Physical TheraPT

Youth Athletics

Are You Spring Ready?

Spring sports ramp up fast — practices lengthen, intensity spikes, and competition schedules fill up. Whether you’re a high school athlete or a weekend warrior, your performance and durability are built long before the first game. In this blog, you’ll find tips for maximizing spring sport performance and the checklist every high school athlete and weekend warrior needs, covering strength, mobility, progressive speed exposure, and recovery strategies to set the stage for a healthy, successful season.

When the weather shifts, so does activity. Spring sports ramp up fast — practices get longer, intensity spikes, and competition schedules stack up quickly.

But here’s the truth:

Injuries don’t spike because spring arrived. They spike because preparation didn’t happen in winter.

Across both high school athletes and adult recreational athletes, research consistently shows the same pattern: early-season overload, overuse accumulation, and inadequate strength or tissue preparation drive injury rates up.

Let’s break it down.

 

High School Athletes: The Early-Season Risk Is Real

 

Track & Field

  • Overall injury rate: 0.84 injuries per 1,000 athlete exposures

  • Girls experience 37% higher injury rates than boys

  • Nearly 70% of track athletes sustain at least one injury in season-long studies

  • Training in spikes + ≥6 hours every two weeks increases injury risk 8-fold

Lower extremity injuries dominate — especially hamstrings, calves, knees, and ankles.

Translation: Winter should focus on posterior chain strength, tendon loading, and progressive speed exposure — not just mileage.

Baseball & Softball

  • Shoulder and elbow injuries are most common

  • Pitchers account for nearly 40% of shoulder injuries and 57% of elbow injuries

  • Injury rates are highest in the first month of the season

Translation: Arm care, scapular strength, and gradual throwing volume must begin in winter — not at the first bullpen.

Tennis (Youth)

  • Lower extremity injuries (knee & ankle) are most common

  • 43% of injuries cause >4 weeks missed

  • Training ≥3x/week or >4.5 hours/week doubles injury risk

Repetitive rotation + quick direction changes stress both lower body and shoulder complex.

Translation: Winter needs rotational strength, landing mechanics, and ankle stability work.

Weekend Warriors: The Spring Surge Problem

Adults face the same issue — compressed preparation and intensity spikes.

Recreational Runners (5K/10K Season)

  • Most common: shin splints, Achilles tendinopathy, patellofemoral pain

  • Median recovery time: 56 days

  • Poor sleep, high mileage (>20km/week), and higher bodyweight increase risk

Protective factor?
Foot-core strength training reduces injury risk by 60%.

Translation: Winter is the time to build tissue tolerance gradually — not jump into race mileage.

Adult Recreational Soccer

  • 60% sustain at least one time-loss injury per season

  • Knee (29.9%) and ankle (12.4%) most injured

  • 30% of injuries last >1 month

  • 14% are reinjuries

Contact accounts for over half of injuries — but many ligament injuries stem from poor neuromuscular control.

Translation: Winter should include deceleration drills, landing mechanics, and strength for joint stability.

Pickleball (Especially 50+)

  • 34% of recreational players report injury annually

  • Knee, elbow, shoulder most common

  • Achilles ruptures often require surgery

  • Fracture risk increases after age 60

Interestingly, experience and consistent play reduce injury risk — so if you’re gonna play, maybe don’t make it your annual “dust off the cleats and hope for the best” appearance.

Join a regular group. Your muscles (and your pride) will thank you.

Translation: Winter should emphasize balance, calf strength, and reactive footwork.

Why Winter Matters

The first month of spring season consistently shows the highest injury rates across multiple sports.

That tells us one thing:

The body wasn’t prepared for the demand.

Winter training should:

  • Build tendon resilience

  • Increase force production capacity

  • Improve neuromuscular control

  • Gradually expose athletes to speed and volume

Preparation reduces the “too much, too soon” spike.

