“Survive and advance.”

This was the rallying cry of the late, great college basketball coach Jim Valvano as his North Carolina State team was navigating the 1983 NCAA March Madness tournament.

His underdog Wolfpack team pulled off upset after upset in thrilling fashion, concluding with an improbable national championship.

Win or lose, the most important outcome of any game your son or daughter plays is whether they come out of it healthy.

That they survive, ready to advance to the next game.

More than 90% of youth athletes are moderately or severely injured at some point in their career.   

Injury isn’t inevitable, but it’s pretty darn close.

We all know there is a safety risk in sports, that bumps and bruises are part of the process.   

It’s the serious injuries, the type that keeps you out for months or even years, those are the ones we all pray don’t happen to people close to us.

Funny thing is, when you know what to look for, many of the risk factors that create these catastrophic injuries are easy to spot.

If you’ve ever had a hot water tank that showed signs of rust and cracks, you knew it was likely to burst.  

When your car burns oil faster than normal, you know the engine is likely to break down soon.

Sports injuries work in a similar fashion.  

Thanks to the medical side of our field, we know many of the early warning signs that, if fixed soon enough, can head off bigger problems.

A Lack of Flexibility or Stability in Key Spots

Recently we mentioned that all athletes start their journey with us by going through a Functional Movement Screen, an analysis of flexibility and stability at key injury risk sites.

Stunningly, over a 500 athlete sample size only 28 percent passed the ankle flexibility test.

Now who really pays attention to their ankle flexibility?

Likely no one, but it is a huge predictor of future foot, knee, hamstring and ankle injuries.

The same goes for a weak core, or tight hips and shoulders.

Identify your risks and eliminate them through exercise.

It's that simple.

Poor Single Leg Balance

When running at high speeds we are on a single leg of support the whole time.

Those with poor balance likely won’t land squarely very often.  This can put an overload of stress on areas that aren’t equipped for it, like the inside of the knee.

If you don’t have good single leg balance, you also are more likely to have poor coordination overall, leading to awkward landings from jumps and other athletic movements.

This skill is masked by the fact that most of the time we are standing on both legs.   

Try holding a high knee balance position with your hands behind your head for thirty seconds per leg.  

By the end of the minute you’ll know if you need to fix this or not.

Inability to Decelerate & Cut Efficiently

It takes a good four to six strides for most athletes to really get up to a top speed.

When it comes to slowing down, though, many athletes want to dive or jump to a stop in one or two strides.

This puts an incredible amount of stress on the joints in your lower body. 

And when combined with poor coordination, an ankle or knee sprain is likely in your future.

The problem is magnified if you try to make a cut off of one leg, as you would when moving laterally.  

Without a gradual deceleration over three to five strides you are likely to put too much weight on the outside of your foot when changing direction.

Again, the likely result is an ankle or knee sprain.

These are basic, easy to learn skills that can be learned and carried over to practices and games.   Any kid can fix this issue in a relatively short period of time.

Repetitive Motion

Let’s say you’re a doctor and I come to you because I’m having elbow pain.

You rightly ask what I do for physical activity, and I reveal that every day I bang my elbow into a brick wall for ten to thirty minutes straight.

How would you fix my elbow pain?

Prescribe painkillers?

Send me to physical therapy?

It doesn’t take nine years of college to know the answer is to stop banging my elbow into the wall.   

Yet hundreds of thousands of athletes nationwide currently have knee, shin, and foot pain.  

They never seem to consider drastically cutting back on distance running as a solution.

Throwers have similar issues with their shoulders and elbows, yet often continue to throw nearly year-round.

The human body is incredibly adaptive at tolerating amazing amounts of physical stress, provided the increases are not drastic, nor the total volume.

Chronic soreness in a joint is a sign that you’ve done too much for too long.  

There’s no exact amount that’ll tip you over the edge, because there’s variability in how much load each of us can handle.

What I can tell you is that battling through chronic joint pain is likely the biggest ticking time bomb when we’re talking about sports injuries.

Athletes who are mobile, stable, and coordinated, who show great speed and agility mechanics have a much better chance of staying healthy at appropriate workloads.

They are the ones who can build from one season to the next, one year to the next, without lengthy injury setbacks.