What Happens When a Young Athlete Plays Through Pain

Just like an adult athlete, when a child or teenage athlete gets injured, they are no longer at peak performance and may be forced to slow down. When playing time or a starting spot is at risk, the young player may try to keep the injury a secret or work through the pain. This happens particularly with older children who may also want to avoid a coach or parents thinking they are not playing their best.

John Colville, a physical therapist with the OrthoCarolina Wellness Center, says that when a young athlete plays through pain, several things can happen:

• The athlete suffers decreased performance. While in some cases the injury may heal itself, it often won’t. The body naturally looks for ways to avoid the pain during play, which can lead to further injury.
• The player develops compensatory patterns. In an effort to avoid pain, the athlete may unknowingly teach themselves a new, abnormal pattern of movement to compensate for pain or stiffness. Over time, the body will eventually adapt to these unusual patterns and have a hard time ‘unlearning’ the new pattern. Compensatory patterns can mean a drop in athletic performance, which will eventually show in play.
• The athlete becomes apprehensive. Because they are trying to avoid pain, the child is now at risk for what’s called fear avoidance – they create a fear pattern where they are afraid to play in a normal manner. Fear avoidance can also affect their mental well-being.

If a child is complaining of pain it’s always a good idea to have it assessed by a medical professional. As doctors don’t always have time for extended visits, consider scheduling a visit with a physical therapist who can check movement patterns. A physical therapist can take more time to assess and advise for appropriate return to sport after injury, and can watch the child jump, run and do functional movements to get an exact idea of what the underlying issue may be. Physical therapists also can utilize a patient reported outcome measure, such as ACL-RSI, a 12-item scale developed to measure three types of psychological responses believed to be associated with resuming sport following injury — emotions, confidence in performance and risk appraisal.