Trying to Bulk Up? How to Support Young Men Desiring to Gain Weight for Sports

Trying to Bulk Up? How to Support Young Men Desiring to Gain Weight for Sports

by | Jul 9, 2020 | Sports Medicine

Taylor Morrison, M.S., R.D., CSSD, L.D., hears this question from young male athletes commonly, “What can I do to build muscle?” These athletes often end up turning to fancy and expensive supplements or loading up on meat at lunch and dinner but often don’t see the results that they want. It’s important as members of the athlete’s care team that we provide the right information and appropriate support to help them achieve their goals.

Keys to Success

  • Work on any body composition changes during the off-season.
  • Plan for gradual weight gain with a well-balanced diet.
  • Pair a solid nutrition plan with a developmentally appropriate strengthening program.
  • If your young athlete’s doctor determines a supplement is needed, teach the athlete how to evaluate supplements for safety. Learn more about supplements here.
  • Consult with a physician, dietitian or other qualified health care professional with any concerns or questions.

Here are some questions to ask when the young athlete’s plan isn’t working:

What stage of development is the athlete in? 
Make sure this is the appropriate time to be building muscle. Remember that large gains in lean muscle cannot be achieved in boys until they have gone through puberty and have the hormones to support these gains. Only if the athlete is ready developmentally will the following strategies help him reach weight and strength goals.

Has the athlete increased his total caloric intake?
Many athletes focus entirely on protein and miss the big picture. If your athlete is eating a ton of protein, but still not eating enough overall, he will not see gains.  An athlete must increase his overall caloric intake to see gains in weight and muscle.

Is protein intake spaced evenly throughout the day?
Many athletes will skip breakfast, eat what they can find for lunch and have a huge dinner. Unfortunately, the body only utilizes, on average, 20 to 30 grams of protein at once (exact amount may be higher or lower than this range and is unique to each athlete) to build muscle. Waiting to eat all of the day’s needed protein at the end of the day will not support desired gains. For optimal strength and muscle gains, make sure the athlete is getting protein at every meal and in some snacks.

Is the athlete eating enough carbohydrates?
While protein is important to build muscle, carbohydrate is needed for energy. If the athlete is under-consuming carbohydrates, the body may use protein for fuel. Make sure the athlete eats enough carbohydrates from whole grains, vegetables, dairy and fruits so that the protein can be used to build and maintain lean muscle.

Is the athlete including regular resistance training in his workouts?
All of the protein, carbohydrates and calories will not help if the muscles are not being worked! Make sure the athlete is including consistent resistance training each week to build lean muscle.

Tips for Young Athletes

  • Set appropriate goals.  For most athletes, gaining one to two pounds per week is a safe and reasonable goal.
  • Remember the overall goal:  Optimal performance is the overall goal.  Measure improvements in performance, not just a number on the scale.
  • Be realistic.  Young pre-pubertal athletes will not gain muscle mass like an adult
  • Focus on real food.  Choose healthy higher calorie foods instead of junk foods with “empty calories.”
  • Get enough sleep.  This is often forgotten for meeting goals to gain or lose weight.

*If unsure where to start, it’s always a good idea to work with a certified sports dietitian who can help you create a plan, recommend products and support you as you work towards your goal.

D Magazine: Scottish Rite for Children is Studying the Impact of the Pandemic on Children and Young Adults

D Magazine: Scottish Rite for Children is Studying the Impact of the Pandemic on Children and Young Adults

by | Jul 8, 2020 | Press Coverage, Psychology

Researchers at Scottish Rite for Children are looking into the impact of the pandemic on kids, teenagers and adults. One study is analyzing current and former patients 18 years of age or older, volunteers, community members, and others to see the psychological impact of the pandemic, while the other is studying the virus’ impact on children’s activity levels and sports.

Read more on D CEO, about how the pandemic may have coaxed some children into more outside play, while canceling organized activities for others. 

Get to Know our Staff: Jessica Dabis, Therapy Services

Get to Know our Staff: Jessica Dabis, Therapy Services

by | Jul 6, 2020 | Sports Medicine

What is your role at Scottish Rite for Children? 
I work in the Sports Physical Therapy department in Frisco. I evaluate and treat non-operative and post-op sports injuries, spanning all joints. I typically see patients one-on-one throughout the day in 45-minute blocks, implementing activities such as manual therapy, therapeutic strengthening, dynamic movement mobility and speed/deceleration/landing mechanics training. We focus on coordination and motor control development for our young, skeletally immature population. The goal for our athletes is to foster long-term athletic development and equip them with the tools needed to minimize future injury risk factors by building durability for once they return to sport.
What do you enjoy most about Scottish Rite?
I love the people –  my coworkers, the collaborating physicians and nurses, social workers, psychologists and leadership. Everyone seems to truly share a vision of compassion and patient-centered care that I feel contributes to our strong patient outcomes.

