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Helping your athlete kids recover from injury the right way

Early this summer, during her first week of preseason high school basketball practice, my oldest daughter broke the middle finger on her left hand. The fracture marked the end of seven sports-injury-free months for our family, a record. As a mom, I took comfort in knowing that there was nothing I could have done to prevent my kid from jamming her finger on a rebound, other than forbidding her to play. That felt like progress.

Didi, 15, along with her sister, 13, and brother, 14, have been involved in organized sports since kindergarten and racked up scores of injuries along the way. Black eyes and pinched nerves. Sprained ankles and pulled groins. Bruised bones and swollen joints. A dislocated shoulder. A torn eyelid. A torn ACL. At least one diagnosed concussion, though I suspect others were missed. For my husband and me, parenting three young athletes has served as a literal crash course in injury management and recovery.

According to a 2014 ESPN sports poll, more than 87 percent percent of parents worry about their child getting hurt while playing sports. My husband and I aren't sporty people. My three seasons of youth softball passed injury-free, probably because I spent 75 percent of my time on the bench. John's short Little League career proved equally safe and lackluster. We adopted our children, and while we've done our best to nurture their inherent physical talents, we didn't have personal experience to draw upon. That explains why, in the beginning, I didn't even know enough about the risks of youth sports to be nervous. I anticipated nothing more than the normal bumps and scrapes of an active childhood.

My perception started to shift when Didi was about 11 and she got hit in the face with the ball at soccer practice. The trainer (a former Division I player whom I later learned wasn't certified in sports medicine) didn't do much more than tell my daughter to stop crying. The next day Didi had two black eyes.

We moved to a new city not long after that, and our kids joined a well-organized soccer club. But after only a couple of months with her team, Didi dislocated her shoulder during her physical education class. She'd just turned 12, and the injury kept her off the pitch for five months. She attended physical therapy as the ER doctor advised, and I hired an older soccer player to give her some additional workouts before she returned to game play. But in hindsight, I recognize that I didn't take the steps needed to help her rebuild her overall fitness. When Didi was ready to begin practice again, she was rusty, and her coach wasn't happy.

I recently spoke with Craig Bennett, director of sports medicine at the University of Puget Sound in Tacoma, Washington, and president of the Washington Athletic Trainers Association. He told me that one difference between youth and collegiate athletics is that serious college programs offer players a dedicated, knowledgeable sports medicine staff. In youth sports, it's the parents' job to identify qualified health care providers with expertise in both sports injuries and child development. You need to somehow build your own treatment team.

"You need a health care professional who understands that there must be a plan for returning to play," Bennett says. "If you heal and return to play without restrengthening, you are at risk for reinjury."

And that is exactly what happened. At the end of that painful season, Didi's club moved her to the B team for her age group. She handled the demotion with grace, played hard, and within a couple of months was invited to start training with the A team again. Then, during her first practice with her old teammates, she tore an ACL fighting for the ball. She hadn't yet turned 13.

I can't describe the anguish I felt watching my daughter suffer another injury, especially one so serious. This time, though, I networked to find the best doctor, a surgeon who'd repaired ACLs for NFL players and teenage girls. His plan for Didi's return to play involved physical therapy, personal training, and a conservative nine months of recovery.

Didi brought maturity and positivity to the struggle, emerging stronger than before. The physical therapy and athletic training addressed not only her post-surgical weakness, but also the individual quirks of her physiology that had predisposed her to injury, such as overly flexible joints. Today I don't worry about her tearing an ACL again or suffering another shoulder injury. Accidents will continue to happen, just like this summer's broken finger, but at least I have the peace of mind that comes from having educated myself and done all I can to protect her.

I've learned to accept that coaches aren't perfect, even the good ones. Sometimes they aren't qualified to assess a child's injury. And of course, doctors aren't perfect either. Dealing with youth sports injuries is complicated, and an otherwise excellent pediatrician likely will have no training in sports medicine at all.

"More specialized care immediately after a sports injury can help prevent lifelong problems," says Dr. Steven Anderson, founder of Seattle Pediatric Sports Medicine, an organization of medical professionals dedicated to education, collaboration and research in pediatric sports medicine. But "you will never have enough specialists." He and his colleagues are working to grow the organization's website as an educational resource for coaches, parents and doctors who might not otherwise have access to the latest information.

I feel lucky to have Dr. Anderson on my family's "treatment team." The certified athletic trainer who helped Didi after surgery now trains all three of my kids to help stave off injury. The kids grumble a little about the extra work, but just yesterday the trainer warned my son and me to monitor his foot for a possible stress fracture. I see the cost of her sessions as an investment.

