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Plan Your Pre-Season

As the sports medicine team at Children’s Mercy Hospital, we recognize the benefits of sports, especially now. After time away from sports, however, there is a concern for an increased risk of injury due to being out of shape and/or increasing the time spent practicing, training or competing. As restrictions start to lift in local communities, athletes, coaches and parents are excited for opportunities to return to exercise and sport, just as much as we are.  However, a thoughtful guided approach to exercise after we have been away from sport is important to try and minimize risk of acute and overuse injuries.

Gradual Return1,2

There is so much that we are going through together and returning to sports will be one of them. Many are starting at approximately the same point: pre-season. This stage in sports is intended to get the body moving and ready to compete.

  • Adjust activity level to around 25-50% of the athlete’s pre-pandemic activity level. This should include training frequency, intensity, volume and repetitions.
  • The first couple weeks should focus on low to moderate intensity: Light jogging, bodyweight exercises.
  • Athlete may adjust or increase workload by about 10-20% per week.
  • Be sure to take frequent breaks during your exercise sessions.

Once you get started – keep training! Muscle strength and recovery is improved with training consistency.


In combination with a gradual return to activity, it is similarly important to talk about acclimatization. In the Midwest, we focus much attention on heat acclimatization, which is a description of training to encourage the athlete’s body to change and tolerate the hot environment better. This is especially important as the weather continues to warm up.

  • Athletes should acclimatize to heat gradually over 10-14 days.
  • Athletes should not be practicing more than once per day for the first 5 days.
  • Total practice time should not exceed 3 hours per day.
  • Protective equipment should be added gradually over the 14-day period.
  • Double practice days may begin on day 6; the first practice may not exceed 3 hours and must be followed by a 3-hour rest period with both practices not exceeding 5 hours total.
  • Consider alternating double practice days with a single practice day or rest day.
  • Athletes must complete full acclimatization period; if any athlete experiences illness during this period, re-acclimatization should be considered.
  • Any benefits achieved from heat acclimatization may be decreased if not maintained.

We hope these training tips will help guide our community for a safe return to sports. Most importantly, we hope to not see you in the office! Stay safe and stay healthy.


  1. Caterisano, Al, Decker, D., Snyder, B., Feigenbaum, M., Glass, R., House, P., Sharp, C., Waller, M., Witherspoon, Z. “CSCCa and NSCA Joint Consensus Guidelines for Transition Periods.” Strength & Conditioning Journal, June 2019 - Volume 41 - Issue 3 - p 1-23

  2. Clarkson, Priscilla M., and Monica J. Hubal. “Exercise-Induced Muscle Damage in Humans.” American Journal of Physical Medicine & Rehabilitation, vol. 81, no. Supplement, Nov. 2002

  3. Casa DJ. Csillan D. Pre-season Heat Acclimatization Guidelines for Secondary School Athletics. Journal of Athletic Training. 2009; 44(3):332-333.

Sports Medicine, Pediatric Orthopedic Surgery

Sports Medicine; Assistant Professor of Surgery, University of Missouri-Kansas City School of Medicine

Sports Medicine, Pediatric Orthopedic Surgery

Primary Care Sports Medicine and Non-Operative Pediatric Orthopaedics Physician; Pediatrician; Assistant Professor of Orthopaedic Surgery, University of Missouri-Kansas City School of Medicine

Sports Medicine Outreach & Athletic Training Manager

Physical Therapy

Sports Physical Therapist