Twitter Facebook RSS Feed Print
Your Child

More Kids Suffering ACL Injuries

2:00

Kids involved in sports like soccer, basketball and football are increasing their odds of damaging their knees, according to a new study.

A common knee injury — an anterior cruciate ligament (ACL) tear — has steadily increased among 6- to 18-year-olds in the United States, rising more than 2 percent a year over the last two decades, researchers report.

These injuries peak in high school, said lead researcher Dr. Nicholas Beck, an orthopedic surgery resident at the University of Minnesota. Girls have a higher rate of ACL injuries, Beck added.

Sports like soccer and basketball often require the child to pivot or cut back and forth, putting stress on their ACL and risking a tear.  Contact sports like football can further increase the risk. But ACL tears can occur in tennis and volleyball, too.

The study didn’t look at why the injuries are on the rise, but co-author, Dr. Marc Tompkins, an assistant professor of orthopedic surgery at the University of Minnesota, has a theory.

“One potential cause is the year-round sports specialization that is occurring in kids at an earlier age,” Tompkins said.

Instead of playing a variety of sports and using different muscle groups, many kids are focusing on just one sport creating muscle fatigue and an increase for injury, Tompkins explained.

“Another potential cause is that children as athletes play with more intensity and force than 20 years ago, which may put the body at increased risk of injury,” he added.

The numbers of girls experiencing ACL tears are rising because their sports participation numbers are up.

Beck hopes this study will increase awareness of ACL tears in young athletes and promote interest in prevention programs or developing athletic participation guidelines.

The anterior cruciate ligament sits in the center of the front of the knee. It’s one of the ligaments that holds the knee bones together. When it tears, the ligament splits into two, causing knee instability, according to the American Academy of Orthopaedic Surgeons.

“ACL injuries are serious in the short term because they generally require six months’ to a year’s worth of hard recovery work before going back to sports. And even then it often takes longer to get back to pre-injury function,” Tompkins said.

“ACL injuries are serious in the long term, too, because we know that even if they recover well with or without surgery, the risk of developing arthritis in the injured knee is higher than before the injury,” he added.

Some sports medicine specialist say there are ways to reduce injuries among young athletes, by having coaches teach good running techniques that promote improved function and agility.

Children participating in sports can also benefit from flexibility and stretching programs.

The researchers found that girls of all ages experienced a significant increase in the incidence of ACL tears over 20 years. In boys, however, only those aged 15 to 16 showed such an increase.

The report was published online journal Pediatrics.

Story source: Steven Reinberg, http://www.cbsnews.com/news/acl-tears-on-the-rise-among-kids-especially-girls/

Play
2164 views in 5 years
Prevent a Concussion!

Prevent a Concussion!

Daily Dose

Busy Sports Schedules

1:30 to read

I can’t get over how many of my young patients who play sports tell me that they are up late at night during the school week due to their soccer schedule, or who miss church on Sunday due to a soccer or baseball game. Not only are kids starting organized sports at younger and younger ages (soccer for 3 year olds, flag football at 5?), the commitment to practice or play at what I would term “inappropriate” times seems to be more prevalent and absurd to me.

The mother of a 10 year old boy called me recently to discuss how upset and tearful her son had been since school has started.  Upon further questioning it seems that he had joined a fall baseball team and some of their games are scheduled on school nights at 8 pm....which means they don’t even get home until 10:30 or 11:00 pm?  When my own sons were playing high school sports I was not thrilled about Thursday evening JV games and how late we got home....but elementary school?  Of course, her son was exhausted and then he would get anxious about getting his homework done before hand and getting to bed so late and then being able to get up in the morning etc. etc.  She said that he now wanted to “quit playing baseball”, and cried every time he had to practice.

She was trying to explain to him that he had made a commitment to his team and needed to finish out the season, which I agree is an important life lesson about following through.  At the same I totally understand how upset he is that he has to stay up past his usual school night bedtime. It is not uncommon for some children to get very tearful when they are just exhausted...same for adults.

So how do you rationalize teaching your child about loyalty to their team and commitment when adults make up crazy schedules requiring young kids to stay up past an appropriate bedtime, or forgoing Sunday school if that is what they typically do on Sunday morning rather than going to a scheduled soccer game?

