Just as high school and college athletes were gearing up for spring practice, Covid-19 brought sports to a sudden halt around the world. Staying home made staying in shape difficult, especially for elite athletes accustomed to workouts.

Although some team sports are attempting a return, on a limited basis, it is still uncertain how long it will be until athletics in America will be anything like normal. As teams get ready to resume play, we need a plan for keeping our young athletes safe.

Robert Agee, MD and John Young, MD of Brookwood Baptist Health Specialty Care Network's Precision Sports Medicine and Orthopedics work closely with student athletes.

"Our student athletes aren't likely to be in the same shape they normally would be in this time of year," Agee said. "We are getting into football season, and the coaches we work with have been good at gradually getting their players up to speed. Cheerleaders are in the same situation. Their routines are physically demanding and they need to ramp up their conditioning to be ready."

"From an orthopedic standpoint, strength and flexibility are the main concerns," Agee said. "Our athletes need to build muscle to protect joints and develop their range of motion to avoid tears. The pandemic has made it more difficult to get in shape. They have to wear protective masks when they are in close contact. In summer, they can quickly become overheated and dehydrated. Frequent breaks and hydration are essential to avoid cramps and passing out."

John Young, MD

Young said, "This is also true for kids who are in the band. We often see them come into the office with stress fractures from marching. The heavier instruments can also be tough on the back, shoulders and arm muscles if band members haven't had time to build their strength. Their uniforms can also be hot, which makes hydration and time to cool off important for them as well."

Since we're into football season, those players have had the shortest time for conditioning. Basketball, baseball, track and other sports may have longer to condition, but the truth is we don't know how much of a season the pandemic will allow any sport in the coming year. Despite trying to keep athletes safe in a partial bubble, if one member of the team is exposed to the virus, all the players may have to quarantine. It can also happen quickly to other teams on the schedule, leaving the team without a game.

If Covid-19 deaths almost double by the end of the year, as some models have predicted, we could easily find ourselves at home again, waiting out another shelter-in-place. So what can athletes--or people in general--do to keep themselves in better shape and ready to return to sports when the opportunity comes?

"I tell athletes to work on a home routine that does as much as what you would be doing at the gym or in practice," Agee said. "Athletes needs weight training to build muscle. If you don't have weights, go to the pantry and find some heavy cans. Use them like hand weights and free weights. Do stretches to stay flexible. If you can get out to the sidewalk or park, keep up your running. You're going to need lung capacity and a healthy heart when you're back in the game."

Keeping the athlete's immune system in good shape is particularly important this year to keep them healthy to play another day. Even if younger people are less likely to die from Covid-19, it can cause lasting lung and heart damage that could cancel the hope a talented athlete might have of building a career.

"Team doctors need to watch for this in the future. Even with an asymptomatic case, there could be damage that might not show up until the stress of play." Agee said.

Young said, "Sleep is vital to the immune system, especially to young athletes in their formative years. If they are staying up late studying, or get out of their sleep routine staying at home with a lot of late screen time, they may not be getting enough rest. We have to help them understand that they need their sleep and why."

Agee said, "Nutrition is also essential. Some kids depend on meals at school for nutrition. If they are at home, they may be snacking more than eating real meals. With so many parents losing jobs, food insecurity could become an issue. If we can't be sure they are getting everything they need in food, they may need supplements to support their immune system, like Vitamin D, zinc, the antioxidants and maybe a good overall multivitamin and mineral supplement.

"We also need to watch for signs of depression in our young athletes. Being young is an emotional time, and being isolated at home, not getting to do the things you enjoy, and perhaps missing an opportunity for a scholarship because you aren't getting a chance to show recruiters what you can do is hard."

Whether there will be socially distanced fans in the stands or games that can only be seen on screen, Young reminds parents and sports fans that this is a time to be realistic in their expectations and give young athletes a break.

"You have to remember it takes a lot of practice to play with precision," he said. "Teams haven't had nearly as much preparation as they would in a normal year. So it isn't reasonable to expect the same speed, agility and dexterity. But even if this isn't a normal year, sports are good for young people. They are good for their physical health, teach them teamwork and leadership, and gives them an activity they enjoy.

"For now, we just have to do the best we can and keep moving forward. We need to make sure kids understand that washing hands and using sanitizer, social distancing and wearing masks is something they can do for their team and themselves and their family."

When we look back at 2020, it likely won't be the championship season every kid dreams of having, but if we keep working together, fighting the pandemic day by day, there will be other seasons.