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Does My Young Athlete Get Enough Calcium?

Does My Young Athlete Get Enough Calcium?

by | Feb 21, 2025 | Sports Medicine

For young athletes, calcium is an important micronutrient essential for bone health, injury prevention and optimal performance. The benefits of physical activity far outweigh any risks, but it’s important to know that high volume or intensity in sports can place added stress on a growing athlete’s bones. Maintaining proper nutrition can help prevent bone stress injuries and promote strong bone development.

Sports medicine physician Jane S. Chung, M.D., understands that a child’s pre-teen and teenage years are a critical time period for building a strong foundation for their bones. “I see many young athletes, especially girls, who have a history of overuse-related bone stress injuries,” Dr. Chung says. “These injuries include stress fractures, often related to underfueling. A way to avoid this is by making sure young athletes receive the recommended amount of daily calcium.”

Read the following from Dr. Chung about incorporating calcium into a regular diet, as well as advice on when to consider supplements.

Daily Calcium Guide for Strong Bones

There are many ways for young athletes to meet their daily calcium needs, with food being the best source. If necessary, taking supplements can help them reach this goal. Adding a vitamin D supplement or consuming vitamin D-rich foods and beverages helps the body’s ability to absorb calcium.

Some medical conditions may require a different approach, but below is a guide for incorporating calcium in the diet of a child between the ages of 9 and 18 years old.

Calcium in Food

Aim to eat or drink 4 to 5 servings of calcium-containing foods a day, which could include:

  • Milk
  • Yogurt
  • Cheese
  • Calcium and vitamin D, such as fortified orange juice
  • Almond milk
  • Cottage cheese
  • Calcium fortified cereals, granola bars and tofu
  • Vegetables, such as bok choy, kale, arugula, watercress, collard greens, broccoli and kidney beans
  • Nuts, particularly almonds, sesame and chia seeds

Calcium in Supplement Form

Supplements can be found in tablet, chewable, gummy forms, among others. It is important to find the one that works best for your young athlete.  To meet your daily calcium intake, young athletes can take 1300 mg of calcium from a daily supplement. It is best to have no more than 500 to 600 mg at a time for optimal absorption.

Calcium with Food and Supplement

Aim for half food and half supplement

  • Around 500 to 600 mg calcium with supplement
  • Around 800 mg calcium with food. Here are some examples:
  • One 5-ounce yogurt at breakfast (250 mg calcium)
  • Two slices of cheese on a sandwich (300 mg calcium)
  • ¼ cup almonds (about 23 almonds) in a snack (75 mg calcium)
  • Two cups fresh kale in a salad (180 mg)

These are general recommendations. If you have concerns about calcium intake for your young athletes, please speak with your physician, a sports medicine physician or a registered dietitian.

Call 469-515-7100 to schedule a consultation with Dr. Chung or another sports medicine physician.

Protecting Young Athletes’ Hearts For a Stronger Game

Protecting Young Athletes’ Hearts For a Stronger Game

by | Feb 13, 2025 | Sports Medicine

As a nation, we celebrate our loved ones and cardiac health in February. Sports medicine physicians and athletic trainers are especially passionate about the heart health of young athletes. Shane M. Miller M.D., FAAP, sports medicine physician and the Section Director of Medical Sports Medicine at Scottish Rite for Children, shares key insights to keep young athletes in top shape.

“A well-rounded view of an athlete’s heart health and safety includes parents, administrators and coaches being aware of the signs and symptoms of cardiac emergencies,” says Dr. Miller. “Being prepared with a clear plan can significantly reduce the risk of catastrophic events.”

To protect a young athlete’s heart health, Dr. Miller shares key steps for families to create a plan.

REPORT signs, symptoms and any history of cardiac problems in young athletes at each preparticipation evaluation and when new problems develop. Some examples are chest pain, shortness of breath and passing out.

ASK your family members about a history of cardiac problems or sudden death in the family. Knowing your family’s medical history is a critical step to prevent sudden cardiac death in healthy young athletes.

PREPARE by learning the emergency plan for schools and sports venues. Know where to find the closest AED (automatic external defibrillator) and be sure it is accessible to all event participants, every time.

Dr. Miller advises parents to take athletes to their pediatrician for preparticipation evaluations. Although some schools and organizations do not require a release, seasonal checkups and discussions with the doctor can help to prevent many problems and address injuries before they become more serious. One in 300 youth has an undetected heart condition, and up to 72% percent of youth sudden cardiac arrest victims had at least one warning sign that was not recognized, according to Parent Heart Watch.

“Athletic trainers and youth sport coaches are the first line of defense in a crisis,” Dr. Miller says. “Readiness can save lives when seconds matter, and advocating for young athletes’ health ensures they have the support and protection they need to thrive on and off the field.

Having an emergency action plan can help parents, coaches and athletes respond to injuries in a timely manner. An emergency action plan is a comprehensive detailed written plan that prepares for medical, environmental and security emergencies. It is developed and coordinated with local EMS, venue officials, medical personnel and organization administrators.

