About the Author
James R. Andrews, MD, is an orthopedic surgeon in sports medicine and a pioneer in arthroscopic surgery. His patients and consultations include Albert Pujols, Drew Brees, Brett Favre, Roger Clemens, John Smoltz, Charles Barkley, Jack Nicklaus, Hope Solo, Bo Jackson, Troy Aikman, Emmitt Smith, and both Manning brothers. Sports Illustrated recently named him as one of the top forty most influential people in the NFL. He is the team doctor for Auburn University, the University of Alabama, the Washington Redskins, and the Tampa Bay Rays. He is a founder of the American Sports Medicine Institute (ASMI) in Birmingham, Alabama, and the Andrews Research and Education Institute in Gulf Breeze, Florida.
Excerpt. © Reprinted by permission. All rights reserved.
Don Yaeger is a former associate editor for Sports Illustrated. He is the author of seven books and coauthor of the New York Times bestseller Under the Tarnished Dome and the critically acclaimed Pros and Cons: The Criminals Who Play in the NFL.
Any Given Monday Introduction
What Is the Point of This Book?
Why, after nearly forty years of practicing medicine and preparing for inevitable retirement, would I want to write a book? And since the focus of my practice for the majority of my career has been on adults, why would I choose to write a book about youth sports injuries?
The reasons are simple but tragic. I am writing this book because it absolutely needs to be written to help curb the growing epidemic that is endangering our most athletically talented children, adolescents, and young adults. I want to make sure that parents, grandparents, coaches, trainers, and all medical personnel are taking the steps now to maximize the opportunities for the next generation of young athletes. This book is intended to do just that: to raise awareness of the most common youth sports injuries and the best ways to prevent them, while explaining the most constructive ways to build a child’s potential. My hope is to educate all adults on how to protect an active child already involved in organized sports and how to select the best activities and safest exercises for a child who is looking to get physically fit.
Juvenile obesity (and the health risks brought on by the condition, such as diabetes and cardiovascular disease) has captured a great deal of media and political attention in recent years, and poor dietary choices and a more sedentary lifestyle are often to blame.
But what about the children at the other end of the spectrum: the ones who are not only physically active but also follow a strict athletic training regimen and dedicate dozens of hours every week to exercise and activity? The serious health risks facing those children are often overlooked or simply shrugged off as “just part of growing up.” But the truth is that youth sports injuries are an epidemic in American society, and we can do more to combat them.
Every year, more than three and a half million children under the age of fourteen require medical treatment for injuries incurred while participating in team or individual sports, and this number is on the rise. Over the past fifteen years, children have gone from being a rarity on my operating table to constituting nearly half of all my patients. More than one-fifth of all traumatic brain injuries in children are the direct result of athletic activity. Almost one-half of all sports injuries in adolescents stem from overuse, in which specific muscles and joints are damaged due to repetitive motion as part of athletic training or conditioning.
Yet despite these startling statistics, sports injuries are largely preventable, especially in children and adolescents. Even something as seemingly harmless as overuse of a joint or muscle can have a dramatic impact on future athletic ability, and even basic functions of movement and control. Both the short-term and long-term repercussions need to be considered when a child begins participating in any kind of sport.
Over the course of my nearly forty-year career, I have been the go-to surgeon for high-profile professional athletes such as Roger Clemens, Albert Pujols, Charles Barkley, Scottie Pippen, Kerri Strug, Jack Nicklaus, Raymond Floyd, Jerry Pate, Troy Aikman, Drew Brees, Brett Favre, Bo Jackson, Emmitt Smith, Terrell Owens, Sam Bradford, Matthew Stafford, and both Manning brothers, just to name a few. My goal has always been not only to return these great sports icons to the top of their game but also to help spread awareness of the causes and prevention of potentially career-ending injuries. Any Given Monday refers to the major consultation day in my clinic, when many of America’s premier athletes, fresh off broadcast TV, arrive at the Andrews Clinic in Birmingham, Alabama, or at the Andrews Institute for Orthopaedics & Sports Medicine in Gulf Breeze, Florida, for an examination of any injuries from their weekend matchups.
