Skins infections and concussions rate among the top five concerns in wrestling

    Editor’s Note: Matt Doyle is the Director of the Athletic Training Outreach Program for University of Iowa Sports Medicine. From 1999 until 2011, he provided athletic health care for the University of Iowa wrestling team. He recently spoke to WIN Editor Mike Finn about the major health issues affecting wrestling.

WIN: What are the top five health concerns in high school and youth wrestling?
DOYLE: No. 1 and what is always on people’s minds, when it comes to wrestling, are the types of skin infections and preventing skin infections that wrestlers would have.
Concussions are another hot topic. With wrestling, it’s not the most common injury that we see. But it’s a very important topic and we are learning to manage them more effectively and it’s changing the way we have to look at it. We are doing a better job educating people about concussions and you are seeing more (athletes) taking time off and it’s appropriate that they are held from competition.
Next there would be weight control and nutrition issues. That includes proper nutrition and basic diet, maintaining a healthy weight and competing at the appropriate weight class. A lot of kids are into supplements and thinking about how much money can I spend to get a supplement here or there, where actually they can maximize their performance simply by getting basic nutrients at the right time and the right volume.
Then there are the increasing injury rates in youth sports in general and preventing specific injuries common to youth wrestling. Upper-extremity injuries like elbow dislocations and shoulder injuries are much more common as there are more mismatches (at that age group) and probably more kids who are not physically developed, with strong and stable joints in their upper extremities.
If you look at adolescent and youth wrestling injury data, the parts of the body where injuries occur are similar to Greco-Roman wrestling, probably because there are more lifts and throws and more upper-extremity injuries, compared to high school and college folkstyle wrestling where there are more knee injuries.
The fifth health issue deals with preventing wrestling-specific problems like cauliflower ear, knee bursitis and other common wrestling injuries.

 WIN: What is the role of a parent?
DOYLE: Parents know their kids and what’s best for them, but they need to learn more about the sport of wrestling and guide their kids. They should be aware of what their kid’s interest is. Are parents pushing them too much? Do kids want to do this year round? Also, most parents don’t know everything about care and prevention of injuries. They need to find resources and talk to other parents who’ve had kids to make sure they are taking in the right information to make the right decisions for their children. They should also talk with and evaluate coaches or even offer assistance to help create a safe and healthy environment.

WIN: Regarding skin infections, can the sport of wrestling ever be skin infection free?
DOYLE: I don’t think so. We can really do many things to prevent them, but the nature of wrestling is that it is a contact sport so you are going to see more of it in wrestling than other sports.  And with the trauma from wrestling there is going to be skin wounds and scratches where there are opportunities for germs to cause infections. At some point our immune systems break down but if there is good nutrition, proper rest and recovery, and good personal hygiene we can really decrease the chances of having problems.

WIN: Is there any product made that can totally eliminate skin infections?
DOYLE: No. Most of today’s products serve a purpose and help decrease the chance of infection. There are ones to clean the environment. You have to think about the locker room surfaces, the wrestling mats and the equipment wrestlers wear. All those things need to be cleaned on a routine basis and you need to have a plan in place.
Coaches know they need to have clean mats for their athletes, but they also need to think about the person-to-person contact and enforce good personal hygiene. Everyone has to follow a routine of showering after practice, washing their gear appropriately and washing your hands throughout the day.
There are simple and basic products available to do all these things but they all have a role and have to be used correctly.

WIN: Regarding concussions, is this another problem that has been ignored in the past? For example, Jake Deitchler (the 2008 Olympian and Minnesota college wrestler who recently gave up wrestling) said he first dealt with concussions when he was seven.
DOYLE: If you had to ask me what the common injuries are in wrestling, concussions would be low on the list. But right now concussions are a hot topic in all sports. We have learned there are more long-term consequences to ignoring treatment of concussions. If you don’t restrict these people, they are more easily concussed again. If they have a history of repeated concussions, this can lead to further problems.

