Getting Youth Athletes Back on the Field

Safe play practices beat virtual alternatives during pandemic

For youth athletes who are constantly moving and competing, slowing down for a pandemic is harder than asking a soccer player to perform flawless toe taps. Take Pippa Hodgins, for instance. The 16-year-old can hardly remember a time when she didn’t play the game.

“I love the feeling when you are on the ball and going at it, pushing yourself to the limit every day,” says Hodgins. “With the pandemic, I had to figure out what I could do to challenge myself and stay active without practices.”

Hodgins plays for Pleasanton RAGE Girls Soccer Club, which has more than 800 players ages 4 to 18 in their recreational and competitive programs this season. During the shelter-in-place order in the midst of the COVID-19 pandemic, the club used virtual training for months to keep coaches and players connected and working on skills. Even though it worked, they were ready to get back on the field. First, they had to figure out how.

“Many of the guidelines are vague around returning to play for youth sports. There are confusing differences between what’s allowed for camps versus what’s allowed for youth sports, and each city and county has their own set of guidelines beyond the state and federal mandates,” says Erin Sharpe, director of coaching for RAGE.

Young Athletes Academy leads the way

Sharpe turned to Christine Boyd, MD, a pediatric sports medicine specialist at Stanford Medicine Children’s Health and a frequent source of medical advice through Stanford Medicine Children’s Health’s Young Athletes Academy. The academy was established by Stanford’s Children’s Orthopedic and Sports Medicine Center to support school and club teams with injury prevention, sideline sports medicine, access to specialty care, education, and more. Today, the academy supports 31 teams.

“Dr. Boyd was instrumental in getting us back on the field,” Sharpe says. “She advised us every step of the way, including the implementation of safe distancing, mask policies, appropriate sanitation measures, health screening, and the execution of our check-in and checkout processes. It is also very helpful that she is familiar with the sport of soccer and the important aspects of our training regime. She also understands how critical it is for the mental health of our players to have the opportunity to engage with each other in person, and to be able to safely exercise together in a structured environment.”

Dr. Boyd says that RAGE has been an ideal partner, not just during the pandemic but for years.

“I’ve been working with RAGE for 15 years. They did an excellent job returning to play within constantly changing guidelines,” she says.

Boxing in players for safety

In order to return to play, RAGE athletes each started with their own practice boxes, drawn on the turf or grass, to keep them 30 feet from other players. Players have their own balls, and their backpacks had to sit directly behind their box.

“Being able to see their coach and teammates in person, even at a distance, is better than interacting through a computer screen,” Sharpe says.

Hodgins agrees. “When I heard we were practicing again, I got so excited. I thought, ‘I can run with friends with a soccer ball at my feet!’ she says. “The boxes are not ideal, but they keep us safe. Plus, they allow us to work on our individual technical development, which I think will make us all better players when we go back to games.”

Out of 480 competitive players, only six families initially decided to forgo the new on-field practices. Sharpe attributes the strong participation rates to their hard work to establish safe play and to a town hall meeting held for parents with Dr. Boyd present to answer questions.

“Having Dr. Boyd on hand to answer medical questions put a lot of parents’ minds at ease. But we put no pressure on parents to have their daughters participate if they didn’t feel comfortable,” Sharpe adds.

The plan for in-person practices is going well. There have been only a few cases of COVID-19 among the players over the roughly 10 weeks of play, all of which were traced back to outside sources. Per CDC guidelines, if someone has the virus, or if a member of their family has the virus, they must isolate or quarantine for the required 11 to 14 days. Players don’t wear masks while practicing because of exertion, but they do wear masks before entering their box and when leaving the field.

“Every step forward, we review and make decisions that best fit the needs of the athletes and families. We decide whether to keep things the same, or progress,” Dr. Boyd says.

Recently, Hodgins’s team added a drill called alligator ally to the mix, where players work with their ball while running in formation with another player at a safe distance. Next up? Hopefully, someday, contact play.

“In our competitive program, we initially had our players stay in one box for the duration of the session, but then progressed into adding additional empty boxes for our players to transition into,” Sharpe says. “This optimized movement, but still clearly defined the required distances needed between our players. Now that our players are growing more comfortable with training at game pace while not violating these distance requirements, we are progressing to eliminating boxes, but still have cones on the field to identify the appropriate spacing that our players must maintain at all times. We are most eager to move to the next phase, where contact play is deemed safe and allowed at the state and county levels. Even if it is just one versus one or smaller games of seven versus seven contact play with a singular training group, it will be a big step for us. Dr. Boyd is working closely with us on all of these progressions. She is very forward-thinking, and she understands soccer.”

Preventing injuries when returning to play

Dr. Boyd also shares tips with teams on ways to prevent injuries when transitioning back to sports. She and other sports medicine doctors at Stanford Medicine Children’s Health are seeing more fractures in kids from an increase in outside play. They are seeing soft tissue and overuse injuries as a result of repetitive exercises or suboptimal techniques with home workouts. Jumping back in too fast is also a problem.

“When kids get back to play, they want to give 110%,” Dr. Boyd says.

That’s what happened with Hodgins, who injured her ankle the day before the start of shelter in place. She did a good job healing her injury on her own, but when she went back to practices with RAGE, her competitive side got the better of her. She started getting pain and weakness from pushing her ankle too hard. That’s when she had a virtual appointment with Dr. Boyd, who got her back on track with physical therapy exercises and a dialed-back practice approach.

“I’ve worked with Pippa through multiple injuries. She is always positive and incredibly resilient,” Dr. Boyd says. “She just smiles and asks, ‘What do I need to do to fix it?’”

Getting back on the field has been great, not only physically but also emotionally and socially, for kids who are feeling cooped up inside. Hodgins loves seeing her friends’ smiling faces and calling to them across the training field.  

“I love the girls on my team,” Hodgins says. “I really appreciate the amazing effort from everyone who took into account our interests as players and got us back to practicing together.”