Cheryl Martin (Host): How can you best protect your young athlete? Coming up next, a must listen dialogue for parents and coaches. Orthopedic surgeon Dr. Colin McDonald is here to provide expert insights on youth sports injuries, prevention, trends and more. This is Medical Minds, Conversations with Guthrie Experts, a podcast from the Guthrie Clinic. I'm Cheryl Martin. Thanks for coming on, Dr. McDonald.

Colin M. McDonald, DO: Thanks for having me.

Cheryl Martin (Host): As an orthopedic surgeon, what are the most common youth sports injuries you treat?

Colin M. McDonald, DO: Yeah, so we certainly see a wide variety of various surgical and non-surgical injuries within youth sports. Some of the more common injuries include ACL and meniscal injuries of the knee, labral tears of the shoulder, fractures, as well as overuse injuries, including elbow, UCL injuries, stress fractures, and various tendinopathies.

Unfortunately, youth injury rates are on the rise and also seem to be occurring in younger aged athletes. There are obvious trends within athletes today towards earlier specialization, which seems to be correlated with some of the increase in injury rates.

Host: Any other trends you want to discuss that parents and coaches should be aware of?

Colin M. McDonald, DO: I would say that it's definitely becoming more common that younger and younger athletes are seeing more of the overuse type injuries. Unfortunately, that's becoming, more and more of an issue.

Host: And why is that?

Colin M. McDonald, DO: Well, I do think that early sports specialization is becoming more and more pushed in the sporting community.

So I do feel like that, certainly is pushing the envelope in the direction of more year round sports, which seems to be pushing that trend towards more of the overuse type injury patterns.

Host: Now, from an orthopedic perspective, how can parents and coaches support focused athletic development while minimizing injury risks?

Colin M. McDonald, DO: So, in terms of things that can be done from a parent and coaching standpoint, you know, I do feel like a lot of the things that we start to talk about are more of the prevention programs. So, some of the more common prevention programs, you start talking about ACL and UCL type prevention programs. So, all of those are things that we're doing more and more commonly to try to prevent further injuries.

Host: How does sports performance training fit into this?

Colin M. McDonald, DO: There are a couple of different factors that weigh into preventing injuries within athletes. There's both the strength training portion along with the neuromuscular and proprioceptive training. So all of those things are important features of any type of prevention program.

So, within our network, we have both athletic trainers and strength and conditioning coaches at some of the schools that we participate with. And I think that it's very important to strengthen some of the muscle groups surrounding some of the higher areas of overuse and general sporting injuries, like around the knee and the elbow. A lot of times just having someone that is well versed in some of the strength training avenues to be able to strengthen and to work to prevent some of these injuries.

Host: So, is this something that a student or the parents could do on their own or do they need to hire someone to assist?

Colin M. McDonald, DO: Some of that depends on location and where they're at in relation to some of the schools. So we have within many of the surrounding schools, we have Lourdes Employed Trainers. There's also throughout some of the various Guthrie and other local health systems. There's athletic trainers and strength and conditioning coaches that are within some of those school districts. That's one of the easiest routes through the local schools. Obviously, there are other routes. We do have our Guthrie Lourdes Health and Fitness Center, which also has multiple strength and conditioning coaches and physical therapists in that area that also can be utilized for this. Obviously, there are various other private institutions that also offer similar types of opportunities. So those are a lot of the best ways to gain access to some of these prevention programs.

Obviously, some of them are also available online. But sometimes with this type of thing, it's helpful to have someone coaching you and working you through the strengthening portion.

Host: Doctor, what are the key concerns with overuse in young athletes and how can we reduce these risks?

Colin M. McDonald, DO: So overuse injuries are certainly becoming more common. To reduce the risk, it remains crucial that athletes are cross training, and taking time off of a particular sport. Prevention programs prior to season initiation are also very helpful and beneficial in preventing some of these in-season injuries.

Obviously, we just spoke about athletic trainers and certified strength and conditioning coaches. They're a really helpful resource for prevention. In particular, ACL and UCL programs have been shown with multiple studies to be effective in reducing injury rates for these particular injury.