People ask me why I don't pull my kids out of sports after all they've been through, but the answer is simple: They are athletes. To ask them not to compete would be like asking them to change who they are. So, I'm trying my best to be the mother they need, and I'm learning that a big part of that is teaching them how to heal.

Source: ESPN


MHSAA releases study of head injuries in Michigan schools

The Michigan High School Athletic Association's study of head-injury reports from the state's member schools during the 2015-16 year unveiled some surprising statistics. Executive director Jack Roberts released results of the MHSAA's first head-injury survey of more than 750 high schools. It received data from nearly every school.

Schools were required to designate if potential concussions occurred during competition or practice and at which level -- varsity, junior varsity or freshman, and the survey includes baseline testing of athletes in football and other sports to help with concussion diagnosis.

Michigan schools reported 4,452 head injuries in boys and girls sports, or 5.9 per school. Contact sports had the most head injuries. Ranking first was 11-player football with 49 head injuries per 1,000 participants, followed by ice hockey with 38 and 8-player football with 34. Girls soccer had 30 injuries per 1,000 participants, and girls basketball ranked fifth with 29 injuries per 1,000.

"Soccer doesn't surprise me at all," said Betty Wroubel, Pontiac Notre Dame athletic director, girls volleyball and softball coach. "Basketball did. A lot of those kids . . . we have a lot more kids hitting the ground than we ever had in basketball for some reason.

"We're just not as strong in our neck, and our head isn't as strong to withstand jarring which is sometimes causing some of those concussions. . . . It's not amazing to me, but it's an educational tool we can use now to help us improve our programs even better."

A startling disparity in the number of reported head injuries suffered by girls and boys playing the same sports was the most significant finding revealed by the report.

Boys soccer players reported only 18 head injuries per 1,000 participants. Boys basketball players reported 11. Softball players reported 11 head injuries per 1,000 participants, while baseball players reported four.

Dr. Jeffery Kutcher, one of the country's leading experts in sports neurology and a board-certified neurologist, said there is some validity to boys' necks being stronger than girls at that age.

"That trend of seeing a higher concussion rate in girls or young women playing sports as compared to boys in the same sports, we see that actually in data across the country," Kutcher said. "We do think there are multiple reasons for that. One of them is likely to be neck strength. There may be others that have to do with style of play and nature of the game and those types of issues."

Health and safety advocates fear concussions often go undetected because of inconsistent protocols at districts unable to spend money for detection. It's often on players to self-report concussions, or on coaches, who have many responsibilities and sometimes little training, to recognize symptoms.

Brian Gordon, athletic director at Novi, was concerned that some of the numbers might be inaccurate because boys might hide injuries to stay on the field.

"I think it's the first year where the MHSAA has required all those head-injury reports, where they started to collect the data," Gordon said. "I think some schools did a really nice job of reporting that data, whereas other schools did not. It does require that we have to do that.

"I think where you see reports of a head injury doesn't mean that guy was concussed. For instance, we had a head-injury report for soccer last week. The kid got stitches. There was no concussion."

Total participation in MHSAA sports for 2015-16 was 284,227 -- with students counted once for each sport he or she played -- and only 1.6% of participants experienced a head injury. Boys experienced 3,003, or 67% of those injuries, although boys participation in sports, especially contact sports, was higher than girls.

More than half of head injuries (54%) were experienced by varsity athletes. A total of 2,973, or 67%, came in competition as opposed to practice. More than half took place during either the middle of practice or middle of competition as opposed to the start or end.

Nearly 56% of injuries were a result of person-to-person contact. The largest percentage of athletes -- 28% -- returned to activity after six to 10 days, while 20% of those who suffered head injuries returned after 11-15 days of rest, according to the report.

"As far as the physical contact of football, I still think we have to continue to teach kids and make sure that they're aware of all the rules and regulations and how we're supposed to tackle and not use the face mask or helmet," said Greg Carter, Oak Park athletic director and football coach.

Reporting for the 2016-17 school year is underway, and Roberts hopes universities, health care systems and the National Federation of State High School Associations will help analyze the data from last year and this year.

Source: USA Today


Mizzou softball pitchers' head injuries put spotlight on safety, facemasks

A terrified Tori Finucane, temporarily deaf and blind, crumpled to the dirt in the pitching circle during an NCAA super regional softball game last May.

