Kids Love Dr. Barton

Getting Back in the Swing

by Dr. Douglas Barton, M.D., Pediatrician 10/29/2009

            A common question we receive in pediatrics is when to go back to full activity after an injury.  This has been highlighted in my own life as I try to return to some kind of physical activity after my knee surgery.  We often see ankle sprains, knee sprains, wrist sprains and fractures of all kinds that take a week to six weeks to heal completely.  So how does a family decide when to return to full sports?
            My first reaction to that question is always, “If it hurts, don’t do it!”  I have to laugh as I say that because my sister, the high school and college soccer goalie, was once told by her doctor, “then don’t do that!” when she told him she lands on her hip quite often when trying to stop the ball.  My mother was in the room at the time and was quite offended.  Needless to say, as irreverent as it may sound, it is good advice.  Always, when coming back from an injury,If it hurts, don’t do it is sound advice.
            Always think in terms of baby steps.  If you or your child has had a four to six week layoff from vigorous activity, never assume you can get right back into it. Your muscles, ligaments and tendons have gotten used to inactivity and are not primed for full intensity work.  Pretend you’re a beginner again.  Start with very basic, low impact, low intensity practices.  If you’re a runner, start with short slow distances. A gymnast might start with gentle stretching exercises and a slow, low impact floor or beam routine. A weight lifter/body builder might start with very light weight, slow movements and high repetitions. 
            As these gentle activities start to feel better and the muscles start to react the way they did before the injury, then the athlete can start to increase duration of the activity.  It may still be best to keep the intensity low, but the athlete can work out for longer periods of time.  As the muscles and joints start to adapt, then the intensity can gradually be increased back towards full activity. 
            This entire process is extremely variable in duration depending on the age and fitness of the athlete and the performance level demanded.  A relatively lumbering old man like me might be able to get to full activity very quickly.  A spry young high-impact gymnast might take four to six weeks to return to full activity. An older fitness runner who does long distance is likely to return from an ankle sprain more quickly than a college soccer player who puts a heavier load on the ankle. 
            Regardless of the injury, let pain be your guide.  A gentle feeling of being stretched and a “comfortable” soreness after physical activity is normal.  Pain during the activity or lingering long after an activity is a sign that things have not healed back to full strength.  Back off some and remember that long term injury free health is far more important than short term sports successes.

Dr. Douglas Barton is a pediatrician serving Lake Saint Louis and St. Peters, O'Fallon and Wentzville, as well as the surrounding areas such as Warrenton and Troy. Patients come from as far away as Bowling Green.




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