August 27, 2020

How do we keep student athletes safe? Vanderbilt’s Dr. Alex Diamond discusses strategies and addresses sports safety during the pandemic.


For weeks, coaches have put athletes through an endless series of drills in hopes that the repeated exercises will lead to a mastery of the skills.

Their ultimate goal: wins.

While plays and routes will become second nature to student athletes, there are a few additional skills that need to be in the lineup – ones that can ultimately save lives, said Alex Diamond, DO, MPH, associate professor of Pediatrics and Orthopaedic Surgery at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Sports this year are going to look completely different,” Diamond said. “Coaches, families, athletes and students will all have to set the tone and our goal is to make it as safe as possible and that will require some changes. And it will mean everyone pitching in as a community to help.”

“Sports are not a zero-risk endeavor. However, if sports are to occur, there are important risk mitigation strategies that can and should be implemented.”

The importance of continued masking

For months the tenants of safety have included masking, hand washing and social distancing. Diamond said these same safety guidelines can be followed during sporting activities.

Diamond stressed the need to continue masking when not actively participating in vigorous physical activity. Also, if not a strangulation risk, interfering with breathing or increasing risk for heat-related illness, masks can be worn during participation in certain sport settings.

“Regardless of the sport, when a player is on the sideline and not playing on the field, a mask needs to be on. When they are on the bench, a mask needs to be on. They can’t wait until game day to teach all of this and for players to feel comfortable with it. It needs to be practiced just as regularly as a play or skill,” he said.

“When it’s game time, it needs to be part of the routine like anything else.”

Diamond, a team physician for Vanderbilt University, the Nashville Predators and the Nashville Sounds, is one of six physicians from across the country named to the National Federation of State High School Associations (NFHS) Sports Medicine Advisory Committee, a post he was nominated for by the Tennessee Secondary School Athletic Association (TSSAA). He is also one of two physicians nationally representing the American Academy of Pediatrics on its COVID-19 Return to Youth Sports and Recreation Collaborative.

He said he has spent months with others working on guidelines to address sports safety during the pandemic to ensure a safer sports season.

“Any situations where social distancing can be instilled, masking and hand washing as well as a phased-in return to sport process … that can be really helpful,” he said. “We realize that there are some sports that lend themselves to these and some that do not. Every second outside of that sport should be used to mitigate the risks and limit possible exposure.”

Off the field

And the safety concerns do not stop with the athletes, he said.

Coaches, officials, referees, spectators and vendors are also required to abide by the protective measures of masking and social distancing and practice sports safety during the pandemic.

Seating in stadiums and arenas will have limited capacity to ensure state guidelines are met.

Sanitation of sporting equipment will also be enforced. And while water boys/girls are a traditional sight on Friday nights, that too will look different as each player must supply their own water bottles.

All players, coaches, spectators and officials will be screened upon entry for sporting contests.

“During the spring shutdown, we saw in high school student-athletes that the rates of physical activity and measures of quality of life decreased significantly, while rates of anxiety and depression increased. So, sports are important, but everyone needs to reset their expectations for this year,” said Diamond. “The goal for this season is to get people to be physically active, have social engagement and be around important mentors in their lives. Some of the key components of sports, equity and competition, along with championships can’t be our focus for this year.

“The best way to enjoy sporting events this year will be to shift the focus and mentality of why we do sports in the first place – physical, mental and psychosocial benefits.

“There are no perfect solutions, but we must all keep safety in the forefront, be mindful of the risks and protect each other.”


Assess the Risk

See this chart for Understanding Risk Related to COVID-19 and Youth Sports

A woman hugs a young girl.

Staying Safe is Essential. So is Your Child’s Care.

Monroe Carell Jr. Children’s Hospital at Vanderbilt is taking a careful approach to help keep your child and family safe, along with our team members. Our safety actions follow recommendations by the Centers for Disease Control and Prevention and other trusted experts.

COVID-19 is not the only threat to your child’s health and well-being. Many illnesses and conditions can cause serious problems. Good preventative care and early treatment can save lives. Please don’t delay important healthcare for your child — including all-important immunizations.

Learn More