Despite spring seasons that were cut short and summer workouts that inevitably looked different than in years past, Cincinnati’s student athletes are quickly preparing to get back on the field this fall.

But the upcoming season has some orthopedic doctors worried that students will be underprepared for the grueling demands of the fall season. Some fear a vicious cycle in which a lack of conditioning will lead to higher rates of injuries that could cut students’ seasons short—a cruel irony on the heels of the spring season’s COVID-19 cancellations.

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Orthopedic Concerns

When COVID-19 forced Ohio’s schools to shut their doors for the second half of the spring, high school athletic facilities followed suit, with the OHSAA announcing an official end to the spring season on April 20.

But the season’s cancellation didn’t just affect spring sports. The late spring, early summer period is also a critical time of preparation for student athletes hoping to compete in the fall.

“COVID has disrupted many people’s training schedules, and has disrupted a lot of the pre-sport conditioning that goes into injury prevention once they return to their sport,” says Marc Galloway, M.D., medical director of Mercy Health’s sports medicine program and head team physician for the Cincinnati Bengals.

By summer, Galloway says, high school athletes would have undergone months of team-based conditioning programs to prepare for the upcoming season. Once August rolls around, they would have already adjusted to the oppressive heat of a Cincinnati summer. They also would have had adequate time to focus on strength training, which correlates with lower rates of injury.

“What I worry about is that some [athletes] may not have had access to programs over the summer that would have put them in a position to avoid overuse injuries once they return,” Galloway says.

Student athlete injuries usually fall into one of two categories: acute and overuse. Timothy Kremchek, M.D., has seen the whole gamut, and not only during his time as team medical director for the Cincinnati Reds. He also works with student athletes at several high schools and colleges.

This year, Kremchek has concerns about what the lack of time to prepare will mean for high school athletes. Even players who start off strong at the beginning of the season risk running into injuries later on, as underprepared muscles fatigue and athletes push themselves past their limits.

“Now, many of them have not had that structured program,” Kremchek says. “So it’s a concern that a lot of them, who are not going to be ready, come back and hit the ground at 100 miles an hour. There’s a higher likelihood for injury and there’s also a higher likelihood for early fatigue.”

Today’s Student Athlete

Some injuries simply can’t be prevented. There’s not much student athletes can do when it comes to an unexpected collision on the football field or a misstep on the basketball court that leads to a torn ACL.

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But the injuries that can sideline players—particularly young athletes—can often be traced back to overuse. Today’s student athletes play under new pressures the previous generations simply didn’t experience, explains Robert Burger, M.D., cofounder of Beacon Orthopaedics and head team physician for the Xavier Musketeers.

“These kids are preparing for their sports year-round,” Burger says. “In other words, if they’re a football player, they’re conditioning throughout the summer, they’re working out in the spring, they’ve been in summer programs. If they’re a basketball player or a volleyball player, they’re playing on club teams. So the kids have not been doing that through summer.”

By May, most high school and collegiate athletes have already undergone annual orthopedic exams that allow doctors to comprehensively screen each athlete to catch problems before they manifest on the field.

But because of COVID-19, there were scarcely any routine physicals at local high schools this spring. Now, Burger is concerned about the student athletes who may be about to take the field with entirely preventable injuries. Without the safety net of a spring physical, he believes some students may have fallen through the cracks.

“These kids really never get out of shape because they’re participating in sports year-round,” Burger says. “So now we’ve lost a little bit of that.”

Preparing for the Fall

Months of gym and facility closures mean that, from a conditioning standpoint, many student athletes have largely been on their own. Most players have lost the advantage of working with in-person trainers and coaches at school.

Luckily, there are steps student athletes can take to avoid injuries on the field as the fall season begins. If your team has a timetable to work with before getting back into a sport, work with a coach or trainer to start conditioning now. An early start can help stave off fatigue, one of the most significant factors when it comes to overuse injuries that can sideline athletes.

Above all, local orthopedic experts encourage student athletes to exercise a healthy sense of caution when returning to a sport. Jumping back onto the field or the court too quickly could put athletes back on the sideline or on crutches before the season even begins.

“One of the things that made me so sad this year is that all of our students lost their spring season. A couple of them lost their summer season. So I don’t want to see them come back in the fall and get hurt and miss even more,” Kremchek says. “The time they have to play is so short anyway.”

Local orthopedic doctors offer their advice for getting back into the game after a season of COVID-19 cancellations. Here are four steps student athletes can take to prevent injuries this fall:

Photograph by Lev Dolgachov/stock.adobe.com

Conditioning

With traditional conditioning looking different this summer, it may be up to student athletes to take workouts into their own hands. Robert Burger, M.D., of Beacon Orthopaedics, says volleyball and basketball players, for instance, should focus on honing their jump training to avoid ACL injuries on the court. Not sure where to start? Contact your local sports medicine practitioners for sport-specific advice.

Beat the Heat

“Heat illness can be a very serious problem,” says Marc Galloway, M.D., of Mercy Health. While playing and practicing in the heat is all but unavoidable, student athletes can soften the blow by staying hydrated, Galloway says. Drink plenty of fluids, including water and electrolyte drinks, before, during, and after games and practice to fend off heat-related illnesses.

Stretch and Warm Up

When athletes return to the game after being away for an extended period of time, the time spent stretching and warming up is especially important. But young athletes often don’t understand the importance of doing both, says Timothy Kremchek, M.D., of Beacon Orthopaedics. Sometimes, they simply don’t differentiate between the two. While stretching involves working the muscles adequately—particularly those you’re going to be using during a sport—warm-ups involve activities that increase the heart rate, like jogging.

Prepare for a new environment

This fall, student athletes are going to be competing in an environment that’s going to look different than it has in past years. Galloway, who also serves on the sports medicine committee of the OHSAA, says new restrictions will affect everything from sharing water bottles to distancing on the sidelines. Check with the OHSAA for specific rules and regulations that will impact the upcoming season.