Young Athletes and Injuries: Game Over?

Tennis is a very tough game, from a physical point of view. Players don´t know how much time they will spend on the court (the average in the ATP Tour is 1,5h [1]), and the way the game is played (intermittent periods of high intensity exercise where the player needs to have a quick reaction time and move multidirectionally, separated by short periods of recovery), makes tennis a sport that requires all sources of energy that our body is able to produce. For these reasons, injuries are very common in this demanding sport.

As we know, a young athlete can have trouble recovering from an injury and returning to the level of play he had before the injury. We, as coaches, need to have strategies that improve the way the player copes with his injury, with his recovery and with his returning to play. So, what can we do for injured players? First, we need to know what changes in the life and body of a severely injured young athlete:

· Injury Consequences:

For the majority of young athletes, the sport they play is fused with their identity, it´s one of the biggest parts of their life. So, when a player sustains an injury, he will experience negative psychological responses, such as frustration, sadness, disappointment and feeling of worthlessness.

In addition, young players can also experience sleep disturbance and study issues, in consequence of the responses previously mentioned.

If we put all of this into perspective, we will conclude that the consequences of a severe injury are not only physical and physiological, but also psychological.

· Rehabilitation Process:

The existence of discrepancies in rehabilitation expectations and goals between athletes and clinicians/coach should be highlighted at the start of the rehabilitation, because many times the athletes feel that the rehabilitation program is not suited for them and their lifestyle.

If we reduce the gap and enhance cooperation between the medical staff, coaches at the player himself, treatment process may be quicker and smother [2]. This is also likely to lead to a more complete rehabilitation, meaning the athletes will be more prepared to return to sports.

· Changed Pain Image:

To better understand the way our body responds to pay, we can use the alarm system metaphor:

The pain can be described as the alarm system of our organism. Now, let´s imagine that two people decide to install an alarm system in their house. One of them has been robbed multiple times in their life, while the other has never been robbed before.

The one that has been robbed before will install a very sensitive alarm system, so that it can detect any threat.

The person that has never had any problems will install a normal alarm system, because there is no story of previous issues.

In both situations, the stimuli is still present (the potential robbery). However, there are two potential answers to that stimuli: one where a soft stimulus can trigger the alarm system (1st individual), and other were only a more powerful stimuli will trigger the alarm (2nd individual) .

By giving this example, we want to illustrate that our body´s alarm system (pain), will respond in a different way accordingly to our injury history and our context in the moment of injury [3]. This means the way pain is perceived will vary from individual to individual, and and effort should be made in order to understand what our player feels.

After an injury, the perception of pain of the athlete will be affected. That being said, we need to create and healthy environment, so that the player can accept pain as normal body experience, that helps him recognise danger situations, and not as an experience with a fully negative connotation [4].

· The Role of the Coach:

As coaches, we have the responsibility of assuring that the player has the best recovery possible. We can do that by putting into action several strategies (that should be selected accordingly to the player´s personal characteristics, and that should be discussed with the athletes´ family).

Bearing in mind what was said before, some of those strategies are [2]:

· Bridge the gap between medical staff, coach and the injured athlete;

· Promoting a healthy conceptualisation of pain, allowing as well for transparent communication about injury risks, causes and behaviours to prevent them;

· Using the experiences from other injured athletes in education to show how injuries can support maturation, athlete development and minimise self-blame;

· Maintaining injured athletes in the parts of training and exercise that we can participate (video analysis and physical conditioning, for example);

· Addressing social support, group inclusion and the identity of the injured athletes;

· Asking for help when necessary. The player may need to be accompanied by a specialist (like a psychologist), and the coach must pay attention to identify the need to refer the player to a professional with the skills to help him.

References:

[1]: Fernandez Fernandes J., Ferrauti A., Ulbricht A. (2014). “Fitness testing of tennis players. How valuable is it?”. British Journal of Sports Medicine. April.

DOI: https://doi.org/10.1080/17461391.2018.1440009

[2]: Philip Von Rosen, Anders Kottorp, Cecilia Fridén, Anna Frohm & Annette Heijne (2018): “Young, talented and injured: Injury perceptions, experiences and consequences in adolescent elite athletes”, European Journal of Sport Science,

DOI: 10.1080/17461391.2018.1440009

[3]: Chapman, C. R., Tuckett, R. P., & Song, C. W. (2008). “Pain and Stress in a Systems Perspective: Reciprocal Neural, Endocrine, and Immune Interactions”. The Journal of Pain, 9(2), 122–145.

DOI: 10.1016/j.jpain.2007.09.006

[4]: Bahr, R. (2009). “No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports”. British Journal of Sports Medicine, 43(13), 966–972.

DOI: 10.1136/bjsm. 2009.066936