She can't remember throwing the pitch, the resulting line drive off the bat of UCLA freshman Kylee Perez, "and probably like 20 seconds after." Nearly a year later, Finucane still hasn't watched a replay, but the scene remains unforgettable for those who did.

Finucane ducked as she raised her glove in self-defense, but standing fewer than 40 feet from Perez's bat, there wasn't enough time to avoid the bright-yellow 12-inch circumference, 6 1/2 -ounce ball. After the ball struck near her left temple, Finucane helplessly waved a shaking right hand in the direction of the Tigers' dugout as she covered her bleeding nose with her other hand, the left side of her head throbbing from a hairline sinus fracture.

"I just ran into the infield," center fielder Taylor Gadbois said. "I was in shock. I think a lot of people were."

The ball missed Finucane's left temple by an inch; doctors say a direct hit might have been fatal.

"The first thing I thought was, 'I hope this doesn't kill her,'" Mizzou coach Ehren Earleywine said. "When it hit her, the sound was just chilling. It was so solid."

It was also a sobering reminder of softball's inherent danger and begged the question why equipment that can protect pitchers' and other defensive players' faces from hard-hit balls isn't required.

Even at a time when there's more awareness about head-injury risks, especially in football and soccer, the NCAA has yet to mandate that pitchers, or other defensive players, wear protective headgear in softball. One of the reasons is that there isn't a national standard on what the protective gear should entail.

But even without a requirement, Finucane is part of a growing trend of softball players, particularly pitchers, who are opting for safety over style and convention.

Growing up, Finucane never considered wearing a defensive facemask -- "It wasn't the norm, and I didn't think about it," she said -- but now she never takes the field without one.

Missouri sophomore Paige Lowary, who replaced Finucane after Finucane was injured against UCLA, says her mother for three years tried to get her to wear a defensive facemask, which is similar to a catcher's mask without the helmet.

"I remember telling her," Lowary recalled, "I'm not wearing a mask unless I get hit in the face."

Lowary now wishes she'd heeded her mom's advice sooner.

On Feb. 27, ESPN's Holly Rowe interviewed Lowary for a story about Finucane's injury. A few hours later, Lowary pitched against Oregon during the Mary Nutter Classic in Cathedral City, Calif.

The Tigers were up 7-0 in the fourth inning when Nikki Udria slashed a line drive that hit Lowary above the corner of her left eye.

"The only thing I really remember from it is blood running down my face and down my neck," said Lowary, who now wears a mask when pitching.

Before last year, Earleywine didn't think defensive masks were necessary, but now he would support a rule to require them.

"I was old-school before Tori got hit," he said. "Now, Paige too, it just makes sense really, especially when you put it in the context of, if it was your daughter."

The NCAA discussed mandating defensive facemasks, especially for pitchers, a few weeks after Finucane's injury, but no action was taken at a June 2015 rules meeting.

"We didn't feel there was adequate data or information really to warrant requirement for defensive players," NCAA softball secretary rules editor Vickie Van Kleeck said. "The softball rules committee requested additional data be collected."

The committee passed a rule requiring batters to wear helmets with a facemask -- a decision in line with organizations like the American Softball Association -- but NCAA membership rejected it, Van Kleeck said.

Defensive facemasks are an even tougher sell, especially for pitchers who didn't grow up wearing them. They have never been commonplace in the sport, and there's a stigma that players who wear them are scared of the ball.

"Our generation maybe just thinks it's a weakness type thing," Lowary said. "In my head, I just thought it was more intimidating, I guess, if I didn't wear one."

The aesthetics of facemasks are another issue for some players, while some others find the equipment ill-fitting or uncomfortable.

"It was especially tough for me if it was hot or humid, because it would get slick and slide around," Finucane said.

Slowly, attitudes in the softball community toward defensive headgear are shifting.

"I see it changing and, I want to say, for the better," Belton High coach Jeff Hulse said. "I see more and more kids having face protection and skull and brain protection. I think it's a really positive thing. They're being proactive and avoiding the risk."

Hulse, who guided Olathe East to seven state championships and 14 regional titles in 16 seasons before moving to Belton last fall, spent several years on the National Federation of High Schools' Softball Rules Committee.

He said defensive facemasks have been a topic of conversation for several years and eventually he believes they will be required equipment.

"There's a lot of research and numbers about concussions and these types of injuries," Hulse said. "I see something like that coming down the road. I really do, but it has to be supported by data to give it validation."

Many kids today aren't waiting. The entire infield on Hulse's Pirates team last fall wore defensive facemasks, a first in his three decades of coaching.