Learn more about the importance of an emergency action plan.

Fueling For Gymnastics: A Conversation with a Certified Sports Dietitian

Fueling For Gymnastics: A Conversation with a Certified Sports Dietitian

by | Feb 5, 2025 | Sports Medicine

Gymnasts have unique fueling needs. From long training days to busy competition days, proper nutrition is key to meet their short- and long-term energy needs. Scottish Rite for Children hosted a webinar, featuring sports dietitian Taylor Morrison, M.S., R.D.N., CSSD, L.D., and sports medicine physician Jane S. Chung, M.D. From their multiple projects together, they shared valuable insights on fueling strategies for young gymnasts.

 

Common Signs of Underfueling

If a gymnast experiences any of these symptoms, nutrition could be a key factor:

  • Fatigue before practice ends
  • Dizziness during training
  • Recurring injuries, such as stress fractures
  • Difficulty building muscle
  • Plateau in skill progression
  • Increased anxiety or mood swings

With proper fueling, many of these issues can improve.

 

There are Four Key Areas of Gymnastics Nutrition

1. Building a Strong Nutrition Foundation
  • Aim for three meals and three snacks daily.
  • Each meal should contain at least three food groups.
  • Snacks should include two food groups.
  • Balance proteins, carbohydrates and healthy fats.
2. Key Micronutrients for Performance

Certain micronutrients are critical for gymnasts:

  • Calcium supports bone strength and injury prevention. Good sources include dairy, leafy greens and almonds.
  • Vitamin D aids calcium absorption and bone health. It is found in salmon, eggs and fortified foods.
  • Iron helps prevent fatigue and supports oxygen transport.  Iron is found in lean meats, beans and spinach.

 

3. Energy Availability: Are You Eating Enough?

    Gymnasts need adequate daily calories to support training and growth.  Skipping meals or snacks can lead to low energy availability, affecting performance and recovery. If you are unsure on the number of calories that your young athlete needs, talk with your pediatrician, a sports medicine physician or a sports dietitian.

     

     4. Performance Nutrition Strategy

    Nutrition timing is key for training and competition days:

    • More than three hours before activity – A balanced meal with protein and complex carbs.
    • One to 1.5 hours before – Simple carbs for quick energy, such as fruit or yogurt.
    • 15 to 30 minutes before – Easily digestible carbs, such as applesauce or pretzels.
    • During long training sessions – Quick energy snacks, such as sports drinks or granola bars.
    • Post-training recovery – A mix of protein and carbs, such as chocolate milk, a smoothie or a sandwich.

     

    By building a strong nutrition foundation, prioritizing key nutrients, ensuring adequate energy intake and implementing a fueling strategy, gymnasts can optimize performance, prevent injuries and improve recovery.

    For more expert tips, watch the full webinar here.

    Understanding Common Injuries in Youth Hockey

    Understanding Common Injuries in Youth Hockey

    by | Feb 3, 2025 | Sports Medicine

    Ice hockey is becoming an increasingly popular team sport for many young athletes. However, with more participation comes a rise in hockey-related injuries. Physician assistant Cody Todesco, P.A.-C, M.M.S., is dedicated to helping young athletes, beginning with educating them about sports injury prevention. This passion is fueled by Todesco’s history as a young athlete

    “I played both ice hockey and baseball from a young age,” Todesco says. “Because of a shoulder injury right before college, I underwent shoulder surgery, giving me an impactful perspective of youth hockey injuries and the field of sports medicine. I then went on to return to sports playing both collegiate hockey and baseball. This life changing experience fueled me to pursue an education that allows me to treat youth athletes in all sports, but I will always have a special love for hockey.”

    It is important to equip young athletes with key strategies regarding youth hockey injuries, including how to prevent them and when to seek treatment. Continue reading to discover ways young athletes can protect themselves on and off the ice.

     

    Common Injuries in Youth Hockey

    The five most common injuries in youth hockey players are concussions, shoulder injuries, hip injuries, knee injuries and soft tissue injuries. Concussions can result from falls, collisions or impacts, like from a body check or a puck. Leagues that allow open-ice body checking often have higher rates of concussions. 

    The shoulder is a very mobile joint, and it is at risk of injury even with top-of-the-line padding and equipment. Injuries to the collarbone (clavicle) and shoulder, such as fractures, dislocations and separations, can occur from any collision or fall. Additionally, hip injuries, such as growth plate damage and muscle strains, are frequent due to the repetitive motion of skating. Goalies tend to experience femoroacetabular impingement, a condition caused by abnormal hip bone shaping.

    Knee injuries, especially to ligaments like the medial collateral ligament, are common from skating motions and player collisions. These injuries often require medical evaluation before returning to play. Soft tissue injuries, including cuts and bruises from slashes, skates, or falls, are also prevalent. While minor injuries typically heal with basic treatment, more severe injuries that take longer to recover from should be assessed by a medical professional to prevent long-term complications.

