PLAYING HURT

Untrained coaches lead to adult-sized injuries for young athletes

By Randy Griffith CNHI News Service

Editor’s note: This is part one of a three-part CNHI News Service Elite Project series on youth sports injuries.

It was all about making the team for a dozen Danbury, Conn., boys who dressed in plastic garbage bags on Labor Day weekend last year for an intensive sweat-down, weight-loss session just days before their football team’s first game. The Pop Warner football league restricted players on their team to 110 pounds. The boys were all over the mark. One had to lose nearly 9 pounds to be eligible. In a little more than 24 hours, all lost enough weight to play. Parents later complained to authorities that two of the team’s volunteer coaches went too far with the pre-game weight loss regimen for the boys, ages 7 to 13, some of whom were driven around in cars with windows up and heaters on. They also were taken to a local sauna and given over-the-counter diuretic pills to speed the loss of fluid and reduce weight. Police arrested the coaches - Joshua Weyer, 22, and Christopher Murphy, 24 - and they were charged with felony child endangerment, carrying the possibility of 10 years in prison. Both avoided prosecution when they entered a program for first-time offenders. If they complete two years’ probation, the charges will be dismissed. The case shocked Danbury and its youth sports community. It also illustrated what some youth sports experts call a national problem of untrained coaches who, through ignorance or determination to win at all costs, expose children to injuries that could have lifelong effects. More than 50 million children play organized sports in the United States, according to the National Council of Youth Sports. Each year more than 1 million suffer an injury that causes missed school, forces a trip to the hospital or requires surgery. Besides the usual sprained ankles and knees, doctors report a surge of serious injuries from overtraining, poor athletic techniques and rushed recovery from old injuries - cases that might have been avoided if adults had taken steps to prevent them. Still, many schools and sports organizations require little training or proof that their coaches know how to keep such injuries from happening. “It’s a great problem and something we have to address,” said Dr. Lyle Micheli, director of sports medicine at Children’s Hospital in Boston. “Quality of the adult (coaches’) supervision is key.” A CNHI News Service survey of coaching requirements found seven states - Arizona, Florida, Michigan, North Carolina, North Dakota, Pennsylvania and Virginia - have no medical training standards at all for school sports coaches. Another dozen have no requirements for teachers who become coaches. Most of the others have limited safety guidelines. Only three states - Iowa, Wyoming and Connecticut - have training requirements specifically related to injury prevention. In youth sports groups, rules are just as thin. Pop Warner football, for example, has no certification for coaches, though starting next year it will make them attend one-day clinics that include tips on player safety and health. Advocates for tougher standards say states and sports groups are gradually tightening rules for coaches, especially as concern grows about injuries. Yet teaching coaches how to develop healthy players is just one step in reducing the danger. Another, the experts said, is emphasizing the purpose of youth sports - teamwork, dedication and sportsmanship. “Sports by themselves don’t teach any of those things,” said Roch King, coordinator of the graduate coaching program at Ball State University in Muncie, Ind. “It’s the people who are leading the organizations that teach those things.”

Small athletes, big injuries

Statistics show injuries among young athletes are common, though they do not necessarily show how those injuries are changing. Evidence of that is instead found walking into the offices of doctors like Lyle Micheli, who report they are seeing more children suffering from problems more commonly found in older adults. Year-round organized sports, and their repetitive drills, have introduced adult conditions like stress fractures, bursitis and tendonitis to the world of children’s games. “We are now seeing these overuse, or overtraining, injuries that we never used to see very much before,” said Micheli, who works with youth sports groups and advocates education about injuries and their prevention. Doctors report increased cases of: Little League elbow, a condition caused by young baseball pitchers’ repetitive whipping motion. Soft, undeveloped bones in the elbow are more easily damaged during growth spurts. These injuries can lead to arthritis in young adults. Elbow ligament damage, also related to overtraining young pitchers. This condition can lead to ligament replacement surgery, a procedure once reserved for big league pitchers but that is increasingly common among high school athletes. Life-threatening brain hemorrhages, which afflict athletes who return to action too soon after a concussion. Even minor contact after a concussion can cause a lesser but still serious condition known as second-impact syndrome. Patellar pain syndrome, which happens when repetitive stress wears cartilage in the knee. Once unknown among young athletes, the condition is marked by pain and swelling. It is now the number one diagnosis for children in Micheli’s clinic.



Wear and tear

Rick Roberts is an example of a young athlete who suffered such an injury. It ended his dream of a professional baseball career. Roberts grew up playing baseball in rural coal mining and farming communities about 10 miles northeast of Johnstown, Pa. He was a standout at Forest Hills High School in Sidman, Pa. The Detroit Tigers drafted him in 1997 and sent him to play rookie ball for the Lakeland, Fla., Tigers in the Gulf Coast League. Roberts later played for the West Michigan White Caps, a Tigers Class-A team, before being traded to the Los Angeles Dodgers. He played in that team’s minor leagues in Florida, California and Arizona before landing on the big league roster for spring training in 2003. After only six games, Roberts’ arm hurt so much he was sent to a doctor. His rotator cuff and shoulder ligament were torn. He needed arthroscopic shoulder surgery to repair the damage. “It was just wear and tear over the years,” Roberts said, because he had never learned proper pitching techniques until he played professional baseball. Two procedures to repair the damage sapped Roberts’ pitching prowess. The injury sidelined his major league dream. Four years of rehabilitation later, Roberts considers himself at 80 percent - good enough to coach pitching for University of Pittsburgh at Johnstown, but not good enough for the Dodgers.