At least once a week, concerned parents will come into my clinic to inquire about their child’s hurt shoulder, swollen elbow, or aching knee and how that injury could affect his or her athletic participation. As part of the exam, I will ask the parents to detail the child’s practice schedule for the past month and year on a blackboard in the examination room so that we can look at it together. More often than not, the intensity, amount, and duration of the exercises are staggering—sometimes they are actually comparable to the training regimen of a pro. I sit down with the family and try to make them understand the potentially irreversible damage that such a schedule can do to a growing body; then we discuss better options. I want parents to seriously consider the implications of putting a twelve-year-old through the same paces as a twenty-five-year-old. Many times they have no idea as to the extent of the injury that their child is suffering; the focus of many parents and coaches is simply on pushing the child to achieve at the highest level possible for college opportunities or to gain a big break into the professional realm. What they often don’t seem to realize is that if a child’s body is overworked at an early age, he or she might not be able to stay in that sport long enough to make it to high school varsity, let alone to the elite level they so desperately desire. Families come to me to put their dream back together, but I want to make sure that parents and coaches understand how to prevent those dreams from shattering in the first place. Those adults have the child’s best interest at heart, but most do not fully understand the risk factors at play in a specific sport.
This dangerous trend is continuing to rise year after year, while the average age of the patients on my table continues to drop. Baseball, in particular, posts some of the highest numbers in terms of serious injuries in youth sports. Recently, in a single day, I completed eight Tommy John surgeries—an operation to repair an injured elbow. Two of my patients were major league pitchers, two pitched for college teams, and four were high schoolers ranging in age from fourteen to seventeen. The following day, I took a photograph of them all together, their arms in splints and ice bags on their shoulders. It was a remarkable day because it reminded me how widespread the problem of professional-level injuries has become, even at the teenage level.
This book will pull from the hundreds of anecdotes and examples I have collected over the past four decades to highlight the types of injuries that are common in athletics; the consequences of childhood injuries; and the advice, treatment, and rehabilitation plans I have prescribed for many of the sports stars you see dominating the field or court every week. Because of the real-life experiences of sports figures who have been on my operating table and now are outspoken advocates for youth sports injury prevention, this book offers readers a personal connection to the headliners who promote this important cause.
Additionally, Any Given Monday provides a reference guide to the twenty-eight most popular youth sports, outlining the health concerns most common to each, how best to treat them, and how to prevent them from happening again—or from happening in the first place. It also addresses the various myths and misconceptions surrounding juvenile orthopedic sports medicine and serves as an overall guide to raising healthy, injury-free children and young adults.
I want to take a moment to speak specifically to the grandparents who might be reading this book. I want to thank you for the interest you’ve taken in the lives of the grandchildren you love, and I hope you know that the role of grandparents in looking out for young athletes is now more important than ever. In some cases, grandparents are also primary caregivers, which is a serious undertaking. Athletics may have changed since you were in high school—both the types of sports that are now popular as well as the style or roughness of play. Safety equipment and rules may also have undergone some changes. I hope that this book will help you to gain a better understanding of current trends, rules, and modes of thinking surrounding youth sports.
For those grandparents, I also believe that the information presented here will help you feel more connected to the world of training and competition in which your grandchild is involved. But even more than that, I hope it helps empower you to voice any concerns you may have. Very often in my practice, I have seen that it was the grandparents who first recognized an overuse injury or burnout in a child or teen. Sometimes the parents are too close to the situation and so wrapped up in carpools, prepping postpractice snacks, and making sure that homework is completed after practice that they miss some of the warning signs right in front of them. Other times, a child might admit to a grandparent that he is experiencing pain or exhaustion due to participation in a certain sport but doesn’t want to tell his parents for fear of disappointing them. If grandparents sense that a grandchild is being overworked or overcommitted, I urge you to express your worries and your desire to see your grandchild live as healthily as possible. By gently explaining the long-term risks of year-round leagues and overuse injuries, you might be able to help protect the growing joints, muscles, and bones of the young athlete’s body, enabling him to maximize his talent as he grows older.
Because of the work conducted at my clinics in Birmingham and Gulf Breeze by my highly talented staff of physicians, surgeons, physical therapists, athletic trainers, and other experts, in 2010 Sports Illustrated named me one of the forty most influential people in the National Football League. It was an honor I both greatly appreciated and deeply regretted. It is my sincere desire to see a generation of athletes grow up knowing how to care properly for their bodies, how to explore and grow their talent in the most effective way, and how to reduce the need for work such as mine through proactive treatment.
