Kristine Delgado
Administrative Director of Rehabilitation
Richmond University Medical Center
While physical therapy can help people of all ages—from a 6-year-old who walks on her toes to a 60-year-old with arthritis—it is especially beneficial for adolescent athletes. Sixty million teens in the U.S. play at least one sport, according to the American Physical Therapy Association, and their growing bodies need to heal properly. Also, teens often hastily return to the field (or court or track) and get injured again. It may not always be easy to get a teenager to be cautious or heed advice, but according to experts, physical therapy is essential for injured adolescents.
What are the benefits of physical therapy for teens?
According to Kristine Delgado, administrative director of rehabilitation at Richmond University Medical Center, adolescent athletes seek physical therapy most commonly after sprains and strains—a sprain is the ligament, and a strain is the muscle—with ankle sprains at the top of the list. Other common injuries are ACLs, dislocations, fractures, and breaks. Also, any teen who has had orthopedic surgery usually has to complete physical therapy.
“The physical therapist, or PT’s job, first, is to get the muscle back to normal function, to decrease the pain level of the patient, and then to regain the prior functional activity level,” Delgado explains. This usually requires about twelve 45-minute sessions. “They’ll start off with heat or ice because that helps get the muscle ready for them to work with, and then they go to the actual manual therapy, where they stretch, and then they put them on the machine—a bike or treadmill,” Delgado explains.
These sessions may include stretching, strengthening, mobilization, resistance exercises, and resistance training. Ultrasounds are often used to apply heat to the tissues and the TENS (Transcutaneous Electrical Nerve Stimulation) machine helps reduce pain.
After alleviating the acute problem, a PT works on preventing a recurring injury by educating the patient on how the injury occurred. They might also prescribe orthotics, like a compression sleeve for the quad or the hamstring, knee braces, knee sleeves, or lumbosacral belts—which can support the muscle and prevent pain.
One of the most important parts of recovery for adolescent athletes is the work they do at home. “It’s not enough for them to come two or three times a week to recover, if they’re not doing anything the other days,” Delgado says. “They have to work on increasing muscle strength in the surrounding areas, so that the injury doesn’t happen again.”
At RUMC, the physical therapist creates individualized exercise plans for each patient that can be found on an app. The app also has videos that demonstrate each exercise and keeps track of how often they are performed. “It gives them exercise reminders. And it reports back to the therapist if the patient is compliant,” Delgado says. “It’s a lot more motivating.”
How is physical therapy for teens different than PT for adults or kids?
One of the major components of youth sports physical therapy is education—not only does the injury need to be treated but the adolescent athlete needs to learn how to keep it from reoccurring. “A lot of times injury occurs because of poor positioning or poor core strength. So it will just keep occurring because you’re doing the same thing over and over again that caused it,” Delgado explains. “So it’s good to address it this way. And then we can talk to them about how to avoid it.”
Also, adolescent athletes are more active than adults—many play more than one sport and/or play sports with friends, so they are susceptible to overuse and reinjury, especially if they are not fully rehabbed before they return to sports.
While many of the youth sports physical therapy techniques are the same as those used on adults, teens often need a counseling component. “You have to explain, ‘You can’t do that because you’re going to get hurt.’ Over and over and over again,” Delgado says. Also because of their age and the fact that their bones are still forming, injuries can cause permanent damage to their young bodies.
Adolescent athletes also often need motivation. “A lot of them don’t want to come—the parents are dragging them here. They don’t want to do the home exercise,” Delgado says.
Physical therapists therefore focus on the therapy part of their job, talking to patients and trying to inspire compliance and understanding. Often youth sports physical therapy includes the parents in the treatment. “We educate the parent at the same time because the parent has to make sure that they are complying and that they’re following directions,” Delgado says.
How can teens prevent injury?
There are several steps adolescent athletes can take to prevent injury in the first place, according to Delgado. Warming up and cooling down can prevent cramping. Daily stretching increases flexibility and will prevent injury. “A big, big one is hydration. Teenagers are not hydrated properly, but hydration is huge because it prevents cramping, which leads to injury. And then not only water, but you need electrolytes,” Delgado says. Also the proper gear like shin guards, a chest protector, and cleats can help.
Of course, none of these things can entirely prevent injuries. But even if the swelling goes down and/or the pain subsides, teens should be treated by a physical therapist, like those at RUMC, in order to prevent further damage and injury reoccurrence.
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