all—but sports medicine is at the heart of his interest. It’s a career path he began to consider during those injury-laden high school years. “After several bouts of physical therapy, I got interested,” says Duer. “It’s not an understatement to say that I know PT from the patient side.”

Back in the 1980s, there wasn’t adolescent-specific physical therapy. Duer went to generalized adult therapy. And while there’s nothing wrong with that, specialization is always a positive—especially for kids. Bones and brains are different at that age. And most youth athletes don’t know how to take care of their bodies. They have to be taught proper stretching techniques, how much rest their bodies need, and the warning signs of dehydration. When they’re thinking about winning, kids aren’t concerned with long-term impact on joints and muscles. 

Playing smarter can mean playing longer, says Meghan Mattson, manager of athletic training services for the Rothman Institute. In June, Mattson and her Rothman colleagues sponsored the first Youth Sports Safety Symposium, a daylong event held at Lincoln Financial Field. Close to 100 coaches from middle schools, high schools and independent leagues around the region attended. Speakers included Philadelphia 76ers assistant coach Todd Wright, who talked at length about the importance of nutrition for youth athletes. Scott Sheridan, head athletic trainer for the Phillies, spoke about overuse injuries. 

So serious is the rise in youth-athlete injuries that, just days after the Rothman symposium, the National Athletic Trainers’ Association launched At Your Own Risk, a new public-service campaign aimed at educating kids and parents about how to safely play sports. The stats speak for themselves: 90 percent of student athletes have some kind of injury during their careers; 54 percent say they’ve played while injured; and 62 percent of organized-sports-related injuries occur during practice. Much of that is preventable, which is why local schools have hired pros. Lower Merion, Harriton, Radnor and Conestoga high schools have Rothman trainers as part of their coaching staffs. “They act as advocates for the athletes in helping them reach their peak performance, but also keeping them safe,” Mattson says. 

When injuries do happen, athletic trainers at those schools monitor both the students’ immediate care and their long-term rehabilitation. Reinjury is always a danger, so trainers communicate with physicians to see when kids can start exercising again and what they should be doing. “It takes the stress off of the coach,” says Mattson. 

Rothman’s athletic trainers also track injuries. If there are a lot of shoulder problems on a high-school football team, the trainer may talk to the coach about what weight the players are lifting and if they’re using proper form. Members of the track team may be stretching incorrectly, Mattson says, leading to problems with ankles and quadriceps. Baseball players also get special attention. “We ask if anyone is keeping track of the pitch count, the speed of the pitches and those things,” Mattson says. 

Of course, sports-medicine professionals are also focusing on concussion prevention. Duer points out that most concussions don’t require treatment. For those that do, Nemours’ Center for Sports Medicine has an array of therapies, from low-tech balance beams to the super-high-tech NeuroCom SMART EquiTest, a diagnostic assessment of balance, which can be altered after a concussion. Some coaches and parents are even having kids come in for testing so Nemours has a baseline of their normal balance, just in case they suffer a concussion. “We don’t want to scare kids,” says Duer. “We think of it as making them better athletes.”

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