As part of my effort to see this goal through to reality, all of my personal proceeds from Any Given Monday will go directly to the STOP (Sports Trauma and Overuse Prevention) Sports Injuries Campaign I helped to initiate as president of the American Orthopaedic Society for Sports Medicine (AOSSM) during 2009 and 2010. Together with members of our “Council of Champions”—including Hank Aaron, Bonnie Blair, Shaquille O’Neal, Bart Starr, Matthew Stafford, and industrialist Jim Justice, among many others—I have appeared on numerous public service announcements and talk shows on networks ranging from ESPN to HBO. To learn more, please visit the STOP website at www.stopsportsinjuries.org.
But lest this come across as a thinly veiled self-promotion, I need to stress that this book is not about me. My life and my career have never been an “I” statement but a “we” situation!
There are doctors out there doing far more to saves lives and combat serious illnesses than I have ever done or will ever do. There are many surgeons in my own field of orthopedics who are working continually to improve the lives of men, women, and children with devastating injuries. There are specialists dedicated to helping wounded veterans learn to adapt to life with prosthetic limbs and others who are focused on helping children with physical birth defects achieve full, enriching lives. These are the real heroes of the medical field: the doctors, nurses, and therapists who are helping one person at a time reclaim his or her birthright of “life, liberty, and the pursuit of happiness.”
But me? I have just been fortunate enough to work with famous people who throw or bat around a ball for a living.
Of course, athletes have every right to those goals as do the rest of us, but sometimes it seems a little backward that people know my name because they’ve seen it mentioned in articles or interviews with A-list sports celebrities and not because I’ve cured anything or changed the world for the better.
I think that’s important to state at the opening of this book. While I am writing about some of my experiences and philosophies, this book is not intended to celebrate my accomplishments or contributions to the world of sports medicine. Anything I share about my life and career is intended to introduce myself to the reader and establish a sense of credibility for my recommendations.
It is my hope that the long-standing relationships I have had the privilege of sharing with many high-profile athletes will help to make this book an automatic and authoritative platform from which to reach parents, grandparents, coaches, and children with the message: “Safe on the playing field, out of the operating room.”
It’s time to put a stop to this pervasive problem that is, quite literally, crippling our children before they even have a chance to live their dreams—and to focus on the behaviors and practices that can help a child maximize his or her athletic potential.
If that is the goal you have for your child, then we have a great deal in common and a lot to discuss. I urge you to read on.|Any Given Monday Chapter 1
Approximately forty-five million children and adolescents are involved in organized athletics in the United States and, as I stated earlier, nearly three and a half million of them under the age of fourteen are treated for sports-related injuries each year, making athletics one of the leading health risks for children. The majority of injuries, of course, are relatively mild sprains, strains, and bruises, but a significant percentage will be more severe, with some even requiring hospitalization. What is even more troubling is that roughly 50 percent of all sports injuries are related to overuse, and studies show that at least 60 percent of overuse injuries can be prevented simply by employing a little common sense—and even more by taking just a few safety precautions. It must be the primary responsibility of the parents, grandparents, coaches, paramedical personnel, and young athletes themselves to help prevent these injuries the best they can.
These statistics are followed carefully by the American Sports Medicine Institute (ASMI) and the Andrews Research & Education Institute (AREI) in Gulf Breeze, two organizations of which I am the chairman. Each year, as new numbers come in, it is a sobering experience for many reasons. Injuries certainly reduce participation in sports and fitness activities, thus contributing to the childhood obesity epidemic as well as other social misgivings. Some injuries can be career ending or even life limiting well before the child or teen has had a chance to pursue his or her dreams. Even less serious injuries can have long-term implications, as damage to joints in childhood contributes exponentially to the chances of developing arthritis later in life. Additionally, there is no question that the evaluation, treatment, and rehabilitation of youth sports injuries is expensive and can lead to lost time and productivity at work for parents. Recent reports have placed the costs associated with youth sports injuries between $2.5 billion and $3 billion annually.
As stated above, many of these sports-related youth injuries are preventable through educational programs at the grassroots level. I will discuss some of the more common youth sports and associated injuries and provide some information related to their prevention, including rule changes, safety equipment, and preseason and in-season conditioning programs.
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