Why did you decide to do the work you are doing now?
Scottish Rite for Children was my first job out of physical therapy school. I have worked here for four years now. I was drawn to sports physical therapy because it is a way to use my passion for learning about and understanding the human body – from injury to healing. It is great to know that my work can help to get an athlete back to doing what fulfills them.
 
What’s the coolest or most interesting thing you’re working on right now?
From a rehab to performance standpoint, I have been working on some sport-specific programming resources. I also work on the Keeping Up With the Count dance project, where we have created a variety of resources for the dance community.
 
What are you currently watching on Netflix/Hulu/TV/etc.? 
I watched Money Heist during quarantine and am about to start the Japanese anime series, Demon Slayer.
 
What would be the most amazing adventure to go on?
I would love to make it to Thailand and Bali in the next few years – explore their culture, architecture and tropical landscape!

Keeping Up With the Count – Among other clinical and injury prevention interests, Dabis works closely with a multi-disciplinary team providing patient care and content for young dancers.​

My Child Has a Buckle Fracture, Now What? – Fracture Clinic Tips

My Child Has a Buckle Fracture, Now What? – Fracture Clinic Tips

by | Jul 3, 2020 | Fractures

A buckle fracture, also known as a torus fracture, is a very common injury for children. Because pediatric bones are softer and more flexible than adult bones, one side of the bone may buckle (or bend) upon itself without disrupting the other side of the bone. These fractures are most commonly seen in the wrist and are often caused by a “FOOSH” (fall on outstretched hand) injury. Buckle fractures can also occur in other bones throughout the body.

These are common injuries that tend to heal quickly with low risk for complications. The typical treatment for a buckle fracture is aimed at keeping the patient comfortable while allowing the bone to heal. Sometimes this may include a cast or splint. Deciding which treatment is best for your child depends on the fracture pattern, the child’s comfort and the parent’s comfort level with the treatment plan.

Most buckle fractures heal well with no long-term complications. Our Fracture Clinic staff are experts at managing fractures in growing children. Learn more about our Fracture Clinic.

In-toeing, Out-toeing and Crooked Legs: Treatment Options and When to be Concerned

In-toeing, Out-toeing and Crooked Legs: Treatment Options and When to be Concerned

by | Jun 22, 2020 | Spotlight

The following is a summary of a presentation on rotational and angular alignment conditions in the lower extremity. Corey S. Gill, M.D., pediatric orthopedic surgeon addresses when to be concerned and when to make a referral. The lecture was given as part of the Coffee, Kids and Sports Medicine series and is available in our on-demand learning offerings.

Watch the full lecture I Print the PDF

Physical Exam

Tips for Infant and Toddler Exam

  • Set up the environment for a relaxed exam: evaluate on the caregiver’s lap, dim the lights and play music.
  • Screening for other conditions is important.
    • Measure height, weight, and head circumference.
    • Evaluate the hip to rule out developmental hip dysplasia.
  • Toddlers are more likely to walk away from you than toward you.

Tips for School Age Children Exam

  • Must be able to see the legs. Provide or ask the child to wear shorts.
  • Leave the exam room to observe walking and running if space allows.
  • Talk to the child directly to help him or her relax.

Rotational Deformities

Structural abnormalities that cause rotational alignment issues can be measured with these tests:

  • Foot progression angle
  • Hip internal and external rotation in prone position
  • Thigh-foot angle
  • Forefoot alignment

Watch the full lecture to learn these tests.

In-toeing

This is likely the most common condition referred to pediatric orthopedics. In a study at Scottish Rite, only one percent of referrals had a diagnosis other than “benign in-toeing.” It is important to educate families that there is wide range of normal in all of these measures and it changes over time. Parents may feel that this condition will lead to long-term problems without surgery or bracing, which is inaccurate.

Common misperceptions include:

  • “My toddler falls all of the time because of in-toeing.”
  • “My child’s feet will be stuck this way forever without treatment.”
  • “The in-toeing is going to cause my child to have arthritis and joint problems.”
  • “In-toeing will prevent my child from being a high-level athlete.”

