Leg Cast by squarejer @ FlickrOver at Youth Soccer Insider, they have an informative article on how to deal with players recovering from serious injuries. If you haven’t had a player get seriously injured, it can be a significant challenge as a coach. The article goes into much detail about the rehabilitation, but one area that I found most important as a coach was dealing with the psychological issues:

There’s never a good time to be injured. With soccer, we are dealing with an almost year-round sport, even in cold winter climates. So, no matter when in the “season” the injury occurs, something in your training or competitive schedule will be missed. My advice to athletes I’m treating is to try and “let it go,” and understand that an injury occurred, understand that treatment will almost always get you successfully back to play, and understand that it will take some time to get back.

It’s normal to be upset, especially if the injury will involve treatment with surgery and extensive rehabilitation. Most athletes will get over their initial feelings and get on with the task of getting healed. Some athletes, however, have significant difficulties coping psychologically with an injury. If you are feeling overwhelmed by the injury, or just having a hard time dealing with it, be certain to let your treating doctor know as help is available for that too.

As a youth coach, the doctors, specialists, and trainers will handle much of the rehabilitation, but you need to be informed about the injury, things to look out for, and more.

Like it or not, parents will look to you to help ease the player back into the normal routine, but in a way the prevents reinjury or complications. Expect to often be pushing back against the player rejoining activity too soon.

I had a player on my then u11 Girls soccer team break her leg badly in softball right in the middle of the Spring season and she was out for many months, most in a full leg cast. I spoke with her parents extensively about what the doctors were saying related to her coming back to play, things to watch for, and so on. But what I was really concerned about was mentally how she would deal with it. She’s one of our team’s most intense and competitive players.

The first thing we did as a team was put together a care package for her, including The Daring Book for Girls, which I found quite comical and sort of ironic. A few of her teammates delivered it to her as soon as she was up for visitors. I explained to her parents that the team missed her, but they understood this was a severe injury and it would be some time before she was able to get around, even with crutches. I explained to them that if she wanted to and when she could, I wanted her with me on the team sideline. I wanted to use her as an assistant or apprentice coach.

I still remember the day she came back to the soccer complex. It was cold, cloudy, and drizzling. Our team was playing like the weather. Miserable. So at half time, as I’m settling the team down, I noticed she was on the bleachers bundled up. So I explained to the girls that their teammate had come out in this miserable weather, because she loved her team. We needed to start playing like a team, if not for ourselves, then for her. The girls were SO excited to see her back, they played an completely different match in the 2nd half. It was great.

But that was the start of a long season for her. Her parents were GREAT. She came to just about every match we had, home or away, no matter what the weather was like. She wanted to be with the team. The apprentice thing was mixed. I tried to get her to watch the match and let me know what she saw – it got her thinking about the game. But she also felt shy at first about telling me what she thought her teammates were doing wrong. Like she’d be ratting them out or something. Was kind of funny. One little thing we always did was when the team lined up for their equipment check, she stood up there with them, on crutches, in her uniform. The refs always chuckled when we asked if she could play if we wrapped up her full leg cast, but it reinforced she was a part of the team.

The timing of her recovery meant that she would be cleared for contact sports (yes it IS a contact sport!) around the time we started our Fall season. She’d be able to do non-contact activities earlier than that, which was great – she could come to pre-season practices. I’ll admit I had to shoo her off the field and admonish her for kicking a soccer ball when she still had her boot on. It was driving her crazy. As the day drew closer that she could ‘officially’ practice and her boot came off, I started her preparation. I explained to her parents that her knees and ankles would be weak. I thought it would be a good idea for her to start doing strengthening exercises for her ankle, which had been immobile for so long. Stuff like lifting a paint can upward with her toes, standing on the edge of a stair and flexing her ankles from full compression to extension. I also told them to check with their specialist about anything I was suggesting to ensure it meshed with what they were recommending. As an 11 year old girl, I don’t think she did the exercises very often, but she did some.

When she was finally allowed to start practice, we put her in an obnoxiously bright pinnie so the girls knew to stay away. There was a strict 2yd rule – the girls could not get closer than that to her, and it worked well. It allowed her to slowly get back into the feel of the game, even small sided scrimmages, without teammates crashing in for the ball. As expected, her knee and ankle were sore and hurting often because they had been immobile for so long. We eased her into activities slowly and had her icing her joints, and still doing the joint exercises. One of the most important things for us was trying to keep her from doing too much at once. She’s very competitive and wanted it all to be better now, now, now. But we would sit her down often to rest, and limit which activities she did at first.

Over time she got her strength back and was cleared for full contact. She was nervous at first, despite her doctors assurances that her leg was stronger at the break point than anywhere else. She normally would go in harder than anyone else on the team for a free ball, but was hesitant at first. That didn’t last long, and by mid season, she was just about back at 100%.

The point in sharing this is to highlight some of the things you’re likely to encounter when you have a player return from a serious injury:

  • Do everything you can to include them while they are sidelined. Encourage attendance at matches. Do things to keep them engaged – if they’re bored, they won’t want to be there. But don’t force them to.
  • Players will often want to return sooner than they should. Make clear to players AND parent that you will not allow them to return before they are cleared. Make sure the delineation between contact and non-contact return is clear.
  • If they show up at team events, do everything you can to involve them. Apprentice/Asst coach is a great way.
  • Coordinate with their specialist/physical therapist via the parents as to early activities. Ask them for suggestions.
  • Provide exercises they can do at home to strengthen joints, etc. before they return to the pitch. If they come to practices before they can participate, have an asst work with them on strengthening exercises. It’s not just about rehab for the injury – the rest of thier body will be out of shape as well.
  • Ease them into activities once they are allowed to start practices. Have them wear a bright shirt or pinnie that makes it clear they are ‘untouchable’. They may not like it – but necessary and can help them from going in on their own as well.
  • Monitor them closely for excessive joint pain or possible reinjury as they work to get back to full form.
  • Be aware that player will be worried and tentative. Ease them back into the game mentally and physically.

Hopefully as a coach you never have to deal with this, but life happens and kids hurt themselves. Helping them get back into a sport they love can do wonders for their recovery. I hate that one of my players had to go through something like this, but was thrilled we were able to have her back within 6 months.

Have you gone through something similar as a parent or coach? What types of things did you do to ease the mental anguish of not being able to play a sport they loved as well as helping ease them back into it?

Adding: Jenn highlighted something I totally forgot to mention in her comment below. Tryouts. This player DID miss tryouts because of her injury. Our league has a policy that says players can ‘keep’ their spots in the case of a serious injury that causes them to miss tryouts. That was one of this player’s biggest fears when she first got hurt – she thought she’d lose her spot on the team. We told her flat out, the spot was hers with the league’s full backing. You can’t punish a kid because they get hurt. If you know they’ll be back – why force them to work their way back up? One less thing for them to stress about during their recovery.