Avoiding Double Trouble

Fall Sports and the Dreaded "Double Sessions"

by

D. Scott Marr, M.D.

 
Among high school athletes participating in fall sports like soccer, football, and field hockey, the month of August often marks the start of dreaded "double sessions."  These multi-session per day practices are prescribed as a means of accelerating an athlete's sports-specific fitness in advance of September's competitive season. Unfortunately, if the student athlete is not prepared for the sudden increase in activity, there is also an increased risk of injury.

Common injuries like sprained ankles, kneecap pain, shin splints, stress fractures, muscle pulls and overuse tendon injuries can sometimes be avoided with proper preparation and planning. Identifying pre-existing conditions and the appropriate rehabilitation of prior injuries can help avoid a cycle of repetitive injury. Parents can help by encouraging their children to plan ahead and to maintain some level of exercise and sport-specific skill training during summer vacation. By incorporating sport-specific activities in your children's weekly routine and by understanding the important principles behind progressive exercise load, hydration, nutrition and recovery, student athletes will be better prepared for the fall season and the often difficult practice sessions that precede it. 

Injury Prevention

Double sessions usually present a dramatic increase in exercise volume and intensity to a young high school athlete. An athlete may go from a few one-hour games per week and a lot of summer "couch time" to twice a day, two to three hour sessions with increased stress on muscles, tendons, bones, joints and the cardiovascular system. Overload and fatigue may lead to increased vulnerability to injury.

The principles of progressive exercise load and sport specific training is critical in minimizing the likelihood of overload/overuse type injuries. Athletes are encouraged to participate in a progressive strength program over time in order to build strength in areas that are most susceptible to injury based on sport-specific requirements. For example, a soccer player has increased risk of hamstring injury and thus should incorporate hamstring strengthening into their routine. A football player will be required to perform explosive movement off the line of scrimmage and therefore sprint and speed work should be included in their training routine.

Start slow, then build the amount of time spent doing these types of activities each week leading up to double sessions. A few sessions with a strength coach or athletic trainer can also help get you started in the right direction.

Since most competitive high school sports are aerobically intensive, student athletes are also encouraged to develop and maintain a strong aerobic base. Simple summertime activities like running, swimming and bike riding on a regular basis will help your child develop the necessary aerobic base to build upon during the upcoming season.

Hydration and Nutrition

Hydration and nutrition are often overlooked as important parts of sports preparation and participation. August is often our warmest month with daytime temperatures routinely in the 80s. High sweat loss during these hot summer days can lead to dehydration, heat illness, muscle fatigue and decreased reaction time. Accordingly, student athletes are encouraged to develop appropriate hydration habits. Athletes should drink plenty of fluids each night before going to bed and in the morning prior to practice. During practice, athletes should try to consume between 24 and 30 ounces of fluid for each hour of exercise. Higher amounts of fluid may be required as the temperature begins to rise. Additionally, because the body consumes carbohydrates and calls upon electrolytes such as sodium, potassium and calcium to fuel muscles for exercise, sports drinks are the better choice of fluid for your student-athlete. As a rule of thumb, athletes should drink before they are thirsty to avoid dehydration. Sometimes, sweeter tasting sports drinks actually encourage the amount of consumption needed to avoid dehydration. Eat and drink well and performance will be maximized, and the risk of injury and fatigue minimized.

From a nutritional point of view, foods rich in carbohydrates and essential minerals are the best foods for athletes. Yes, the body also needs proteins and fats, but carbohydrates predominantly fuel muscle contraction and influence performance. If your student athlete eats plenty of whole foods like fruits, vegetables and legumes along with whole grain breads, pastas and lean meats, your child should have everything needed to grow and develop as an athlete. In my experience dealing with student athletes at Orthopedic Associates, I have seen that teams and individuals that emphasize good hydration and nutrition habits have a huge competitive advantage on the field.

Rest and Recovery

Rest and recovery is what helps the body adapt to the stress and strain of a workout. Immediately following exercise, athletes are encouraged to consume plenty of carbohydrates to help restore depleted levels of muscle glycogen. Specifically, athletes should consume between 60 to 100 grams of carbohydrate within the first 30 to 60 minutes after exercise to aid critical muscle recovery.

Overuse injuries can also be avoided by allowing your body to rest and recover from the day's workout. Hydration, nutrition and rest all play a critical role in the recovery process. Muscles actually grow stronger by the repair and adaptation that occurs during rest in response to the level of exercise performed. No recovery = no muscle adaptation.  Sleep plays a critical role in this recovery. That means that student athletes need to remember to get enough sleep each night. Growing adolescents participating in intensive athletic activity need nine to ten hours of sleep nightly in order to recover properly for the next day's session.

So enjoy your summer vacation, but for student athletes and their parents, now is the time to start thinking about fall sports. The more the athlete prepares today, the more enjoyable (and hopefully injury free) the fall sports season will be.