Belton junior ace Madison Hunsaker started wearing a defensive facemask when she was 10 years old after seeing a pitcher get hit in the face by a batted ball during a tournament in Olathe.

"She was laying there for a long time," she said, "and I just didn't want that to happen to me."

Hunsaker has never regretted the decision, which was reinforced last spring watching the Mizzou-UCLA game.

"I was watching that game when Tori got hit in the face," Hunsaker said. "They kept playing it over and over again, and it was just a scary thing to see. . . . The reaction time between a pitch and it being hit back is so quick. I'm glad to see more people wearing the masks."

For many years, Hunsaker was the only player on her team who used a defensive mask.

"When I was younger, people would say, 'Are you sure you want to wear that? Most people don't,'" Hunsaker said. "I understand that people might say that a person who wears a mask is soft or scared of the ball . . . but I went against that and now it's a natural habit."

Hunsaker's teammate with the Pirates, Amelie Hall, never wanted to wear a facemask, but her mother, Stephanie, intervened a year ago when she switched positions.

"My mom was like, 'If you're going to start playing third base, you need to start wearing a mask,'" Hall said. "Basically, it was start wearing a mask or I was going to be grounded."

Similar to Finucane and Lowary, Hall's opinion on the protective gear has changed.

"I was always told that my glove is my best friend and it was supposed to protect me," Hall said, "but now I'm happy my mom made me wear the mask. I had a couple hits last year that I caught, but, if I didn't catch them, they would've hit me in the face and it could've injured me very badly."

As encouraging as the trend is, some question remains if the new generation of defensive facemasks go far enough.

The National Operating Committee on Standards for Athletic Equipment drafted safety specifications for defensive headgear in baseball and softball during the last few years, but it has declined to certify a facemask-only device.

"We couldn't, in ethical good conscience, make a standard for that when we didn't have confidence that alone would protect against the kind of injuries that are going to be seen . . ." executive director Mike Oliver said. "To withstand a straight-on hit, it needs to be something more substantial."

The only way a mask alone would be sufficient, according to NOCSAE's guidelines, is if it was heavily padded like a catcher's mask, but field players aren't likely to use such equipment, Oliver said.

Being struck in the face by a batted ball is a rare event in softball and baseball, but the data on such injuries also proved problematic for another reason.

"The injury epidemiology indicates the risk of getting hit in the face with a batted ball is the same as getting hit in the head by a batted ball," Oliver said. "We didn't feel confident that we could draft a standard for a facemask alone, knowing there was also a substantial risk of head injury in that circumstance. . . . You could have a helmet by itself with no face protection or a helmet with a facemask, but you can't have just a facemask and meet our standard."

Currently, several companies manufacture defensive facemasks, but none meet the comprehensive specifications for defensive headgear developed by NOCSAE, which is based in Overland Park.

Oliver believes facemask manufacturers don't see a market for defensive headgear that includes a shell that encompasses the entire head, even if it's lightweight, akin to a bicycle helmet.

The lack of equipment that meets safety certifications also presents a hurdle for the NCAA in making defensive headgear mandatory, Van Kleeck said.

The net result is that safety, for now, remains an individual choice.

"There's nothing that prevents a player from wearing a facemask right now," Van Kleeck said. "The rules committee feels that if a player feels more comfortable wearing one of the defensive facemasks to play an infield position that they are welcome to do so."

Unfortunately, players don't always make prudent choices.

After Lowary was hit by a comebacker against Oregon, she begged Earleywine to put her back into the game, a request at which he understandably balked.

"I was like, 'Go to the hospital or do something,' but the trainer came to me and said she had no concussion symptoms, so if you want her to pitch she can pitch," Earleywine said. "I looked at her and said, 'Do you really want to pitch?' She said, 'Yeah, I'm fine.'"

Lowary had witnessed firsthand the mental anguish Finucane went through trying to get back in the pitching circle and wanted to get out there again as soon as possible.

"My eye wasn't swollen shut yet, and I didn't feel lightheaded," Lowary said. "I actually felt pretty good still. No one else was warming up, and I was pitching a really good game. I didn't feel like it was affecting me very much. Even when I threw my warm-up pitches, I felt fine, but, when that first batter stepped in there, I got scared instantly."

After reflection, Earleywine said he wishes he hadn't let her re-enter the game.

Finucane had trouble sleeping for several weeks after she was struck in the head last May and still experiences "constant and annoying" black floaters in her peripheral vision, which gets worse in bright sunlight or when looking at bright white monitors during class.