Winter-to-Spring Readiness Checklist

High School Athlete Checklist

Strength

☐ 2–3x/week lower body strength (posterior chain focus)

☐ Single-leg strength work

☐ Core anti-rotation & rotational strength

☐ Arm care program (for overhead athletes)

Mobility

☐ Ankle dorsiflexion mobility

☐ Hip internal rotation

☐ Thoracic rotation

Speed & Conditioning

☐ Gradual sprint exposure (no sudden spikes)

☐ Acceleration + deceleration drills

☐ Progressive volume build

Recovery

☐ 8+ hours sleep

☐ At least 1 rest day/week

☐ Monitor soreness and early pain signals

 

Weekend Warrior Checklist

Strength

☐ 2x/week resistance training

☐ Calf and Achilles loading

☐ Knee control exercises

☐ Foot-core training (especially runners)

Volume Management

☐ Increase mileage or play time ≤10% per week

☐ Avoid jumping from “zero to league play”

Balance & Stability

☐ Single-leg balance drills

☐ Lateral movement prep

☐ Deceleration mechanics

Lifestyle Factors

☐ Prioritize sleep

☐ Manage stress

☐ Address lingering injuries before season start

Final Takeaway

Spring performance is built in winter.

Whether you're a high school sprinter, a pitcher, a tennis athlete — or a 42-year-old signing up for a 10K — the research says the same thing:

Preparation determines durability.

Train smart now.
Load gradually.
Build tissue capacity before demand spikes.

Because the goal isn’t just starting the season.

It’s finishing it healthy. 

References

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  2. Prevalence, Incidence and Characteristics of Musculoskeletal Injuries in Athletics (Track and Field): A Systematic Review and Meta-Analysis. Edouard P, Tsukahara Y, Mann RH, et al. British Journal of Sports Medicine. 2026;:bjsports-2025-110541. doi:10.1136/bjsports-2025-110541.

  3. Epidemiology of Overuse Injuries in US Secondary School Athletics From 2014-2015 to 2018-2019 Using the National Athletic Treatment, Injury and Outcomes Network Surveillance Program. Post EG, Simon JE, Robison H, Morris SN, Bell DR. Journal of Athletic Training. 2022;57(5):510-516. doi:10.4085/1062-6050-600-20.

  4. Training in Spikes and Number of Training Hours Correlate to Injury Incidence in Youth Athletics (Track and Field): A Prospective 52-Week Study. Ek A, Kowalski J, Jacobsson J. Journal of Science and Medicine in Sport. 2022;25(2):122-128. doi:10.1016/j.jsams.2021.09.006. 

  5. Shoulder Injuries in US High School Baseball and Softball Athletes, 2005-2008. Krajnik S, Fogarty KJ, Yard EE, Comstock RD. Pediatrics. 2010;125(3):497-501. doi:10.1542/peds.2009-0961. 

  6. Epidemiological Features of High School Baseball Injuries in the United States, 2005-2007. Collins CL, Comstock RD. Pediatrics. 2008;121(6):1181-7. doi:10.1542/peds.2007-2572. 

  7. Epidemiology of Shoulder and Elbow Injuries Among United States High School Baseball Players: School Years 2005-2006 Through 2014-2015. Saper MG, Pierpoint LA, Liu W, et al. The American Journal of Sports Medicine. 2018;46(1):37-43. doi:10.1177/0363546517734172. 

  8. Incidence of Injuries in High School Softball and Baseball Players. Shanley E, Rauh MJ, Michener LA, Ellenbecker TS. Journal of Athletic Training. 2011 Nov-Dec;46(6):648-54. doi:10.4085/1062-6050-46.6.648.

  9. Epidemiological Analysis of Pediatric Baseball and Softball Concussions in United States Emergency Departments. Abed V, Hawk GS, Conley C, Akarakian R, Stone AV. The American Journal of Emergency Medicine. 2023;69:143-146. doi:10.1016/j.ajem.2023.04.025. 

  10. Injury Profile in Junior Tennis Players: A Prospective Two Year Study. Hjelm N, Werner S, Renstrom P. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA. 2010;18(6):845-50. doi:10.1007/s00167-010-1094-4. 

