The first two to four weeks of fall sports practice carry the highest risk of injury for student athletes, according to a local sports medicine specialist — and the reason often comes down to a mismatch between summer inactivity and the sudden demands of a new season.
"When we look at the equation of stress and strain on the body compared to what the individual athlete is prepared for, there's a lot more stress and strain usually in those first two to four weeks compared to maybe what the athlete was doing in the off season or over the summer," said Dr. John Bocinsky, a board-certified primary care sports medicine physician with Orlando Health Jewett Orthopedic Institute.
That gap, he said, can set the stage for two different kinds of injuries: acute injuries, like a sprained ankle or a concussion that happen at a specific moment, and overuse injuries, which build up gradually.
Overuse injuries don't come from a single hit or fall. Instead, Bocinsky said, they come from repeated stress on muscles, tendons, growth plates and bones that adds up over days or weeks of practice.
Cross country runners are a common example. "They've suddenly ramped up their mileage that they're running each week, and they start to develop pain in their heel, they start to develop pain in their knee," Bocinsky said. Pushing through that pain, practice after practice, is often what turns manageable soreness into an actual injury.
Bocinsky said children going through puberty — typically between ages 11 and 16 — have muscles, tendons and bones that are growing rapidly, but aren't as resilient to stress during that growth.
"When you pair that rapid growth with a sudden increase in activity in potentially a body that isn't conditioned ... it's too much for the structures to handle, and that can be part of the recipe for injury," he said.
Bocinsky's central piece of advice is to start conditioning well before the first official practice.
"I like to use the phrase preseason starts before preseason," he said. If tryouts begin in August or September, he recommends athletes start gradually increasing their activity in June or July.
A helpful benchmark, he said, is increasing training volume or intensity by no more than 10 to 20% each week. For an athlete who will eventually practice 10 hours a week in the fall but is only active one hour a week over the summer, that means building up gradually over roughly eight weeks rather than jumping straight into a full practice schedule.
Bocinsky said dynamic stretching — moving through stretches and drills rather than holding a static position — tends to help prepare the body for activity better than static stretching alone.
After activity, he pointed to three pillars of recovery: sleep, nutrition and hydration.
"Your body is going to work on its recovery while you're sleeping," Bocinsky said, recommending 8 to 10 hours a night. He also advised parents to focus on the basics — three meals a day plus high-protein, high-carbohydrate snacks — rather than overcomplicating nutrition.
For hydration, he suggested drinking consistently before, during and after activity, aiming to keep urine a light yellow color. "If your body is telling you it's thirsty, usually that's too late," he said.
Bocinsky described pain as typically progressing in stages: first appearing only after activity, then during activity, and finally at rest — even away from sports. That final stage, he said, usually signals an established injury.
"Ideally, athletes are listening to their body earlier in that pain cycle and recognizing, okay, maybe I am overdoing it," he said.
Addressing pain early might mean rest, physical therapy or simply modifying an activity — steps Bocinsky said can keep young athletes on the field rather than sidelined for an extended stretch.
"In primary care sports medicine, we're here to help identify potential injuries early — or even before they happen — to help keep you playing throughout the season without having to miss much time," he said.