WIN: Regarding youth wrestling, the number of kids involved is growing. Wrestling does not want to scare parents away from having their kids wrestle. What are things that can be done to protect these kids? For example, should there be a limit to the number of matches a kid wrestles?
DOYLE: You have to look at the supervision of the tournament. Who is organizing it? Who are the coaches? Who are the officials? I do think that children are pretty resilient. They can handle quite a bit of activity, especially if they have been practicing and gradually building up to that. Limiting the number of matches would not be as important as teaching all kids the proper rules for safe participation. For example you can’t slam a wrestler or put an illegal hold like a full-nelson on a kid and injure their neck. Officials need to be aware of kids’ positions and the coaches need to make sure they are teaching these kids the proper skills.

WIN: Many of the coaches who work with the youngest kids don’t have some formal training in dealing with health issues. A lot of these coaches are just parents. Should some standard be established for anyone working with kids?
DOYLE: That is a difficult question, because you definitely want educated and knowledgeable coaches working in the sport, but it is also difficult to get enough people to coach at all levels. There are organizations that are discussing youth sports injuries and what can be done to help in these areas. The NATA recently hosted a Youth Sports Safety Summit in Washington D.C. that brought together concerned groups to address health issues in youth sports. Another effort called STOP (Sports Trauma and Overuse Prevention) Sports Injuries is a campaign initiated by the American Orthopedic Society of Sports Medicine and provides injury prevention resources for athletes, coaches, parents and health care providers.

WIN: In talking about weight control…. wrestling is a sport where we match up athletes at the same weight. Many wrestlers think through the following question: do they go down to a lower weight by cutting weight or do they go up and increase their weight training to compete at a higher weight?
DOYLE: When you are talking about youth wrestling, you have to be aware that kids are growing and developing. Nutrition-wise, you really have to be careful about limiting calories. It’s an interesting problem, because if you look at society, we have a problem with obesity.
The majority of kids need more physical activity and they don’t have good nutrition. So the first issue is you need all kids to eat healthy foods and amounts that are appropriate for them, so improve their diet.
WIN: When should wrestlers start weight training?
 DOYLE:  The better question to ask is how can I safely introduce the young athlete to strength training? I think it is OK to introduce weight training in young athletes and the junior high age groups, just to teach them techniques and not to stress their bodies. They don’t have the hormones to benefit from it but they can learn routines and techniques and healthy habits.

WIN: Why should young wrestlers weight train if they will not receive the immediate benefits?
 DOYLE: There are benefits, but just not the benefits most people are probably thinking about. You are going to find some debate about what age group athletes should start, but you have to start at some point and they need to learn the techniques to properly perform the exercises and not injure themselves. We do need to remember that there are kids growing up on farms that are scooping and hauling things and doing weight training their whole lives. We just have to structure it in a different way and kids need to learn how to do this. You don’t want them to do it incorrectly and injure themselves. Eventually, they can make adjustments as they mature and will be developing muscles from their strength training.

WIN: Does wrestling deal with the problem that cauliflower ears are looked at as a badge of honor; if you have a cauliflower year, you are truly a wrestler?
DOYLE: Definitely. People want to be identified as a wrestler. They don’t think it’s a big deal and don’t like headgear. It’s really a discipline issue. People should just get used to it because they aren’t going to win in competition without it. Initial injuries to the ear can become infected, and then you have a worse problem. The changes to the outer ear and can produce a significant deformity and functional loss of hearing, especially if the canal of your ear changes. I remember there were guys on the team who could not listen to their music because they could not get their ear plugs in their ears. Also wrestlers with deformity tend to have a lot of ear infections since their ears don’t dry out well after showering.
I would think most coaches would not want their wrestlers to miss one day of practice because of an infection or ear pain when it is something that could have been prevented. People need to do everything they can to maximize their practice time and performance. Injury prevention is really about discipline, getting the right amount of sleep, having your proper protective equipment in place for example. It’s all about living the right way. There are many lessons kids can learn from participating in wrestling if people do things right. Wrestling can help a kid learn about dedication and discipline that will help them throughout life.