  11. Racket Sports-Related Injuries in Youth Athletes: A Narrative Review. Shrestha M, Usmani A, Karlov S, Harris A, Patel DR. International Journal of Environmental Research and Public Health. 2026;23(1):135. doi:10.3390/ijerph23010135. 

  12. Epidemiology of Musculoskeletal Injuries in Tennis Players: Risk Factors. Minghelli B, Cadete J. The Journal of Sports Medicine and Physical Fitness. 2019;59(12):2045-2052. doi:10.23736/S0022-4707.19.09842-6. 

  13. Diagnoses and Time to Recovery Among Injured Recreational Runners in the RUN CLEVER Trial. Mulvad B, Nielsen RO, Lind M, Ramskov D. PloS One. 2018;13(10):e0204742. doi:10.1371/journal.pone.0204742. 

  14. Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality. Mousavi SH, Hijmans JM, Minoonejad H, Rajabi R, Zwerver J. Journal of Sports Science & Medicine. 2021;20(2):204-215. doi:10.52082/jssm.2021.204.

  15. Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. Suda EY, Watari R, Matias AB, Taddei UT, Sacco ICN. The American Journal of Sports Medicine. 2022;50(1):248-254. doi:10.1177/03635465211056329. 

  16. Running With Injury: A Study of UK Novice and Recreational Runners and Factors Associated With Running Related Injury. Linton L, Valentin S. Journal of Science and Medicine in Sport. 2018;21(12):1221-1225. doi:10.1016/j.jsams.2018.05.021.

  17. Injuries Among Spanish Male Amateur Soccer Players: A Retrospective Population Study. Herrero H, Salinero JJ, Del Coso J. The American Journal of Sports Medicine. 2014;42(1):78-85. doi:10.1177/0363546513507767. 

  18. Soccer Injuries and Recovery in Dutch Male Amateur Soccer Players: Results of a Prospective Cohort Study. van Beijsterveldt AM, Steffen K, Stubbe JH, et al. Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 2014;24(4):337-42. doi:10.1097/JSM.0000000000000028. 

  19. Injuries in Formal and Informal Non-Professional Soccer - An Overview of Injury Context, Causes, and Characteristics. Gebert A, Gerber M, Pühse U, et al. European Journal of Sport Science. 2018;18(8):1168-1176. doi:10.1080/17461391.2018.1475507. 

  20. The Perils of Pickleball: A Two Decade Analysis of Upper and Lower Extremity Injuries From America's Fastest Growing Sport. Boroumand S, Park N, Katsnelson B, et al. Journal of Sports Sciences. 2025;43(14):1378-1385. doi:10.1080/02640414.2025.2496089. 

  21. Pickleball-Related Injuries Treated in Emergency Departments. Forrester MB. The Journal of Emergency Medicine. 2020;58(2):275-279. doi:10.1016/j.jemermed.2019.09.016. 

  22. Injury Risk and Epidemiology of Pickleball Players in South Korea: A Cross-Sectional Study. Jeong B, Lee KJ, Nam SH, et al. Frontiers in Public Health. 2025;13:1617291. doi:10.3389/fpubh.2025.1617291. 

  23. Pickleball: A Standard Review of Injury Prevalence and Prevention in a Rapidly Growing Sport. Azar FM, Lamplot JD, Bernholt DL, Spence DD. The Journal of the American Academy of Orthopaedic Surgeons. 2024;32(22):e1130-e1141. doi:10.5435/JAAOS-D-24-00151. 

  24. As Pickleball Continues to Gain Players, Injuries Are Increasing. Rodgers L. JAMA. 2025;:2840448. doi:10.1001/jama.2025.18833. 

  25. Emerging Patterns of Foot and Ankle Injuries in Pickleball Players: A Short Report. Kingston K, Parker EB, Higgins A, Smith JT. Foot & Ankle International. 2024;45(11):1266-1269. doi:10.1177/10711007241271215. 