This really helps athletes to get prepared to go into their season and perform at the highest level. We do have an ACL prevention program at the Lourdes Health and Fitness Center. I think another thing that's important to prevent overuse injuries is that athletes and families and parents are their own advocate. So a lot of times the pressures of youth sports and travel sports today are such that, you're being pulled in many directions at the same time. So I think it's important, that they are just proactive and advocating for their own health. For instance, baseball is an easy comparison sport.

It's well known that innings limits and pitch counts are beneficial in preventing overuse injuries. However, if you're playing for your own school and for travel teams, sometimes those coaches are not communicating amongst each other. And that's where you can sometimes get into trouble with overuse injuries because the innings limits and pitch counts are not being communicated amongst the two. So I think being your own advocate is just as important in the modern arena of sport to be able to prevent some of these overuse injuries.

Cheryl Martin (Host): Let's talk a little bit about surgical considerations for return to play. So when surgery is needed, how can parents, coaches, and sports medicine work together to support a young athlete's optimal recovery and return to sport?

Colin M. McDonald, DO: So return to play decision following surgery is kind of a combination of many factors, both mental, physical, psychological. So personally, I lean pretty heavily upon a combination of support staff, including the local physical therapists, athletic trainers, as well as my own clinical judgment and performance testing.

So oftentimes a commitment to rehab either through their physical therapists or at times their athletic trainers can ensure an appropriate progression through the rehabilitation and eventually meeting the goals to help with their return to sport. So there are also multiple opportunities in the area to kind of bridge that gap between when insurance is no longer covering physical therapy and when return to sport has been achieved. That's what we call bridge programs. So there are multiple of those in the area through various therapy gyms that, can close the gap between those times.

Host: What do you see as the psychological challenges young athletes face post injury or surgery?

Colin M. McDonald, DO: Yeah. Oftentimes injuries can be traumatic, not only physically, but also can take a toll mentally on athletes. It's important when athletes are reaching the point where they're physically ready to return to sport, they're also mentally prepared to return to sport. So they can frequently experience some apprehension as well as fear for returning to either contact or collision sports, as well as full speed activities following major injury.

And that's why it's just really important to have support staff and resources available, both from your coaches, athletic trainers, strength and conditioning staff, physicians as well as family members to really help with this transition back to sport.

Host: How can they best help parents and coaches?

Colin M. McDonald, DO: Some of it is just open lines of communication. So, obviously talking to your surgeon, talking to your therapist, your support staff, just to have an idea of where the athlete or patient is at within their recovery. And that also helps to keep open that line of if there are particular things that they're concerned about and that kind of allows for reassurance from multiple different avenues, if it's something that doesn't need to be a concern.

Host: Doctor, any other specific recommendations or resources focused on youth athlete injury prevention?

Colin M. McDonald, DO: My main recommendation for injury prevention is just to know the resources available. So, things that are available, just knowing your school supported athletic trainers, your school supported strength and conditioning coaches, as well as what various therapy Gyms and Sports Performance Institutes are around your area to be able to take advantage of the knowledge and resources, so.

Like we talked about in particular, it's worthwhile to participate in ACL or Thrower's Injury Prevention programs, depending on what sport you're going to be participating in. And really, it's also beneficial if the coaches, whether it be through the school or even through travel organizations, are also taking an interest in being involved in understanding some of the important things to be training to allow for safer return to sport at the beginning of seasons.

In particular, preseason times is when it's really important. So, that's something where obviously reaching out to any of those resources available, whether it be local strength and conditioning coaches, athletic trainers, or even our department, can definitely be beneficial to help with keeping athletes prepared for the season, ready to perform their best and also to prevent injury within season.

Host: Dr. Colin McDonald, thanks for sharing your expertise on sports injuries for young athletes. Good information.

Colin M. McDonald, DO: Thank you very much. Thanks for having me.

Host: To learn more, visit Guthrie.org. If you found this podcast helpful, please share it on your social media and be sure and check out the entire podcast library for other topics of interest to you. This is Medical Minds, Conversations with Guthrie Experts, a podcast from the Guthrie Clinic. Thanks for listening.