Metatarsus adductus
Most commonly identified in infants, congenital adductus of the forefoot on the midfoot may be related to intrauterine positioning. Check the contralateral foot (bilateral metatarsus adductus), hips (developmental hip dysplasia) and neck (torticollis). Studies suggest 4% of children with metatarsus adductus have hip dysplasia. Treatment is focused on observation. Stretching may help and gives the parent something to offer the child. Casting may be used if the condition persists for 6-12 months. Surgery is extremely rare. The condition commonly resolves within the first one to three years of life.

Internal Tibial Torsion
Most commonly identified in toddlers, internal tibial torsion does not require treatment, often resolving on its own. Historically, bracing was commonly used, but this is not recommended for this condition. In cases with significant torsion that causes functional problems, surgery may be discussed after the age of ten. This condition is often associated with infantile Blount disease or genu varum which is more likely to cause functional problems than the torsion.

Femoral Anteversion
Most femoral anteversion decreases and resolves around age 8-9 years (elementary school age). These children may prefer to “w” sit because it is comfortable, but there is no clear data supporting “w” sitting causing worsening femoral anteversion. This condition is typically not related to long-term problems like arthritis or other functional disability. In cases of severe functional or cosmetic deformity, surgery can be successful, but can have significant risks. Our multidisciplinary team for these complex cases includes a psychological evaluation.

Out-toeing

Though slightly more functionally limiting than typical in-toeing, out-toeing rarely causes long-term problems or requires surgical intervention.

Femoral Retroversion
This condition rarely causes long-term problems, however, in some, it may predispose to slipped capital femoral epiphysis (SCFE). Osteotomy to correct the alignment is rarely needed.

External Tibial Torsion
Much like internal tibial torsion, this condition improves in most children before or around the age of 10. In patients with suspected external tibial torsion, checking the foot for tarsal coalition or a rigid flatfoot is important. The foot may turn out causing a stance and gait that mimics external tibial torsion. In cases where the deformity causes functional limitations, typically with excessive torsion greater than 40 degrees, surgical corrective osteotomy may be indicated.

Slipped Capital Femoral Epiphysis (SCFE)
With increased obesity in growing adolescents, the nation continues to see a dramatic rise in the incidence of SCFE. If a child presents to a health care provider with hip or knee pain, especially if he or she is an overweight adolescent with an out-toeing gait, ruling out SCFE is essential. These patients present with hip and sometimes knee pain and in about 25% the condition occurs bilaterally. Referral for unstable SCFE’s needs to be made immediately (talk to an orthopedic doctor on the phone or send patient to the ER). Treatment is to surgically stabilize and prevent worsening position and avascular necrosis in the hip.

Gill emphasizes that the factors that make this population at high risk of SCFE also makes them at high risk of poor long-term outcomes. Counseling these patients to manage weight and co-morbidities is a multidisciplinary concern. He encourages the audience to “not miss” this diagnosis so it can be treated early.

Angular Deformities
Babies have a natural progression of genu varum (bow-legged) as an early walker to genu valgum (knock-kneed) in the first few years of life. Counseling parents regarding typical development can provide reassurance. However, there are some conditions that may need to be referred.

Genu Varum – “Bow-Legs”
Pre-existing conditions such as infection, trauma, metabolic bone diseases and skeletal dysplasia’s that cause growth plate disruptions, may cause genu varum. These are typically already known conditions and are not the focus of this discussion.

Physiologic Genu Varum (PGV)
This is a condition that will get better on its own without treatment. The varus may be dramatic, but will resolve without treatment. It is important to distinguish between PGV and Blount’s disease.

Blount’s Disease
Unlike PGV, this will not improve on its own. By age 2, varum should resolve. If it doesn’t, radiologic evaluation may reveal proximal tibia growth deformity. Historically, bracing or osteotomy were provided to improve the alignment. Currently, growth modulation, a less involved procedure, is offered if bracing is not effective by the age of three. In some, the condition does not develop until a later age and may be bilateral. Referral for pain, swelling or unilateral genu varum is appropriate.

Genu Valgum – “Knock-Knees”
Other systemic conditions like rickets, trauma or osteochondromatosis may cause this positioning and need to be addressed directly. Treatment for the genu valgum may be necessary, however, these causes are not the focus of this discussion.

Genu valgum is most noticeable around age 3 in normal children, and then gradually improves until the age of 8 or 9. The structural condition may be minor and cause a cosmetic concern or a many contribute to significant orthopedic problems such as patellar instability and osteochondritis dissecans.

Treatment, when indicated, is surgical. In children who have open growth plates, growth modulation by temporarily tethering the growth plate with a plate and screws is effective. In older children, an osteotomy to remove or add a wedge of the bone realigns the lower extremity.