  26. Common Sports Injuries in Young Tennis Players. Bylak J, Hutchinson MR. Sports Medicine (Auckland, N.Z.). 1998;26(2):119-32. doi:10.2165/00007256-199826020-00005.

When Is an Athlete Actually Ready?

Ever watch an athlete pass every physical test with flying colors but still hesitate when it's time to compete? Or see someone who's technically cleared but just doesn't look like themselves on the field? That's the psychological side of injury recovery — and it's just as important as the physical side.

Here's what many don't realize: an athlete who returns to sport when not psychologically ready may be at increased risk for mental health crisis, physical injury, or both. Let's break down the mental obstacles high school athletes face after ACL injuries, shoulder dislocations, and ankle sprains — and what actually helps them overcome these barriers.

 

The Mind-Body Connection: Why Psychology Matters

Psychological readiness is the critical missing piece in return-to-sport decisions. After ACL reconstruction, mental health scores directly correlate with successful return to sport. In fact, a recent analysis found that psychological readiness was the most effective predictor of return-to-sport success, with an effect size of 1.55 — outperforming physical tests like hop tests and limb symmetry indices.

The numbers tell a sobering story. Despite technical surgical successes and well-designed rehabilitation programs, many athletes never reach their preinjury athletic performance level, and some never return to their primary sport at all. This gap between physical capability and actual return suggests that factors beyond muscle strength and joint stability are at play.

 

The Psychological Obstacles: What Athletes Actually Face

Fear is the biggest mental barrier — specifically, fear of reinjury and fear of movement (kinesiophobia). Research on teens and young adults after ACL reconstruction found that each one-point increase in kinesiophobia was associated with a 28% higher likelihood of reporting unacceptable psychological readiness. Greater psychological readiness was strongly associated with lower kinesiophobia in both teens and adults.

The emotional landscape of injury recovery includes several warning signs that indicate poor adjustment:

  • Unreasonable fear of reinjury

  • Loss of athletic identity

  • Continued denial of injury severity

  • General impatience and irritability

  • Rapid mood swings

  • Withdrawal from teammates and support networks

  • Extreme guilt about letting the team down

  • Dwelling on minor physical complaints

  • Obsession with the question of when they can return

Nearly half of young athletes score below acceptable thresholds for psychological readiness after ACL reconstruction, highlighting just how common these struggles are.

 

What Psychological Readiness Actually Looks Like

An athlete who is psychologically ready to play has three key characteristics: realistic expectations of performance, high self-efficacy, and low anxiety. But here's an interesting finding: perceived physical competence matters more than actual physical competence when it comes to psychological readiness.

In a study of young athletes after ACL reconstruction, meeting criteria for perceived physical competence was associated with higher psychological readiness to return to sport, while meeting actual physical competence criteria showed no association with psychological response. This suggests that how athletes feel about their abilities may be more important than objective measurements alone.

For adolescent athletes specifically, the emotional response appears more influential than confidence in performance or risk appraisal. ACL-RSI scores increased significantly between 6 and 12 months post-surgery (from 55 to 71), and the emotions factor had better predictive ability for return to play than the confidence and risk appraisal factors.

 

Evidence-Based Assessment Tools

Several validated screening tools can help identify athletes who need psychological support:

Injury-specific tools:

  • ACL-Return to Sport after Injury scale (ACL-RSI): The gold standard for assessing psychological readiness after ACL reconstruction, with a cutoff score of 77 distinguishing acceptable from unacceptable readiness

  • Injury-Psychological Readiness to Return to Sport questionnaire (I-PRRS): Psychometric test specifically designed to assess psychological readiness of injured athletes

  • Tampa Scale of Kinesiophobia (TSK-11): Measures pain-related fear of movement

  • Reinjury Anxiety Inventory (RIAI): Specifically measures reinjury anxiety

General mental health screening:

  • Patient Health Questionnaire-9 (PHQ-9): Assesses presence of depression

  • Generalized Anxiety Disorder-7 (GAD-7): Assesses anxiety symptoms

  • Athlete Sleep Screening Questionnaire (ASSQ): Evaluates sleep disturbance

  • Sport Mental Health Assessment Tool 1 (SMHAT-1): Developed by the International Olympic Committee for comprehensive mental health assessment in athletes

Serial assessments using these tools offer a continuing profile of the athlete's psychological progression throughout recovery.

