Youth physio issues
Written by Colin Paterson MCSP SRP: Chartered Physiotherapist, British Trampolining.
I have worked with the national trampoline squads for three years now, both with senior and youth squads. Trampolining itself presents some different factors for the physiotherapist to think about when working in this field, be it at youth or senior level. I will now highlight some of these issues along with my personal experiences in relation to the youth age group.
The youth squad comprises athletes ranging between 12-17 years of age and so presents issues surrounding growth and development, in particular in relation to musculoskeletal development. When combining this with the nature of trampolining and the training required to compete at a high level, problems can arise.
Trampolining, by nature, is a sport where high loads are transferred from the trampoline bed to the athlete in a highly repetitive manner. Axial compression forces are directed through the lower limb up the kinetic chain to the pelvis and spine. Large powerful lower limb muscles are needed to generate the forces needed to execute increasingly technical moves. A certain balance between muscle power and flexibility is needed and this is an important issue in developing young athletes.
Children are not simply little adults, their musculoskeletal system is vulnerable, especially during periods of growth. During these periods their muscular system often becomes less flexible and more powerful creating the normal adolescent injuries we are all familiar with.
From my experience the most common sites of injury to youth squad members are; lumbar spine, knee and ankle. These will be briefly addressed individually.
As previously mentioned large forces are transferred to this area from the contact with the trampoline bed, this combined with the high degree of spinal movements involved with twisting, flexing, extending and somersaulting, impart large stresses.
Often the injuries experienced in this area are chronic, related to overuse, learning of new techniques and muscle imbalances. Treatment often revolves around core stability training (transversus abdominus, gluteals, obliques) along with trunk and lower limb stretching programmes. Coaches need to be made aware of training implications when the athletes are growing. This could take the form of reduced intensity, a period of consolidation of moves rather than the learning of new ones or an emphasis on body conditioning work.
In all sports this is a very common area of musculoskeletal dysfunction due the large amount of growth occurring in this area and its susceptibility to increased forces placed on both the bone and soft tissue components. Due to the elastic properties of the trampoline bed large forces can be generated and when transferred to the immature athlete can cause problems. Osgood-Schlatter’s disease, patella tendinopathies, patellofemoral pain and fat pad dysfunction are all common occurrences. Treatment again often involves modification of training, taping, muscle imbalance work and lots of advice!
This area is often involved in traumatic events, as a result of poor landing causing an inversion or eversion injury. Often more than one body part is affected in “crash landings” whether it be on the trampoline or the end decks (crash mats at the ends of the trampolines). As with all lower limb injuries proprioceptive rehabilitation is vital as the feet make contact with the bed on most moves and a reduced body awareness could have a gross effect on technique and hence on future injuries.
Other injuries do occur. Fractures I’ve seen take place include a fractured neck of talus, supracondylar humeral fracture and a patella which was dislocated mid routine. Luckily these are infrequent.
Another important factor as with all sports injuries is the psychological aspect. Again children are less developed in this area, their coping strategies are limited and this is often witnessed in the competition environment. Stress, anxiety and arousal level all have implications for injury susceptibility. However, from my experience the trampolinists handle this area well, they are all very familiar with the competition environment as many have been competing since the age of 8 years. It is often the international trips that pose problems for them; being away from home, strange country and strange food!
From a personal viewpoint, it’s a rewarding area to work in, large skill improvements are witnessed and physical transformations are seen from one squad to the next. As a team, the Great Britain squad are very successful which is always good for morale!
Summary of role as national squad physiotherapist:
- Screening- injury prevention
- Education- athlete, coaches, parents.
- Musculoskeletal treatment and advice
- Friend and entertainment- the physio room is a meeting place for bored athletes
- Active involvement with (and commitment to) the team of medical and musculo-skeletal support.
As with all sports, when working as a physiotherapist at elite level an understanding of the sport itself is crucial, this doesn’t necessarily mean knowing what all the moves are but understanding the principles is key!
© Colin Paterson