Hard for me to figure out how to “fix” this situation until enough parents say..”we will not let our children participate on the team unless the schedule is appropriate for their age”.  

Have you had any similar experiences? What do you think?

 

Daily Dose

Sledding Accidents

Over 20,000 children were seen in the emergency room for sledding accidents. how to keep your kids safe while still having fun.With another major snowstorm hitting most of the East Coast and blanketing the south in ice, it seems like there will be several more “snow days” with children (and their parents) home from school.

I have such fond memories of growing up in Washington, D.C. and the idyllic “snow days” spent outside with our Radio Flyer sleds.  My brother and I would head out the door for the big hill right outside of our house which would become a mecca for the sledders. The street was fairly steep and for that reason was often closed (guess they didn’t make 4 wheel drive vehicles then?), and the hill was perfect for a fast ride that was probably ¼ mile long. The ride down was glorious, the trek back up seemed VERY long.  Those were the days!  We could spend hours out there, only coming in long enough to change out of wet gloves, grab a hot chocolate, and back out we went. I must say, most of the time there was very little adult supervision, and thankfully there were no “major” injuries that I recall. With those memories in mind I decided to do a little research on sledding safety and accidents. An article in the September 2010 issue of Pediatrics reviewed sled related injuries.   Did you realize that there were over 230,000 sledding injuries reported over a 10 year retrospective period, in other words more than 20,000/year and those were only those that were seen in emergency rooms. There were probably many more that went unreported as the child was seen in an urgent care, or private practice rather than ER. Children 10 – 14 years of age were in involved in 42.5% of sledding related injuries and boys represented about 60% of all cases.  WOW! Sleds can reach speeds of up to 20-25 mph and head trauma is one of the biggest concerns.  It is reported that the head was the most commonly injured body part (I feel lucky that I survived those sled races) and that injuries to the head were twice as likely to following a collision. Children 4 years of age and younger were 4 times more likely to sustain a head injury. Other injuries reported from sled related accidents included fractures, contusions and abrasions.  In this study about 4% of cases required hospitalization and of this number nearly half were due to fractures while about ¼ were due to traumatic brain injuries. The injuries were more common when toboggans, snow tubes or discs were used than with traditional sleds that have a steering mechanism. Another interesting finding was that many of the injuries occurred due to the fact that the sled was being pulled by a motorized vehicle which resulted in more collisions. As you well know, the advent of helmets has really helped to prevent injuries from biking, and helmets are now recommended for sledding, skiing and snowboarding.    A report from the consumer product safety commission showed a 58% reduction in head injuries among children less than 15 years of age after helmets were used for skiing and snowboarding. As more and more people wear helmets for these activities one would hope to see a decrease in injuries reported from sledding. To ensure safety while sledding make sure that there is parental/adult supervision at all times. Sledding on streets should be discouraged and never sled where a hill meets a pond which may not yet be frozen. Sledding slopes should be free of tress and other obstacles that might cause collisions.  Children should sit up and face forward and never sled head first. Sleds should never be pulled by a motorized vehicle, which includes a snow mobile.  Sleds with the potential to rotate like discs (I guess that is the flying saucer of old) and snow tubes may carry significant risks, and should be discouraged. With 49 of 50 states currently reporting have snow “somewhere” on the ground make the winter sledding safety a priority and go buy a helmet and have fun. That’s your daily dose for today.  We’ll chat again tomorrow. Send your question or comments to me. I would love to hear from you.

Play
1288 views in 2 years
Sportsmanship

Sportsmanship with Drew Pearson

Your Child

Young Baseball Pitchers Playing With Pain

2:00

It’s that glorious time of year when pitchers pitch; batters swing and outfielders reach out to catch a fast and furious white leather-bound ball. Yep, it’s baseball season!

While the pros start their 162 game regular season, school teams and Little Leagues are suiting up and hitting the fields as well.

Although typically in good physical shape, professional players are not immune to injuries – just ask the Texas Rangers.

Kids on the other hand, play long and sometimes double games at tournaments on the weekends. Many of these kids are weekend warriors that love the game, but aren’t always in the best physical condition.

According to a pair of recent studies, young baseball pitchers are playing with arm and shoulder pain because they feel pressured by their parents or coaches. Playing through the pain may lead to injuries that won’t heal.