 

What Actually Helps: Evidence-Based Interventions

Three psychological elements are most important for positive rehabilitation and return to preinjury level of play: autonomy, competence, and relatedness (from self-determination theory).

Specific strategies that support positive return to sport experiences include:

  1. Reducing reinjury anxieties using modeling techniques — connecting athletes with others who have successfully recovered from similar injuries

  2. Building confidence through functional testing and goal setting — establishing both short- and long-term recovery goals

  3. Providing social support — keeping athletes involved with their team, teammates, and friends throughout recovery

  4. Reducing stressors related to premature return — ensuring athletes understand realistic timelines and expectations

  5. Fostering athlete autonomy — involving athletes in decision-making about their recovery

  6. Teaching specific stress coping skills:

    • Positive self-talk and cognitive restructuring

    • Relaxation techniques (meditation, deep breathing, progressive muscle relaxation)

    • Imagery and visualization

    • Goal setting

Research shows that psychological strategies like goal setting, positive self-statements, cognitive restructuring, and imagery/visualization are associated with faster recovery.

 

Building Trust and Addressing Misinformation

The foundation of psychological support starts with the healthcare team. Critical factors include:

  • Building trust and rapport — listening not only to make a medical diagnosis but also to assess and monitor emotional state

  • Educating the athlete about the injury — providing clear explanations in terms they can understand, with opportunities to ask questions

  • Identifying misinformation — athletes may obtain inaccurate information from parents, coaches, teammates, or the internet that contributes to confusion and emotional upheaval

  • Preparing parents, coaches, and other stakeholders — with the athlete's permission, educating support networks that injury management is individualized

  • Assessing the social support network — understanding who the athlete can rely on and their perception of that support

 

When to Refer to Mental Health Professionals

Athletes with problematic emotional reactions should be referred to licensed mental health professionals, preferably those with experience working with athletes. Early intervention and referral to the mental health network is important.

The American College of Sports Medicine recommends integrating sports psychologists and other mental health professionals into the athletic care network and coordinating referrals for mental health services as needed.

 

The Unique Challenges for High School Athletes

Adolescent athletes face specific psychological challenges. Adults were twice as likely as teens to report unacceptable psychological readiness after ACL reconstruction, suggesting that younger athletes may have different psychological responses or support needs.

Additionally, athletes with moderate preinjury adversity experienced less negative psychological responses compared to those with low or high preinjury adversity, suggesting that some prior experience with challenges may build resilience.

 

TOOLS FOR BUILDING CONFIDENCE

Resistance bands, balance pads and boards, and BFR cuffs are a few of the essential tools in rehabilitation. Resistance bands safely build strength, balance pads enhance coordination and stability, and BFR cuffs accelerate recovery through low-load training.

Below are our top 5 recommended products to use as a recovering athlete.

 
 

Click the image to shop on Amazon through our affiliate links and access possible discounts!

 
 

The Bottom Line

Physical clearance is only half the battle. Psychological readiness should be evaluated and incorporated into return-to-sport decision-making for all injured high school athletes, not just those recovering from ACL injuries.

The good news? High levels of optimism and self-efficacy and lower levels of depression and stress are associated with improved recovery from injury. Athletes who maintain optimism, believe in their ability to recover, and receive strong social support while managing stress and depressive symptoms are more likely to complete rehabilitation successfully, return to sport faster, and achieve better functional outcomes.

The key is recognizing that physical healing and psychological readiness must progress together — and when they do, high school athletes have the best chance of not just returning to their sport, but thriving in it.

 

References