# When should you sit your kid if they have aches and pains?



## socalkdg (Sep 29, 2016)

Hearing the story's of the brave parents and kids that are going through rehab has me thinking on when you should have your kid sit instead of practice/play?  

My daughter is always active, from playing soccer almost every evening, to basketball, football and baseball at school.  Now 11, she loves PE at school and the chance to play a lot of different sports on a consistant basis.  But like every kid, she comes home with a bump or bruise or cut. Her last two were a bruised foot, and a bruised hip.  

Other kids on our team have bruised elbows, sprained/strained ankles, or a knee that causes discomfort.  Would it be best to just have the kids sit for 1-2 weeks to get better, or practice through the pain.  Equally tough to actually get your kids to rest.  As parents we try to figure out the extent of each pain and injury.  Pushing our kids during a time when an injury is more than what we believe could leave to even more damage or a great injury.

Just interested in the experiences of others, warning signs that we need to keep an eye out for, precautions that we can take.


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## LadiesMan217 (Sep 29, 2016)

Precaution for your daughter since she is as active as you describe. As she enters her major growth patterns (around 13/14) make sure she is doing hip rotator exercises. She will grow 1/4" in one night sleep some night this will cause all kinds of turmoil with this much activity especially if she is 'boy' muscular as a girl.


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## timbuck (Sep 29, 2016)

Good timing for me to respond here.
We just had a sports oriented Physical Therapist come out to the last 30 minutes of our practice on Tuesday.  I'm no expert, so I'll try to recall here what she said.
There are 3 main types of injury:
1.  Trauma -  Caused by a collision or a twist.
2.  Overuse - Caused by not resting enough, playing too much.
3.  Dings, bruises -  Everyday, normal things that happen when playing sports.
And a 4th -  Growing pains.  These occur when the bones lengthen faster than the muscle.  Usually a bilateral pain and you can't trace it back to something from items 1-3.

Leg injuries are interconnected throughout the entire leg.  A knee injury may be the result of a muscle imbalance between the hips, quads, hamstrings and ankle.  

A sharp pain that increases with movement is something to have looked at. If you ask your player if they feel like they are being stabbed, that's a sharp, shooting pain.  Limping for more than a few minutes after the injury happens should be treated with caution.  Any swelling should be treated with caution and should be looked at.
Dull pain is not as big of a worry. But if it lasts for 10+ days, it's worth taking a look.

At around the age of 11, athletes should start to incorporate some strengthening and stretching into their routine.  Weights are not needed for strength.  Body weight exercises like push ups, squats, lunges are great.  There are a lot of variations of each of these exercises (traditional, side, rear, single leg, etc).  Also, using resistance bands to strengthen hips is recommended.  Proper form is THE MOST IMPORTANT aspect of these types of exercises for young athletes.  Young females tend to buckle their knees when doing squat exercises.  Or when doing a lunge, their front and back leg are in terrible positions.  Make sure to strengthen all interconnected muscle.  As mentioned above, muscle imbalances can be a root cause of many types of injuries.

This series of exercises seems to be the recommendation for prevention of lower extremity injuries for athletes.  Try to have your player do it 3 or more times per week.
http://www.uwhealth.org/sports-medicine/physical-therapy-athletic-training/soccer-education-acl-injury-prevention-exercises/42908
My team does it a lot during pre and early season.  We really should do it with every practice.  (The team is 04 and 05 players -  11 and 12 year old girls.  The first time they did it, they were extremely sore in muscles they had not worked very much).

Proper running form is also very important.  And in soccer, we run forward, backward, sideways, shuffle, change of direction.

Flexibility is often overlooked.  Tight muscles also lead to imbalances or compensating my using other body parts. The physical therapist HIGHLY recommended a foam roller routine every day.  Google "foam roller" workout for ideas for quads, calves, hips, hamstrings.

Proper footwear was also discussed -  She recommended making sure you are in the correct cleat size.  Apparently at the pro levels of soccer, many players wear a shoes 1/2 to a full size smaller.  This is not recommended as it puts added pressure on the tiny bones of the feet.  She recommended walking barefoot whenever you are in a safe area (IE- not glass, rocks, sticks, insects, etc).  Let the feet splay out is good for them to get strong.  This is why slides are a good idea to put on after a soccer activity.