The spot where Finucane was hit remains tender nearly a year later and her jaw occasionally cracks and clicks. She also experiences discomfort in the damaged sinus cavity on team flights because of altitude and pressure changes.

Still, the physical recovery, even with lingering side effects, wasn't the hardest part for Finucane.

"The hardest thing to come back from was the fear," she said. "I was scared out there in the circle. I couldn't help but think about it."

Finucane, who said she never considered retiring, worked with a sports psychologist and threw a lot of bullpens trying to regain her comfort.

Her only hope now is that younger players will learn from her experience rather than experience it themselves.

"If it could happen to anybody, I'm glad it happened to me, I guess, because I could come through it," Finucane said. "I'm scared for the girl that maybe can't. Hopefully, now they can see that wearing a mask isn't so bad. It's better than getting hit in the head and having a scarier moment happen."

Source: Kansas City Star


Cardinals name Maren Viland new softball coach

When Tom Langfeldt stepped down as the Bethlehem Academy softball coach last June, a popular name among those close to the program thought to be a top candidate was Maren Viland. Roughly 100 days later, first instinct was proven correct.

Bethlehem Academy announced Tuesday that Viland would be taking over as the head softball coach. She has two daughters at BA, Grace, who's the Cardinals' catcher and a junior, and Maggie, who's a sophomore and runs cross country and track.

"I always thought over the last few years that if the opportunity came up, I would take a shot at it," said Viland. "When the news did come out, I hesitated a little bit for a couple of reasons. One, Grace is on the team and I've coached her a lot over the years. I backed away a little bit last year and I thought our relationship grew by not having that coach-daughter relationship.

"Two, I was a little worried with Maggie as a sophomore and we have a 10-year-old. So I backed away, but then got more encouragement over the summer and as I thought about it more, I thought I could do some good things and take things to another level. I reached out to Ed [Friesen, the athletic director] and he was gracious enough to let me apply."

Viland comes with a wealth of experience as she played softball collegiately at St. Olaf --where she was a MIAC all-conference performer -- and she's spent the last six years as part of the Faribault Fastpitch Association where she's been involved as a coach and board officer.

"I think the things we looked at or liked that she's got a passion for the game," said Friesen. "[She has] an enthusiasm for the game. She's got a nice perspective as far as wanting each kid to get better and improve, just a very good sense of understanding what's important. Those were the things that jumped out during the course of the interview."

Viland has some experience coaching some of the players she'll be coaching with BA during the summer as a few played with the Fury fastpitch team that went to the national tournament. Her experience around that team has helped her develop a lot of relationships and Friesen said that Viland's ability to build the program was something that appealed to them.

That was another aspect that we liked, she's got connections to the Faribault fastpitch association as an opportunity to build on those relationships which can help boost our program," said Friesen. "That can help get elementary kids playing. In the years that I've been the AD, we have two teams; a varsity and a B-squad or a JV team. We're not there like we are with the baseball program. We're hoping that with some of those relationships with Faribault Fastpitch, that can help grow the interest and help us field a bigger program."

In the short-term, Viland inherits a team that could be in for a very strong season. The Cardinals won 15 games and were a game away from playing in the section finals a year ago and return most of their core including top players like Shelby Meyer, Grace Viland and Tess Glenzinski. BA didn't graduate any seniors and returns eight starters.

That was part of the appeal for Viland but what really pushed her to go for the job was the support and encouragement she'd gotten from people around Faribault and the program.

"I had parents of girls that I'd coached before that really pushed me and I think that helped a lot," said Viland. "My husband too, he just kept saying you should do it. The natural worry is about having support and to know you already have that and people believe in, it's really neat. I'm not going to be perfect. I'm not worried about what the reaction will be because my best intentions are for the players."

Friesen had Viland as a main target long before the official decision was made too. When Langfeldt stepped down in June, Viland's name came up as a possible fit.

"She was one of those individuals we were aware of," said Friesen. "Having a daughter in the program and knowing her background as someone who played and has been involved in the game for a while, we knew she could be an option for us as far as filling the position."

It'll be a while still before softball is really on the mind of most, but when that time does come, the Cardinals will go into the season with high expectations and a lot of talent. A lot of the faces will be the same from a season ago, but there will be some subtle differences.

"I'm big on everybody being engaged," said Viland. "It's an hour-and-a-half game so I want a lot of chatter and a lot of hustle. I think coach Langfeldt was really aggressive stealing bases and I'd like to see more of that too. We have depth with young girls coming up and I think we'll have opportunities to substitute and use that against our opponents. I try to focus on effort and attitude. Those are the things I want people to see when they watch BA play."