"Kids are playing harder and longer in more leagues than ever before," said Dr. Paul Saluan, director of pediatric and adolescent sports medicine at the Cleveland Clinic. "Kids also are not getting enough rest in between episodes of pitching, which may lead to insufficient time to heal smaller stress injuries. Over time, these smaller injuries add up."

Kids explained why they kept playing even though they were in pain.  "Players who experience pain often felt their parents and coaches were frustrated with them," said Dr. Christopher Ahmad, professor of orthopedic surgery at Columbia University Medical Center in New York City.

"Throwing with pain is a signal that injury is occurring," added Ahmad, who is the New York Yankees' head team physician.

In Ahmad's study, he and his colleagues surveyed 203 healthy players, aged 8 to 18. Just under one-quarter of them had experienced a prior overuse injury, they found.

Almost half of the players -- 46 percent -- said they had been encouraged to continue playing with arm pain, and 30 percent said their arm pain sometimes made playing less fun.

Those most likely to report being encouraged to play despite pain had a previous overuse injury. They were also more likely to report feeling arm pain while throwing and to experience arm fatigue during games or practice.

The second study looked at whether parents were monitoring their child’s pitch count during a game. Sixty parents of baseball pitchers were surveyed and just over half of the parents were not aware of safe pitching guidelines and did not actively monitor their child's pitch count.

The most important aspects of safe pitching guidelines are a maximum number of recommended throws based on a child's age and the number of days of rest needed between throwing stints, said Saluan.

"The focus has been on creating a better athlete who can throw harder, faster and more accurately than ever before," Saluan said. "Injury prevention has taken a back seat."

One in five parents did not know how many pitches their child threw in a typical game, but 64 percent recalled that their child had experienced pain in the upper extremities because of pitching, the survey found. For one-third of the pitchers, the pain required a medical evaluation.

"Kids who continue to pitch through pain end up with significant injuries that may have lifelong consequences," Saluan said. "Younger pitchers who are still growing are much more vulnerable than adults to sustain an injury to the growth plates around the shoulder and elbow.”

Injuries to the growth plates usually heal with rest, Ahmad said. But he noted that more young pitchers are also damaging their ulnar collateral ligament, an important ligament in the elbow.

"Unfortunately, these injuries do not always heal and often require surgery," he said.

Most of the injuries are caused when kids are playing too many games, specializing in one aspect of the game, using poor pitching mechanics and throwing too hard.

In the pitching study, half the young pitchers threw in at least two leagues at a time, one-quarter pitched more than nine months of the year, and just over half participated in extra showcase situations.

"We have fallen into the trap of 'too much too soon,'" said Saluan. "This has resulted in a rise in injury rates in kids whose bodies are not prepared to handle the stresses that are encountered."

If you’re unsure of how to monitor your child’s pitching, the Major League Baseball website has a “Pitch Smart” guidelines page for young and adolescent pitchers listed at the end of this article.

The studies were presented at the American Academy of Orthopaedic Surgeons' annual meeting in Las Vegas. Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Sources: Tara Haelle, http://consumer.healthday.com/fitness-information-14/baseball-or-softball-health-news-240/young-pitchers-often-pressured-to-play-despite-pain-study-says-697197.html

http://m.mlb.com/pitchsmart/pitching-guidelines

Daily Dose

Keep Your Athletes Hydrated On and Off the Field

1:30 to read

With summer heat all across the country and kids heading back to school athletics, band practice, drill team and the like it is a good time to discuss heat related illnesses and their prevention.

It is always at this time of year that I begin worrying about heat exhaustion and heat stroke and I find myself re-emphasizing the importance of maintaining hydration, even before you start back to outside activities. The Centers for Disease Control and Prevention reported 129 deaths while playing sports due to heat and exposure to elevated temperatures.

Among high school athletes, exertional heat stroke is the third leading cause of death and is often related to lack of acclimation to the heat and dehydration. You can’t just head out to run three miles in the heat or work out in pads or march in the band on the hot field without preparing ahead of time. Heat exhaustion occurs when the core body temperature is elevated between 100.4 and 104 degrees. This is different than having a fever secondary to illness. Symptoms are typically non-specific but include muscle cramps, fatigue, thirst, nausea, vomiting and headaches. The skin is usually cool and moist from sweating and is indicative that the body’s cooling mechanism is working. The pulse rate is rapid and weak and breathing is fast and shallow. Coaches, athletes and others should all be aware of these symptoms. This is the body saying, “I am overheated” and don’t keep going! (You would not drive your car when overheated; you pull over, and at least add water.)