Fatigue can have a big impact on injuries.  Tired minds make bad decisions.  Tired bodies are not positioned properly.  A tired mind and a tired body are a bad combination.  I've personally seen a physical therapist for a lot of lower leg and back issues. I used to do a lot of running.  I really had to work to get my muscles in proper balance.  And I had to consciously keep my form in check if I wanted to run a long distance.  Because you can get away with crappy form for 3-6 miles.   After that, if you have bad form, then it gets worse.  My right knee would dip in and cause me a ton of hip pain.  The knee dipping in was a result of improper foot alignment.

We also asked her where to go first if you think there is an injury - Doctor or Physical Therapist.  If there is trauma, see a doctor for x-rays and diagnosis. If it's just pain from overuse and nothing appears "broken" you could see a PT first or a doctor. A lot of the decision will also come down to how your insurance works.  Some companies require a referral to see a PT.

See if your club can get a PT or sports doctor to come out and talk to your team.  I think it was a good use of 30 minutes.


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## SCS Fan (Sep 29, 2016)

My DD had some problems with her Achilles tendon and some other foot problems between ages 11 – 13 which can be common for athletes at this age as their foot bones are not fully grown.  Related stretching and not going barefoot were critical in resolving this.  Google can usually provide information for dealing with most things that come up.  Don’t underestimate the power of your intuition if you feel she needs some time off.  It’s better to error on the side of caution and sit out when needed than to try to play through an injury.  I believe there can also be some benefit mentally to an injury related break from practice.  I’m always conscious of burn out and wanted to make sure soccer never became a grind and was always fun.


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## Mystery Train (Sep 29, 2016)

I can second SCS Fan on the Achilles/foot problems at that age.   My daughter had that.  In hindsight, more rest at the younger ages would have been better.  So many of us (parents, coaches, players) get caught up in the competition and proving something that kids end up playing through pain because "its a BIG game."  There are no big games at this age.  I had a friend who kept his kid out of State Cup for a fairly minor injury, and the coach was furious.  But his point was, "Who gives a crap about U12 state cup?  I don't want my kid to get in the habit of playing through knee problems."  Hard to argue that.


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## *GOBEARGO* (Sep 29, 2016)

One thing to look out for during the 'growth spurt' years is kids not telling you their boots are too small. This can put major strain on the Achilles as well cause other issues.


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## CopaMundial (Sep 29, 2016)

We've gone through two back fractures (L4 and 5). First was not caught early enough (first doctor missed it) and ended up taking 6 months to recover. 2nd was a trauma injury, but because we were far more knowledgable and more cautious, we decided to do an MRI early. Thus, we caught the stress fracture before it went completely through the pars. So, now, out for only 2 months (still torture). 

What do we know about back fractures now? They are far more common than you think. They most commonly occur in girls from ages 11 to 15 and in boys ages 14 to 18. Basically, in their growth spurt years and especially girls during their hormonal changes. What can you do? Well, a lot! Soccer players are very imbalanced. Super strong on the legs and not equal in the core and upper body. As your girls age, make sure they are doing stability work. Some girls need more than others. This same scenario is also what creates the large number of ACL tears in young girls. They are far too elastic during this growth and hormonal period and stability is key. 

From my experience, if an injury doesn't improve in 2 weeks, seek further advice from an orthopedic doctor or second opinion. Like another poster mentioned, stabbing pain or increase of pain with activity is a major warning sign. Know your kid. If they have a high pain threshold, be careful to make sure they aren't just playing through the pain. And last, but not least, take time to FULLY recover. All too often I see kids come back early and end up more injured than before. Hope this info helps.


