The mornings are getting cooler. The sun angle is changing, and dew is beginning to form on the ground. Yes, it’s that time of year again…It’s PRESEASON! Ten years removed and every August the air still seems to smell like pre-season. I even continue to get phantom butterflies like I have to re-test my mile time again in order to make the team. Now, being a healthcare professional, I’m coming at pre-season with a different perspective.
Preseason and the end-of-season are when athletes are more likely to sustain injuries. The latter is due to fatigue and accumulation of physical stress and/or anxiety while the former is often due to lack of preparation for an acute spike in load, intensity, and volume. Although it is a little too late to improve your fitness, here are some tips, warning signs, and other thoughts for ALL ATHLETES and PARENTS to consider in order to maximize your season.
1) Beat the Heat
Know the signs and symptoms of different forms of heat illness. Heat can increase your risk for physical injury due to fatigue and exhaustion. Heat can also cause its own form of injury that needs to be treated by a medical professional, and, in some instances,requires IMMEDIATE medical attention. Here is a table outlining the signs and symptoms of common heat illnesses:
|Dehydration||Heat Exhaustion||Heat Stroke|
|Definition||Harmful reduction of water in the body||Body overheats||Thermoregulatory failure (unable to regulate body temp)|
|Signs & Symptoms||Fatigue
|Faint or dizzy
Rapid, Weak pulse
Cool, pale, clammy skin
|May lose consciousness
Body temp is >102
Rapid, Strong pulse
Central Nervous System dysfunction
|Treatment||Drink water or sports drink. For every kg bodyweight lost, replace with 1 L of fluid.
|Move to a shaded area
Cover with cold compress
Take cold shower
Sit in front of a fan
|IMMEDIATE cold water immersion
A pdf version can be found here to print: Heat Illness
Heat illnesses are preventable. One way is to train in cooler parts of the day when the sun is not as intense (early morning; late evening). Further, checking the heat index, a measure of air temperature and relative humidity, is also important to know your risk for sustaining a heat illness. A National Weather Service heat index guide can be seen here: https://www.weather.gov/safety/heat-index.
2) Be Proactive Not Reactive
Do you get the same injury year after year? If so, be proactive about determining what is increasing your risk for this injury. To do this, contact a nearby Physical Therapist or Athletic Trainer to get evaluated. Together, set up a game plan with them to reduce the likelihood or severity of the same injury. For example, I used to sprain my ankle each basketball season. Granted, I can’t prevent myself from landing on another player’s foot, but I can reduce my risk for injury through static and dynamic balance work, hip strengthening, and stamina.
Baseline testing is a series of measurements that provides data about your level of function before a concussion injury occurs. We can then use it to determine what exacerbates symptoms and what rehabilitation path to follow to promote recovery. It also allows us to make safer return to play decisions. Baseline testing is a must for anyone in contact sport or has a previous history of concussion.
3) Have Acute Injuries Evaluated
Acute Injuries happen. It is part of the game, and they’re often unpredictable. Unless you have a school Athletic Trainer (ATC) at your practice or competition, we typically recommended an in-person evaluation 48 hrs post injury. This allows the initial inflammatory process to occur and symptoms to develop to allow for a more accurate diagnosis. We also recommend a call when injury occurs to help guide what to do and what not to do for the first 24-48 hrs. Should an X-ray be taken? Should I move it or not? Should I take aspirin or Tylenol? These are all valid questions that need to be answered. Often-times, athletes don’t need a referral to see us at SBPT and therefore have direct access to us. Use us to help you get the information you need to be successful in your recovery and your season. We will collaborate with your school’s ATC and nurse to help ensure you receive the highest quality care possible.
4) Learn to Recover
Once your training session is over, recovery begins in order to maximize your performance in the next session. You need to be able to train hard and do it repeatedly. This gets tough to do without planning for the other “22 hours” of the day. Sleep, nutrition, and stress management are your best friends to enhance recovery. But, I feel like all athletes and parents generally know that these are good ideas, yet they’re still passed off as no big deal.
Did you know that a study of young athletes from 16 different individual and team sports reported that increased training load and decreased sleep duration were independently associated with an increased risk of injury(1) or that lack of total sleep time increases your risk of receiving an upper respiratory infection(2). Getting at least 8 hours of sleep a night appears to decrease risk for injury(3). To me, that seems like an easy way to promote your longevity through the season.
