Keep Kids Safe on The Playing Field

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If your child is an athlete, you’ve probably taped a few ankles, iced some strained muscles or even signed a cast covering a broken bone. Athletes get injured – it’s part of the game. But many parents aren’t aware that young athletes are at risk for more serious injuries: three that can have extremely serious consequences.

feat_basketball-girl.pngThis guide will help you understand concussions, eating disorders, knee injuries and the overuse of muscle creams so you can keep your athlete in the game – safely.

Heads Up

“She got her bell rung.” “Boy, that was a de-cleater.” Ever heard these phrases in reference to a boy or girl after a collision on the field or court? If so, there’s a good chance he suffered a concussion.

The Centers for Disease Control and Prevention (CDC) estimates that about 300,000 youth athletes suffer concussions every year. But that number may be even higher, say doctors. For instance, if you ask players if they’ve had a concussion – defined as mild traumatic brain injury – only about 10 percent say yes. However, if you ask about specific symptoms of concussions, the reports are higher, sometimes up to 40 percent among football players.

Many athletes, parents and coaches mistakenly believe that concussions always result in a player being knocked out cold. However, Kevin Beier, M.D., an emergency room physician at Middle Tennessee Medical Center says, “The hallmarks of concussion are confusion and amnesia, often without preceding loss of consciousness. Early symptoms of concussion may include headache, dizziness, nausea or vomiting, slurred or incoherent speech, and imbalance or incoordination.”

“Conventionally,” continues Beier, “Brain injuries are classified as mild, moderate or severe, based on these measures.”

“Any child suspected of having a concussion should be immediately removed from the game and not return until examined and cleared by a trained medical professional,” says Mark Krakauer, M.D., a pediatrician at St. Thomas Medical group in Nashville.

According to the CDC, in youth sports, for children ages 5 – 18, the three leading sports that account for concussions are football, basketball and soccer.

And while concussions can’t always be prevented, parents and coaches in charge can do things to lessen the chance of concussion in kids:

  • Make sure players use properly fitting equipment.
  • Make sure they wear all mandated equipment, especially mouth guards, even in soccer.
  • Make sure football players are taught proper tackling techniques: heads up, no spearing.

If you think a player has suffered a concussion, remember this: When in doubt, sit him out – until symptoms subside.

Running On Empty

Healthy nutrition is an important part of athletic performance, yet unfortunately so too are eating disorders. Some athletes cast aside the importance of healthy eating in favor of thinner bodies, faster times or increased muscle mass. For girls, according to the International Olympic Committee, the sports that put them at risk for eating disorders are the ones where they are expected to be thin: gymnastics, figure skating and dance.

“Female athletes with eating disorders often fit into a condition called the ‘female athlete triad,’ a combination of low-energy, menstrual irregularities and weak bones,” says Beier. “Identifying athletes with an eating disorder can be difficult, as they can be secretive.”

“Certain sports and activities that emphasize lean body mass place children at particularly high risk, including ballet, gymnastics, wrestling and skating,” says Krakauer.

Dan Bowman, Ph.D., a psychologist specializing in sports psychology and eating disorders, says the number of incidents has doubled in the past 30 years. “Ninety percent of cases are female, but I’ve seen increases in male wrestlers, boxers, even football players,” he says. “Ten years ago, you didn’t see that, but many football players are getting caught up in bodybuilding and they get obsessed with losing fat.”


“The threat to an athlete with an eating disorder is the extreme stress placed upon the body,” says Beier. “The process of binging and purging results in loss of fluid and low potassium levels, which can cause extreme weakness, as well as dangerous and sometimes lethal heart rhythms.” Signs of eating disorders to look out for from the Eating Disorders Coalition of Tennessee (EDCT) include:

  • Preoccupation with food and weight
  • Repeatedly expressed concerns about being fat
  • Increasing criticism of one’s body
  • Frequently eating alone
  • Use of laxatives
  • Trips to the bathroom during or following meals
  • Continuous drinking of diet soda or water
  • Compulsive, excessive exercise

According to the EDCT, the best thing parents can do is to be good role models when it comes to nutrition and exercise. The healthier a role model parents are, the more they can protect their children in all aspects of life.

But if an eating disorder is detected, action must be taken.
“Children with eating disorders are best managed by a multi-disciplinary approach involving a medical doctor, psychologist or counselor and a dietician,” says Krakauer.

To avoid problems, make healthy foods available, model healthy eating behaviors and be comfortable with your own body image, the EDCT says.

Blow Outs

Most female athletes probably don’t think much about their knees, but basketball, football, soccer and volleyball players should pay special attention to this joint.

“The anterior cruciate ligament (ACL) lies inside the knee joint in a depressed area at the end of the femur,” says Beier. “This ligament provides most of the support that prevents the tibia from slipping too far forward and rotating too far inward under the femur. Females have a narrower notch than males, therefore, the space for the ACL’s movement is more restricted, and pinching of the ACL in the joint can lead to rupture of the ligament,” he adds. The ACL connects the thighbone to the shinbone and stabilizes the joint.

The American Academy of Orthopaedic Surgeons says that female basketball players suffer ACL injuries at twice the rate of male players; female soccer players are four times more likely to suffer a tear than males, and there are several theories for why girls are at higher risk. The most popular being biomechanical: It involves the way female athletes activate their leg muscles when they land after a jump or when they make a quick pivot, or cut. Krakauer says that for girls, “estrogen actually makes their joint more lax, so they have to train much harder to acquire the muscle mass of their male counterparts.”

According to the AAOS, females don’t bend their knees as much when landing and they stay in a more erect position when cutting. Learning to crouch and bend at the knees and hips can reduce stress on the ACL, the AAOS suggests.

“For females, the ACL must provide most of the stability in the knee making it prone to injury,” says Beier. “As girls begin participating in sports at an earlier age, and as they continue conditioning and strengthening the muscles around the knee, it’s hoped that the rate of ACL tears in the female athlete will decrease.”

Treatment of a torn ACL requires surgery that can sideline a player for three to four months as it will not heal on its own.

Don’t Rub It In

When athletes’ muscles ache after a long practice or tough game, many reach for the Icy Hot or Bengay. But that may not be the wisest choice.
“Due to the neurotoxicity of camphor (found in muscle creams) Bengay and Icy Hot are not recommended for use in children younger than 12 years of age,” says Beier.

“The best treatment for strained and injured muscles is prevention,” says Krakauer. “Attention should be given to stretching and warm-ups. When a child does injure himself, application of ice and intermittent use of anti-inflammatory medicine such as ibuprofen may be helpful,” he says.

If athletes do decide to use muscle cream, follow the manufacturer’s recommendations and instructions for use and see your family physician or pharmacist with any questions.

Stay in the Game

Research shows that sports help kids develop fitness, camaraderie with teammates and healthy habits that last a lifetime. As long as you make sure your kids are well prepared to play and you keep a close eye on any injuries, the benefits will far outweigh the risks.

Tiffani Hill-Patterson writes about parenting, health and fitness.

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