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## timbuck (Sep 29, 2016)

I wish that clubs could all get on board with a proper "periodization schedule".
You can have kids participate in soccer year round while trying to reduce injuries if you schedule it right.
The 12 week Fall season should be the main season.  
There should be 4-6 weeks at either end of the season for strength, conditioning and recovery.  You can mix in some light soccer work, but competitive games should be dialed WAY, WAY down during that time.  Futsal is good because it's "supposed" to be non-contact, but it's still sharpening soccer skills.
Think about pro soccer players -  They play 1 game per week. They have a long off-season (usually).
Why do we expect pubescent children to play 80+ games a year without any consequence?
But we have the Fall season from August -November.  Then we have Thanksgiving tournaments.  And December tournaments.  A week of during Christmas.  Then we start ramping up for State Cup and/or Vegas Cup.  At the same time teams are getting ready for the big time of State Cup, we also have tryouts taking place.
Once State Cup is done, then we have the "real" tryout season.  And Spring EGSL, Tournaments and/or friendlies taking place.  These Spring actvities are for kids to fight for spots on a team for the upcoming Fall season.  Then we have summer with 5+ tournament options every weekend.


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## Mystery Train (Sep 30, 2016)

I posted this on the ACL thread, too.  The FIFA 11+ warm up routine has been studied and the results show that following the program can drastically reduce the frequency of injury for female players (30-70%).  I found one link where they achieved similar results with male players.  Pass it on to your kids' coach and see if they know about it.  

Fifa 11+ Program:
http://f-marc.com/11plus/manual/
Narrative review, British Journal of Sports Medicine:
http://bjsm.bmj.com/content/49/9/577.long


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## ESPNANALYST (Sep 30, 2016)

timbuck said:


> I wish that clubs could all get on board with a proper "periodization schedule".
> You can have kids participate in soccer year round while trying to reduce injuries if you schedule it right.
> The 12 week Fall season should be the main season.
> There should be 4-6 weeks at either end of the season for strength, conditioning and recovery.  You can mix in some light soccer work, but competitive games should be dialed WAY, WAY down during that time.  Futsal is good because it's "supposed" to be non-contact, but it's still sharpening soccer skills.
> ...


It's a culture change issue. When we were on a team where the coach liked to take 6 weeks off from April to May and not play Spring the parents went nuts. "Not competitive""girls aren't developing" . 
Parents love leagues and tournaments I have no idea why.
I would be happy if we played Manchester, Dallas and Surf every year. That's it.


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## bababooey (Sep 30, 2016)

timbuck said:


> I wish that clubs could all get on board with a proper "periodization schedule".
> You can have kids participate in soccer year round while trying to reduce injuries if you schedule it right.
> The 12 week Fall season should be the main season.
> There should be 4-6 weeks at either end of the season for strength, conditioning and recovery.  You can mix in some light soccer work, but competitive games should be dialed WAY, WAY down during that time.  Futsal is good because it's "supposed" to be non-contact, but it's still sharpening soccer skills.
> ...


TB:

I agree that our children in club soccer likely play too many games. Keep in mind that the tournament season is money making season for these clubs. I cannot imagine the tournaments going away unless we are willing to double or triple our club fees to cover that lost revenue. Maybe we as parents need to go to our clubs and say that we feel our kids play too much and there needs to be more "dark" periods during the year.

Futsal is awesome and should be more common than it is.

Lastly, pro soccer players routinely play more than once a week. If you look at most of the players in Europe that play for their club team and their country, they are playing nearly year round. That doesn't factor in the training these players have.


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## timbuck (Sep 30, 2016)

*"Lastly, pro soccer players routinely play more than once a week. If you look at most of the players in Europe that play for their club team and their country, they are playing nearly year round. That doesn't factor in the training these players have."*

Yeah, you are probably right.  They do play twice a week once in a while.  But they spend the majority of their time in between games with proper recovery and periodized training. They aren't coming right from 6th period science class to the soccer field while scarfing down a smoothie in the car.  And they certainly aren't playing 4-6 games in a weekend tournament.
From August to May, Premier League and La Liga teams play 38 matches.  That' 4.2 games per month.
If a team also plays in the "Champions League" it runs from June (qualifying ) to May of the following year.
Real Madrid won this past year and played 13 games from September through May.  And additional 1.44 games over 9 months.
I'm sure they played a few more matches, but I don't feel like spending all day on google trying to figure it out.  Let's say they played an additional 10 games.  These are usually friendlies or off-season tournaments where some of the superstars might not play.
These guys are playing for millions in salary.  They may play through a bit of pain and/or do whatever it takes to get on the field.   They aren't middle school girls going through puberty.
That puts them at 61 games.  
I'd bet that most "big club" youth teams between the ages of 9 and 14 are playing more than 61 games in a 12 month period.