Coaching standards

It is impossible to know if coaches with more training might have prevented Roberts’ injuries. But Ball State University’s King is part of a movement that believes greater standardized training - particularly for coaches of school-sponsored sports - will at least reduce the number of those cases. In addition to a graduate program in coaching, King leads a national council that reviews training programs to determine if they meet standards set by the National Association for Sport and Physical Education. More than 16,000 teachers, coaches, trainers, athletic directors and sports professionals belong to the voluntary association. Their standards, first published 10 years ago, ensure training programs cover topics such as sports philosophy, ethics, first aid and injury prevention. Coaches also must learn how to communicate with players and parents. “We are trying to provide an easier platform for the states to determine how to accredit coaches,” King said. As it is, training requirements vary widely. That is partly because coaches, even in interscholastic sports, are typically volunteers or get paid nominally, and thus little is expected of their education. Furthermore, youth sports are regulated locally or, in the case of interscholastic sports, by state athletic associations whose rules are uneven. “Because of the nature of the way sports is governed, it differs state by state,” said Gregg Heinzmann, director of the Youth Sports Research Council at Rutgers University in New Brunswick, N.J. “This has been one of the impedances of education of coaches, and injuries to players or participants have resulted.”



Organization problems

Some believe a youth sports culture focused on who finishes first also leads to injury. Roberts, who works with youth athletes in the Johnstown area, said he is concerned about the win-first attitude he sees among players, parents, coaches and leagues. The result, he said, is young players who develop too fast and concentrate, for example, on pitches their arms and shoulders cannot handle. “The biggest mistake I see teaching baseball school is that every kid wants to throw a curve ball,” he said of the pitch that confounds young batters but creates the most twisting pressure on the elbow. “You shouldn’t throw a curve ball until you start shaving.” Not only are youth sports too success driven, King said, they are too organized. Children left to their own devices in backyards and playgrounds will stop games to change rules or reshuffle teams, King said, so that the sides are not uneven. That rarely happens in sports organized by adults. “We went from where the individual is sacred and the rules flexible so everybody can participate,” he said. “Now we’ve flipped it over. The rules are inflexible.” Organized sports - particularly those with trained coaches - also can have a positive influence, King said, which is to help players pay attention to their health and avoid injury. He said trained coaches know what actions lead to injuries and can adjust an athlete’s training and play. They also consider subtleties such as the difference between an athlete’s age and physical development. “That’s where better trained coaches can create a safer environment for the players,” he said.



High-profile cases

Yet change often comes only after a high-profile incident, said Heinzmann, of the Youth Sports Research Council. In New Jersey, for example, parents of a ballplayer struck in the face by a fly ball 20 years ago sued his coaches. The case was settled out of court but led to that state’s so-called Little League Law, which protects coaches with training from lawsuits._Danbury’s Pop Warner football case may be one of the first where coaches have faced criminal charges for excessive training. While the effects of that incident remain to be seen, it has at least stirred passions in a city that devotes more than 1,200 acres to parks, tennis courts and ball fields. The coaches’ attorneys have repeatedly declined to talk about what happened, and the coaches themselves have not been available to comment. Local prosecutors and police have said little and have protected the names of the parents who complained. But in court documents, prosecutors described how Weyer and Murphy dressed a dozen players in garbage bag “sauna suits” for a regimen of exercise interspersed with hot car rides and a session in the Danbury War Memorial locker room sauna. The coaches gave the two heaviest players water pills, prosecutors say. One of those players’ mother learned of the tactics when her son felt guilty for taking a pill without her knowledge and told her. She contacted the league. When she did not get results, she called police. Murphy’s defense lawyer, Joseph Dimyan, said a felony charge against the coaches was severe, especially given the number of people who have told him that such sweat-down sessions are common. He would not offer examples. “This kind of thing is rampant,” Dimyan said. “Since I took this case, people have been coming up to me saying, ‘When we were in school our coaches did that.’” The national group, Pop Warner Little Scholars Inc., has banned both coaches for life and condemned such radical tactics. Spokesman Josh Pruce said the group also has taken steps to protect young athletes. Next year, he said, coaches will be required to participate in one-day clinics that include coaching principles. “Danbury had zero to do with the change,” he said. The Danbury Athletic Youth Organization, which organizes the Danbury Trojans Pop Warner football program, has an ongoing policy that prohibits coaches from participating in weight-loss sessions, said its first vice president, Nicholas Kaplanis. Kaplanis acknowledged that publicity over last year’s sweat-down case has cast a shadow over the Danbury program. “It’s hurting those kids,” he said.

CNHI News Service Elite Reporting Fellowship recipient Randy Griffith is a reporter at the Johnstown, Pa., Tribune-Democrat and may be reached at rgriffith@tribdem.com.

Copyright (c) 1999-2007 cnhi, inc.

Next: Concussions are among the most difficult injuries for players, coaches and parents to recognize. But left undiagnosed, head injuries can have lifelong effects, as one Indiana football player and his family learned.

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