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Managing youth injuries amidst the global pandemic.
February 8, 2021

Goldilocks was finicky. Or at least, she had discerning taste. When she broke into the house of the 3 bears, of the 3 bowls of porridge, one was too hot, one was too cold and one was just right. Of the 3 beds, one was too firm, one was too soft and one was just right.

In the area of behavioral psychology, what keeps us motivated and growing in our sport, work and life, is the Goldilocks principle. Take for instance, our jobs.  If our responsibilities are way beyond our ability to do them, or if we do not have the skills, tools or time to accomplish them, then we will feel overwhelmed and the task will either be done poorly or not at all. The task was “too hot.”  

Or, if the tasks in our work are menial, repetitive and never changes, then we will feel insufficiently challenged and boredom will ensue.  It has become “too cold.”  

In the area of human physiology, the same principle applies. If a muscle is not sufficiently loaded then its strength will either plateau or get weaker. For human beings, unfortunately, we either “use it or lose it.”  On the contrary, if a muscle is loaded too heavily and too quickly beyond its ability, then we will risk injury to that muscle. So, whether in our jobs or for our body, finding that optimal stimulus to keep us growing and motivated is key. Not too hot, not too cold but just right.

In 2020, amidst a pandemic, our Clinic saw the highest number of children and youth with musculoskeletal injuries, neck and back pain and headaches compared to previous years.  These are the patterns we observed:

1. With on-line schooling and lockdowns, kids were using digital screens far more frequently than usual and most were doing their schoolwork on desks, tables and chairs that do not fit them and playing video games on couches and beds. Adults themselves struggled with poor ergonomic set ups while working from home, never mind children.

2. 2020 was a year of starts and stops. With the stoppage of sports and recreational activities for kids who were normally active, many kids struggled with the lack of physical activity.  For kids involved in highly competitive sports, this was a big problem. The long periods of lockdowns resulted in deconditioning. When sports was allowed to continue again, these young athletes returned to training to the same level and intensity and frequency. Some athletes went from doing very little for weeks to training 4 hours a day, 6 days a week as soon as they were able. Inevitably, injuries would ensue.  They went from too cold to too hot too quickly because in their minds at least, this type of training was already familiar to them.  The human body loves consistency. What it does not love is the peaks and valleys of training.

3. Growth. Children insist on growing. For some kids, when their bones grow faster than their soft tissues (muscles, ligaments and tendons) especially during growth spurts, and this combined with (1) and (2) above, we saw many kids with soft tissue injuries. During growth spurts, very active kids especially high performance athletes may need to modify and reduce their training load. However, in a year of frequent starts and stops, reducing their training load or modifying their activities was the last thing these young athletes were wanting or willing to do.

Injury prevention, just like sports performance is both sport-specific and individual-specific. Because no two individuals are the same, each person’s needs is different. Coaches can do their part by easing athletes back to sport slowly after long periods of inactivity or a greatly diminished training load (whether from illness, injury or lockdowns).  Parents are in the best position to monitor their children and to modify their training load when necessary. Therefore, injury prevention, just like nurturing performance, is a collective endeavour. 

Here at Elevation Physiotherapy, we love the energy and enthusiasm of these children and youth! We love to see them grow and thrive in all of their endeavours. If your children are struggling, give us a call and we would love to be of help!

Lastly, we would like to thank the parents and children who have contributed their photos to this blog. Never stop being amazing!

Submitted by Albert Chan

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