Home » Blog » April National Youth Sports Safety Month » Michael Goldenberg: Year-Round Play And Pressure To Play In Pain Lead To Overuse Injuries

In recognition of April as National Youth Sports Safety Month, MomsTeam asked our friends in the medical, health, fitness, nutrition and athletic training communities to write blogs answering two questions: first, how or why did they get into their field, and second, how have they made a difference in the life of a youth athlete in the past year.  Michael Goldenberg Athletic Director Lawrenceville School

Today, we hear from Michael Goldenberg, an Athletic Trainer at the Lawrenceville School in Lawrenceville, New Jersey.

By Michael S. Goldenberg, MS, ATC 

How did I get into my field?

I played football when I was in elementary and middle school, but when I got to high school, everyone else got bigger, but I didn't. Thus I decided to be the manager for the high school football team. I did that for a number of years, and loved it so much that, when I got to college, I volunteered my freshman year to be the manager for the football team. As the manager, I would be at practice every day side by side the athletic trainer and his students. I saw what they did and realized this was the profession for me. I made that decision 34 years ago, and to this day, I am so glad I made it.  Athletic training is a great profession!

How have I made a difference in a young athlete's life in the past year?

In my dual roles as both an athletic director and athletic trainer, I find myself in a unique position when it comes to serving today's young athletes. I practiced athletic training for 30 years prior to becoming the athletic director for the Lawrenceville School, a private secondary boarding school located in central New Jersey.

As an administrator, I strive to make a difference in young people's lives via a myriad of programs and lessons that are implemented through athletics. For example, our department holds leadership classes for our team captains and conducts sessions on the importance of nutrition in an effort to reach peak athletic performance. It is our hope that lessons such as these will transfer to lifelong skills.

Likewise, when an athlete has a concern that he/she would like to discuss with me or a member of our coaching staff, we encourage them to advocate for themselves so they learn how to better communicate with adults versus having their parents do so on their behalf. It is also our expectation that  through athletics we are building character, instilling team values and imparting the knowledge that comes with a lifelong commitment to positive physical and emotional habits.

As an athletic trainer, I interact with and support student athletes in multiple ways such as management of medical emergencies, i.e. taking care of everything from simple sprains to severe fractures and concussions to listening to their problems on and off the playing fields. Our athletes receive proper care because of the commitment of our school to the safety and well-being of our student body.

Unfortunately, there are also some less attractive aspects of athletics that have unfortunately become more commonplace in the three decades since I began working as an AT.

Overuse injuries

For starters, I see more and more athletes coming to school with overuse and other chronic injuries. Many are a result of excessive participation in outside club teams and leagues, and could have been prevented with improved coaching and  presence of an athletic trainer.

Michael Goldenberg AT examining player's injured kneeIn a recent conversation with another AT, he expressed the frustration which too many athletic trainers are experiencing when asked to manage the medical care of their own student-athletes who are injured while competing outside of their school's athletic program.  Most often, the student-athlete is told by their outside coach to see their school's athletic trainer for medical attention!

It leaves to me wonder why isn't that coach and their program taking responsibility for the care of these injuries at the time they occur, rather than urging their player to seek medical attention from someone who is not associated with the club team. The energy spent on evaluating and rehabbing the athlete ends up diverting the athletic trainer's time and resources away from someone who was actually injured while playing for their school.

Early specialization

Another issue that's becoming more pervasive is that today's student-athletes are being encouraged to specialize at younger ages and to play the same sport on a year-round basis.  They're told that if they don't practice more or play in showcases where college coaches frequently visit, they won't be good enough to secure scholarships.

One example that comes to mind was when one of our female athletes continued to play one sport all year for an outside club, all the while not only continuing as a three-sport athlete at Lawrenceville, but being voted captain of each of these sports going into her senior year.

Despite experiencing chronic back pain the summer prior to her senior year as a result of traveling and practicing with the club, she continued to play through the pain. She informed the club coach, but nothing was done about her injury because she was still able to play. Unfortunately, she never told her parents about her overuse injury, because she was afraid they would be disappointed.

When the coach of her fall sport observed her during preseason, she was sent to be assessed by me. After a thorough evaluation, I was concerned that she might have a stress fracture in her back and promptly referred her to our school physician. X-rays were taken and revealed that in fact she had multiple stress fractures. The result: she had to spend her entire senior year in a back brace and never had the chance to play during her final year of high school.

When I asked her why she plays year round, her response was that she was trying to get into a good college. After being told by a college coach that she had potential to play at the next level, provided she played in more tournaments, she took it upon herself to do just that. Had an athletic trainer been at practices and games, it is possible that she would have told the AT about the pain she was experiencing and would have been encourage to "shut down" from athletics right then and there, increasing the chances that, with rest and proper treatment, she would likely have been able to play her senior year in high school.  Instead, she ended up sitting on the sidelines watching her teams instead of playing as captain. Again, had there been an opportunity to discuss this with someone, anyone, perhaps there would have been a more positive outcome.

More athletic trainers needed

With more and more competitive youth club leagues (9-13 year olds), our athletic training staff has seen a number of students who come to school with chronic injuries that have been bothering them for quite some time. Again, many of these injuries could  likely have been prevented from becoming chronic had a healthcare professional intervened.

If parents are going to allow their children to participate in athletics through youth sports and/or organized club teams, they should be as diligent about making sure the programs have access to a healthcare professional such as an athletic trainer.  From speaking to parents and experts, the two reasons most often cited as to why programs don't employ ATs are, of course, cost, and the belief that because kids are young and otherwise healthy, they somehow don't get hurt all that much.

With the respect to the cost argument, when I ask parents how much they're paying for their child to play in a league, including the additional costs of equipment, tournament fees, travel (hotels, transportation, meals), it is hard to believe that they aren't willing to pay an athletic trainer to be present to work with their children should they get hurt.  Perhaps parents should consider having kids play in one fewer tournament and applying the money saved towards hiring a healthcare professional.

Parents and coaches alike need to realize that kids might not say anything to them when they are injured, especially if it seems minor to them. I have seen and heard first-hand how parents bark at their kids to "work harder," "toughen up," or "play through it."  No wonder a young athlete is reluctant to tell anyone, much less their parents, if this is how parents behave in front of other parents and even their teammates?

To be fair, with all the recent media attention regarding concussions, parents are beginning to hear more and more about the debilitating effects of these traumatic head injuries and their potential for adverse long-term health consequences for their child. Some are even beginning to realize that kids are not completely immune to certain injuries and do need some level of care.

Think of it this way: no right-thinking person would let anyone swim at a beach or a public pool without a lifeguard. So, how can anyone run an athletic club program or youth league without an athletic trainer or other proper medical care available?

Michael S. Goldenberg, MS, ATC is an athletic trainer and former Athletic Director at The Lawrenceville School in Lawrenceville, New Jersey.  He has a Bachelors of Science degree from Plymouth State College and a Master in Science from the University of Buffalo. After working as an athletic trainer at a number of high schools, he came to Lawrenceville in 1989 as Head Athletic Trainer.  He was co-chair of a National Athletic Trainers' Association inter-association task force which in 2013 issued a consensus statement on best practices for sports medicine management for secondary schools and colleges.