Recovery Strategies for Pediatric Patients
By Christine Foss, MD, DC, MSED, ATC, DACBSP, DACRB, ICSC
Optimal Recovery Strategies for the Pediatric Athlete
The world of pediatric sports is as demanding as it is rewarding. Young athletes face unique challenges of growth, development, and sports performance that require specialized recovery strategies. Healthcare professionals must be mindful of the multifaceted recovery approach needed in this growing demographic. Let’s explore the art of recovery for pediatric athletes and look into the importance of tailored approaches that cater to their developmental needs.
Understanding the Pediatric Athlete
Pediatric athletes are not just smaller versions of adult athletes; they have distinct physiological and psychological differences that set them apart. Their bodies are still growing and developing muscles that are susceptible to different types of injuries. Additionally, we must remember the psychological differences between youth athletes and adults. Understanding these unique aspects is crucial in developing effective recovery strategies.
Common Injuries and Prevention
Young athletes often face overuse injuries that affect the physis around the knee and foot, such as Osgood-Schlatter disease and Sever’s disease.
This is primarily due to the intense demands of sports on their growing bodies. Additionally, tendinopathies and avulsion fractures are not uncommon in youth athletes. Preventive strategies are critical and should include proper training techniques, adequate warm-up routines, and, to prevent injuries, a functional analysis from a healthcare professional who understands the nuances of athletics on the growing body.
Other important considerations in the care of pediatric patients involve foundational analysis, kinetic chain evaluations, and evaluating the performance of the pedal foundation.
With emerging research, we now understand better how important it is to support and correct structural foot imbalances.1 This added assessment and correction with a custom functional flexible orthotic sets the stage for optimal biomechanics, injury prevention, and strength activation.
Evaluation of the Athlete’s Footwear
The healthcare provider should evaluate the footwear of their athletes. The wear patterns found on the shoes tell an important story about how the body functions. These subtle clues help expose potential injuries or even the history of past injuries.
Often, the interior of the shoe offers inadequate support. This is mostly true regarding cleated shoes. Placing an insert in these shoes can prevent injury and avoid the long-term consequences of pelvic unleveling. The correct orthotic will reset the kinetic chain functionally, making it more efficient. The significant impact of this is limiting injury and preventing future issues such as arthritis. We know that athletes may develop arthritis in joints years before their non-athletic counterparts.
Correcting the imbalance that inherently occurs in our bodies with a functional, flexible orthotic is a great start to delay or even prevent these future issues before they become a more serious problem in the athlete’s later life.
Effective Recovery Techniques
Recovery in pediatric athletes is multifaceted. Nutrition, hydration, sleep, and proper footwear are crucial in their recovery process.
Emerging research on the critical impact sleep has on recovery and performance is staggering. Pediatric athletes need more sleep than their non-athletic peers for optimal recovery and growth. The American Academy of Sleep Medicine reports that adults need roughly seven to nine hours of sleep daily; however, children and adolescents need nine to 20 hours of sleep.2 Research from Stanford demonstrated that basketball players who increased their sleep duration improved their performance. In this study, for example, free throw accuracy improved by 9%; three-point field goal percentage increased by 9.5%; and sprint times also improved.3
Active recovery involving light, non-strenuous exercise can aid in recovery by enhancing circulation, supporting metabolic recovery, and reducing muscle stiffness. Scheduling active recovery days after every 10 days of intense training can help flush out muscle soreness and increase blood flow to support healing. The American Council on Exercise recommends this protocol.
Lastly, using proper supportive footwear with a custom flexible orthotic when not in practice is suggested to allow the kinetic chain to recover in a well-balanced and uncompromised position.
Psychological Recovery
The mental aspect of recovery is as important as the physical. Pediatric athletes need mental rest and effective stress management strategies. Techniques like mindfulness and ensuring regular breaks from their sports routine can help maintain their mental well-being.
Engaging in hobbies and personal interests can greatly reduce injury and recovery-related stress in young athletes. Additionally, developing coping strategies to deal with injuries is crucial to help them navigate the psychological impacts of sports-related injuries. Informing parents about the mental recovery necessary can help avoid pressures on sports performance at home.
Role of Coaches and Parents
Coaches and parents play a pivotal role in the recovery of pediatric athletes. They need to be aware of and understand the signs of overtraining and burnout. Creating a supportive environment that prioritizes the young athlete’s health and well-being over competitive success within their sport and outside of it is necessary for fostering healthier athletes. This role of the parent is important as they might have insights into the coach’s behavior and stress at home.
We often see scholarship athletes experiencing overwhelming stress and pressure to secure and maintain a college scholarship. This pressure comes from coaches and parents, who wear the school’s logo-bearing gear as a sign of support. While such support is needed in many instances, it might become the tipping point of pressure for the young athlete.
Rehabilitation and Return to Sport
Rehabilitation protocols should be tailored to the athlete’s specific injuries and needs. A gradual, closely monitored return to play prevents reinjury and ensures complete recovery. Healthcare professionals, coaches, and parents need to carefully oversee this to ensure the young athlete isn’t working through pain or trying to mitigate family or school pressure.
Conclusion
Recovery strategies for pediatric athletes require a holistic approach that addresses both their physical and psychological well-being. It is about creating a balanced environment that supports their growth both as athletes and individuals. By prioritizing proper recovery techniques, we can foster a generation of healthy, resilient young athletes.
References
Cote KP, Brunet ME, Gansneder BM, Shultz SJ. Effects of pronated and supinated foot postures on static and dynamic postural stability. J Athl Train. 2005 Mar;40(1):41-46. PMID: 15902323; PMCID: PMC1088344.
Watson AM. Sleep and athletic performance. Curr Sports Med Rep. 2017 Nov/Dec;16(6):413-418. doi: 10.1249/JSR.0000000000000418. PMID: 29135639.
Mah CD, Mah KE, Kezirian EJ, Dement WC. The effects of sleep extension on the athletic performance of collegiate basketball players. Sleep. 2011 Jul 1;34(7):943-50. doi: 10.5665/SLEEP.1132. PMID: 21731144; PMCID: PMC3119836.
About the Author
Dr. Foss is the director of the certified chiropractic sports physician program for Northeast Chiropractic College. She was named the 2020 American Chiropractic Association Sports Council Chiropractor of the Year and was the 2023 International Federation of Sports Chiropractic Educator of the Year. Dr. Foss is currently serving as the director of education at Foot Levelers.