One of the biggest signals for your body to “build” is caloric surplus. During pre-season, you can’t afford to continually be in a state of catabolism (breakdown). Being in positive energy balance can be key to combat this and drive anabolism (build-up). The International Society of Sports Nutrition recommends 50-80 kcal/kg/day for strength and team sport athletes (40-45 kcal/kg/day at minimum for female athletes).(4,5) Let us break this down even more, shall we?
4-7g of carbohydrates per kg bodyweight each day (I.e. 68kg [150 lbs] human needs ~272-476g) represents a good guideline during high-intensity practices(6), which is often the level that preseason practices operate. Carbohydrates are your ticket to replenish muscle glycogen after it’s been broken down and used as glucose for energy during practices. This energy drives your performance. Failure to replenish this can leave you in the dumps before the next session and even before the season starts!
A few of protein’s primary functions are to enhance muscle repair and immune function. Team sports often require a lot of acceleration and deceleration, both of which require lots of repeated lengthening and shortening of muscles creating muscle damage. This muscle damage needs to be taken care of, especially if your team also operates in the gym as one of your practice sessions. At minimum, you should be taking in 1.6 g/kg/day of protein to support your efforts.(7)
General nutrition recommendations from the American College of Sports Medicine reported getting approximately 30% of total calories +/- 5–10% from fat.(4) Unfortunately to some, fat has a negative connotation with it. However, this macronutrient is quite vital in maintaining cell membrane structure, enhancing brain health, modulating inflammation, and boosting immune system function(8).
Stress is often an everyday occurrence. Generally, when one perceives that life demands more than what physical, personal, or social resources an individual can supply, stress occurs. This can come in a variety of forms from a medical illness to a social situation. Regardless, managing stresses outside of training can help aid in recovery. A couple of ways to begin managing stress are to perform the following: mindfulness before bed, creating a to-do list for the day, planning out events with friends and family in advance, or preparing for school before the “last minute”. While everyone manages stress differently, it is important to have strategies in place that keep you from feeling overwhelmed so you can maximize your performance.
5) Proper Warm-up
A warm-up is designed to increase the body’s core temperature. What’s considered “proper” depends on your sport and the training you’re doing that day. A combination of a dynamic warm up and static stretches are often used. In general, there is no right or wrong way to warm up. Performing movements in planes of motion (forward/backward, lateral, transverse) that will appear in your practice is a good place to start. If you’re coming back from an injury or have created a plan with your Physical Therapist or Athletic Trainer to minimize risk of injury, the warm-up presents a good time to perform your prescribed exercises.
- Von Rosen P et al. Multiple factors explain injury risk in adolescent elite athletes: applying a biopsychosocial perspective. Scand J Med Sci Spor. 2017;27(12). https://doi.org/10.1111/sms.12855.
- Milewski MD et al. Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. J Pediatr Orthop. 2014;34(2) https://doi.org/10.1097/BPO.0000000000001551
- Cohen S et al. Sleep habits and susceptibility to the common cold. Archives of Internal Medicine. 2009;169(1) https://doi.org/10.1001/archinternmed.2008.505.
- Thomas DT, Erdman KA, Burke LM. American College of Sports Medicine joint position statement. Nutrition and Athletic Performance. Med Sci Sports Exerc. 2016;48(3) http://doi.org/10.1249/MSS.0000000000000852
- Volek JS. Nutritional aspects of women strength athletes. Br J Sports Med. 2006;40(9). https://doi.org/10.1136/bjsm.2004.016709
- Burke LM et al. Carbohydrates for training and competition. J Sport Sci. 2011;29(suppl 1). https://doi.org/10.1080/02640414.2011.585473
- Phillips SM, Van Loon L. “Dietary protein for athletes”. J Sports Sci. 2011;29(suppl 1):S29-38. Doi: 10.1080/02640414.2011.619204
- Bubbs, M. Periodized Recovery. In Peak: The New Science of Athletic Performance that is Revolutionizing Sports. Chelsea Green Publishing. White River Junction, VT: Chelsea Green Publishing; 2019:175-198.