Healthy tips from Torrington PT's own Rich Boulli. Special guest writer in the April edition of the LCS Magazine.

POSTED May 10, 2018
BY Timothy W. Gaffney
Twitter: @TimothyGaffney
There's more to being an athlete than just competing. Physical therapist, Rich Boulli gives us some insight on injuries, conditioning and nutrition.

What are the most common injuries you see from kids ages 10-16?

Common sports injuries that we see in middle school to high school athletes are joint sprains, lumbar stress fractures, ACL tears and UCL tears. By far, the most common injury in this population has to be overuse injuries in children 10-16. These injuries occur from the repetitive application of submaximal stresses to otherwise normal tissues. This type of injury is more prevalent in the setting of organized sports, compared with backyard or pick-up games or purely recreational activities, especially in elite child athlete programs. Overtraining and exposure to excessive levels of physical activity can present an increased risk of injury. Prevention is by far the key with gradual rather than sudden increases in stresses and intensity which can usually avoid physical breakdown.

How should athletes get themselves prepared before an event?

Athletes at every level should prepare themselves both mentally and physically. Mentally they need to be positive and stay focused. Leading up to a competition, it is important to provide athletes with the mental tools so that they can learn to manage their own performance and create their optimal level of mental readiness. Strategies such as goal setting, imagery, thought management, and emotional control can be learned through practical exercises that incorporate these elements into the athlete's practice and daily routines. Athletes can then use these tools to develop their personal routines and plans for achieving mental readiness for competition. Physically they need to make sure they have proper nutrition, plenty of sleep/rest and have adequately warmed-up prior to any athletic competition.

What is the most common question you get as a therapist concerning kids training methods?

The million-dollar question of "when should children start using weights" always comes up. Some experts warn that weight training at a young age can damage a child’s growth plates, found at the end of long bones. We need to keep in mind that this being true, these injuries are almost always the result of using too much weight with improper technique. I believe smart strength training is acceptable—if the right exercises are chosen, and that the youth has an appropriate level of base strength and mobility. I firmly believe that middle and high school age children can start implementing more of a structured approach to strength training. Before a kid ever touches a weight, make sure he/she can perform basic body-weight exercises with perfect form. These exercises would be the Push Up, Sit UP, Overhead Squat, a basic Pull UP and Plank exercises. Poor form and excessive loading are the reasons kids wind up injured and in my office. Once they’ve mastered their own body weight, start with a resistance/weights that allows for 12 to 15 repetitions with perfect technique. Doing Just one or two sets per exercise is fine initially, working up to a maximum of three once strength and endurance improve.

Use a variety of strengthening equipment. Medicine balls, bands, and cable-based machines allow for three-dimensional movement. These are ideal because they offer kids variety, while training balance and stability just like free weights. One problem I see even when kids are ready for weights, the loading is often times imbalanced and that leads to problems down the road. One common problem: People put too much focus on popular exercises like the bench press and start piling on weight even before a kid can do 10 good pushups. Start with simple movement patterns utilizing body weight and then build up using free weights for sport specific related exercises.

How often should athletes work out during their season?

Strength/resistance training can be utilized during the season as well. I usually tailor my athletes training to 1-2 days only. Off season, resistance training can be performed 3-4 days a week with a combination of arm, leg and core exercises. Cross training is also very important. Instead of running or doing the same exercises every day, the athlete should do a multitude of endurance; run, bike, swim, elliptical.  Even a run through the woods which incorporates running on different surface and change of speed and obstacles is also a great shock to the body.

It seems an easy answer but how critical is nutrition in an athlete’s performance? 

Proper diet is one of the most important aspects of a young athlete, yet at most of these sporting events the "Snack Shack" is loaded with fried, greasy, sugary foods that will only make the athlete sluggish and unable to perform to his/her max. Hydration of water should start at least 24 hours before athletic completion and continue throughout the game/event. Eating a well-balanced meal a few hours prior to the game/event will ensure the athlete has enough during the game. I also encourage a fruit or snack between games if playing multiple games or during a tournament, along with water. Bringing a fruit, whether it is an orange, apple, banana or blueberries, and water will ensure your athlete has enough energy to make it through the competition. Stay away from those late-night sleepovers the night before a game/games, they never do any good!

Talk about the conditioning of pitchers in throwing sports. 

Overhead athletes such as baseball and softball players should and can perform there strengthening exercises before, during, and after the season. In addition, I use a program called The Thrower’s Ten Program which is designed to exercise the major muscles necessary for throwing. The Program’s goal is to attain an organized and concise exercise program which is specific to the thrower and are designed to improve strength, power and endurance of the shoulder complex musculature. In addition to this, several weeks prior to the start of a baseball/softball season, all players, especially pitchers, should begin a basic throwing program. This program starts slow and ramps up distance and percentage of maximum velocity to make a smooth transition into the season

In addition, to a strengthening and throwing program, a jogging and running program should be incorporated for all athletes. I usually start with a light jog and then increase to a moderate pace with a goal of doing a total of 1 to 1/2 mile runs 2-3x week. This will allow the athlete to improve their overall endurance and leg strength which is vital in any sport.

We all hear that stretching is very important when preparing for a workout or event. What are the different ways one can accomplish this goal?

Stretching is a very important aspect of training and pre/post game activities. Static as well as dynamic stretching patterns should be utilized. Dynamic stretching is "dynamic," meaning you are moving as you stretch. Dynamic stretching activates muscles you will use during your workout and allows you a greater arc of motion or ROM during the stretch. Think about it, during a sport we don’t just stand there like we do during static stretching. We are moving, so why not stretch moving. A lunge-twist, knee to chest walk, high skips, mummy walks and hip rotations against a fence are all good dynamic stretches to warm up with.

Keeping all this in mind, proper nutrition, strengthening program tailored to the specific sport, mental attitude and proper rest will all help keep the adolescent athlete safe and out of my office, getting your child to actually do this is another topic of discussion!!



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