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## younothat (Sep 30, 2016)

Overuse and over specialization is the #1 cause of injuries
http://www.amssm.org/overuse-injuries-and-burn-p-138.html?StartPos=
http://www.nflplayerengagement.com/wri/health-safety/articles/sports-specialization-and-overuse-injuries/

When my son was younger he literally would play himself to "death" all the day & night if he could.

He would be nonstop playing a variety of  sports at every moment of time he had.   8:30pm at night and he would be challenging his friends and neighbors to play basketball or whatever until the last person had enough.    He got so competitive that he eventually burned out just about everybody he knew and would ask to go to pickup soccer or basketball because he was always "beating up" friends, neighbors,  and family member and not too many people wanted to play with him anymore locally.

Overuse eventually caught up with him and he was in PT/Rehab about 4 times for different things; heels, knees, hip,etc.  During this time he started to understand that the body and mind needs rest and you must take
time to warm-up, stretch, post and pre-activity all the time and work on core strengthening.   Last two years he has been injury and mostly pain-free but we had a couple years stuggling with "growing pains" until he figured out a regiment that worked short and long term.

I was guilty of not understanding the overuse impact and caught it late but if I had to do it over I would have limited both my kids soccer time more and have them rest more often.

They both played too much some seasons like 80+ games and 11 tournaments kind of too much.  easy to get caught up in the bandwagon when your team is rolling through the tournaments or on hot streaks but eventually this can lead to burn-out which I've seen happen to  several palyers including my DD one season.

Nowadays I really see the benefits of  the approach that the DA or ENCL leagues are taking when # of games a limited to  one a week and when there are tournaments:  max two days of playing in a row or 4 games over a 5 days like surf cup.

The tournament money making machines  can cause kids to play too much: 6 games over 3 days for example, is brutal in the summer and not really good for their health.


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## ESPNANALYST (Sep 30, 2016)

Hate to burst everyone's bubble but futsal isn't exactly easy on the joints


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## younothat (Sep 30, 2016)

ESPNANALYST said:


> Hate to burst everyone's bubble but futsal isn't exactly easy on the joints


Regulation futsal tile flooring offers some minimal cushion but yeah can be stressful on your back in particular, joints, heels. 

The speed of play in futsal is greater vs some of the smaller synthetic pitches,  bit of a trade off: less impact on synthetic vs speed and play and greater touch development for indoor regulation futsal.  Because the pitchs are smaller, games shorter, faster both my kids would rather play futsal on regulation tiles vs synthetics.

Sort of like grass vs artificial turf or some synthetics but with a twist

My son enjoys training on turf a bunch but would rather play games on good grass fields if available even though the game is slower;  90 minutes on turf in the heat full speed is harder on the body in his opinion.


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## espola (Sep 30, 2016)

younothat said:


> Regulation futsal tile flooring offers some minimal cushion but yeah can be stressful on your back in particular, joints, heels.
> 
> The speed of play in futsal is greater vs some of the smaller synthetic pitches,  bit of a trade off: less impact on synthetic vs speed and play and greater touch development for indoor regulation futsal.  Because the pitchs are smaller, games shorter, faster both my kids would rather play futsal on regulation tiles vs synthetics.
> 
> ...


"Regulation futsal tile flooring"?


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## timbuck (Sep 30, 2016)

Futsal games are shorter in length and there is (supposed to be) less contact.


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## younothat (Sep 30, 2016)

espola said:


> "Regulation futsal tile flooring"?


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## espola (Sep 30, 2016)

Where do you get that?  All the futsal I have seen or heard about is played on basketball hardwood courts.


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## younothat (Sep 30, 2016)

espola said:


> Where do you get that?  All the futsal I have seen or heard about is played on basketball hardwood courts.


Many of the bigger indoor places have them if they hold http://www.futsal.com/ tournaments 
http://www.snapsports.com/commercial-futsal-pitch.php is a big supplier but there are other vendors as well,


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