The mainstay of treatment is to prevent progression to heat stroke by moving to a cooler place, in the shade, air conditioning etc. Remove as much clothing as possible (uniforms, pads, helmets etc) to help heat dissipation. Water misting fans may be helpful. Begin rehydration with appropriate oral electrolyte solutions and water. When treated quickly and appropriately, symptoms usually resolve in 20 -30 minutes. The child should not return to activities that day, and should avoid heat stress for several days. Heat stroke is a MEDICAL EMERGENCY and will require transportation to the ER for aggressive treatment. In this case the previous symptoms have been missed and the core body temperature rises to 104 degrees or greater. The skin is flushed, hot and dry from lack of sweating. The athlete is confused, or even unconscious. The heart rate is fast and there is hyperventilation. The blood pools away from vital organs and can result in encephalopathy, liver, kidney and multiple organ failure. While awaiting transportation to the ER the athlete should be moved to a shaded area, clothing removed and ice packs may be applied to surface areas overlying major vessels, (i.e. the neck, beneath the arm pits, and the groin). Cooling and misting fans may also be used.

Continue to educate your children about the need for hydrating the evening prior to events, and for continuous hydration while exercising in the heat. They should know to drink fluids even when not thirsty, as once you become thirsty you are already behind in your fluid intake. With good education, and recognition of early signs over overheating heat related illnesses are preventable.

That’s your daily dose, we’ll chat again soon! Send your question to Dr. Sue!

Daily Dose

Too Much Pressure to Play Sports?

1:30 to read

Does your child play a sport “after school”?  It seems children as young as 3-4 years of age are now involved in soccer and even football.  Some children are barely walking before they are signed up for a team.  Parents tell me various reasons for this including, “if they don’t start young they will be at a disadvantage athletically”, “if we don’t get on a team now, there will not be room for our child once they start kindergarten or first grade”,  and “our child wants to play and wear a uniform”. I just see lots of issues with burn out.

It seems awfully early to start “team sports” to me. I am a huge advocate of families and children playing together and learning all sorts of games and sporting skills. Kicking a soccer ball in the yard, or hitting the wiffle ball off of the tee, or having Dad throw a pass with the football all seems pretty “normal” to me. But organized sports with a 3 year old who is still in diapers….really?  Maybe one of the “guidelines” should be you have to be potty trained.  Yes, this is true, I see children in diapers who “will not pee or poop in the potty” according to their parents, but they go to soccer practice?  What is wrong with this picture?

So, while some of these well intentioned parents have told me that they are having fun being the coach, or attending games with other friends, their pre-school children “don’t have time to be potty trained”. They are too busy going to school, followed by organized activities that “it is just easier to let them stay in diapers”. I was even with a 4 year old at a football game and she was still in diapers?

At some point these children and parents will need to skip a practice or two and stay home long enough to get potty trained.  I am noticing that children are getting older and older before they are potty trained. I know there are books written on this topic with the philosophy that “the child will ultimately train themselves”, or “ how to potty train in 3 days, with a child who shows no interest”…or something along those lines.  But really, in my experience, if you watch your child’s cues, spend the time to “talk bathroom habits” and have the “time” to be home to potty train most children are potty trained between 24-36 months of age.  Yes, there are occasional children (none of my own) that just show interest earlier and say things like “I go potty now” and really do it on their own. There are also some who are more difficult to get interested and may be harder to potty train…but again, which is probably a more important life time skill…..getting out of a diaper or trying to figure out how to line up for a soccer game? I’m just saying.

Play
1224 views in 4 years
Too Much Pressure in Sports?

Too Much Pressure in Sports?

Pages

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

DR SUE'S DAILY DOSE

Can you use homeopathic products to relieve your child's illness?

DR SUE'S DAILY DOSE

Can you use homeopathic products to relieve your child's illness?

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.

 

Please fill in your e-mail address to be included in our newsletter.
You may opt out at any time.