    “I think one of the hardest things as a sports medicine provider is balancing an athlete’s injury while also allowing them to recover to the ice both safely and quickly. ” Todesco says. “The importance of recovery along with nutrition and preparation is essential to preventing injuries and allowing a long athletic career.”

     

    Reducing Injury Risk in Youth Hockey

    To reduce injury risks, there are multiple steps young athletes should remember to protect themselves. Proper equipment is crucial, and gear should fit well and meet safety standards, with yearly fittings recommended. Off-ice warm-ups, including dynamic stretches and explosive movements, prepare the body for intense activity. Additionally, early sport specialization can increase injury risk, so a balanced approach to training, including rest and cross-training, is vital. A break between seasons and rest days during the season help avoid overtraining and support overall development.

    By following these strategies, young athletes can protect themselves, ensuring they stay on the ice longer and healthier into adulthood.

    Preventing Overuse Injuries: An Overview with Dr. Henry Ellis & The National Council on Youth Sports

    Preventing Overuse Injuries: An Overview with Dr. Henry Ellis & The National Council on Youth Sports

    by | Jan 29, 2025 | Sports Medicine

    Pediatric orthopedic surgeon and sports medicine expert Henry B. Ellis, M.D., spoke with the National Council on Youth Sports about Preventing Overuse Injuries in Youth Sports. Here are the key takeaways from his webinar:

     

    What is an overuse injury?

    Ellis: Overuse injury is defined as repetitive loading over a period of time. When an overuse injury occurs, it is the result of microtearing in tissues and cartilage while the body is unable to recover and heal. These injuries often occur around growth plates, which are the areas of cartilage that attach to muscles found in children and adolescents. Microtears and stress on the growth plates lead to an inflammatory process and an overuse injury. Inflammation causes pain, which is the body’s way of telling the athlete to slow down and give it time to heal.

     

    What is sports specialization?

    Ellis: Sports specialization is associated with injuries and overuse. Some things that qualify as sports specialization include training in a specific sport year-round (more than eight months a year), quitting all other sports to focus on one sport, or choosing to focus on one main sport overall. Variety in sports is healthy all-around. All athletes need an off-season to do something different to avoid causing an overuse injury.

     

    How do you tell the difference between typical soreness after activity versus an overuse injury? 

    Ellis: A myth is that when you are not sore after training, you are not training hard enough. In children, the body is not meant to be sore or have discomfort after activities. When children are sore, it signals that they are doing too much and could have an overuse injury. Children’s bodies are growing and developing, and because of this, their healing capabilities are different than that of an adult.

     

    What are some common overuse injuries?

    Ellis: Many overuse injuries are related to growth plates around different bones in the body. Hamstring problems in a dancer are common due to repetitive movements such as high kicks causing an overuse injury known as apophysitis, which causes pain and inflammation around a growth plate. Another common overuse injury seen in basketball players is Osgood-Schlatter, which affects the growth plate at the top of the shinbone (tibia) just below the kneecap. This is often due to repetitive jumping and running. In runners and sprinters, it’s not uncommon to find overuse injuries around the growth plate near the hip flexor. In gymnasts and baseball pitchers, we see another condition called osteochondritis dissecans (OCD) of the elbow. This condition happens when a bone underneath cartilage no longer supports it, leading to pain and inflammation.

    Stress Fractures are another common injury seen across all sports. They happen when repetitive loading in a bone creates tiny microfractures. The body normally heals these microfractures, but when an athlete is doing an action repeatedly, the body can’t keep up with healing. This could be due to lack of adequate rest or nutrition, and the body says enough is enough.

     

    What could be the source behind an increase in overuse injuries in youth sports?

    Ellis: We know that in the last 20 years, overuse injuries in youth sports are up at least 600%. As parents of a young athlete, it can be hard to pull in the reins on the amount of an activity they not only love, but that you love experiencing with them. We’re also seeing an increase in sports specialization and the commercialization of youth sports, leading to more pressure for young athletes to perform.

     

    How can families prevent overuse injuries in their young athlete?

    Ellis: Working as a family to monitor activity and staying involved with your child’s coach to keep an eye on training commitments can help prevent overuse injuries. Balancing multiple sports is beneficial, but extreme participation can lead to injuries. As a rule of thumb, try to balance the weekly hours of activity with a child’s age – less activity and training for younger children and more as they age. We’re not concerned about children being in sports all year-round, but those sports need to be different and allow for different activities in different seasons.

    A good method to prevent overuse injuries is following the 70/30 rule. The 70/30 training rule helps prevent injuries by balancing sport-specific training and conditioning. For example, if you have a swimmer in the pool for seven hours one week, balance that with three hours of dry land training to avoid too much repetition in movements.

     

    What are some other factors that contribute to overuse injuries in young athletes?

    Ellis: Adequate sleep is crucial for recovery and performance, and a lack of sleep increases injury risk. Proper sleep and nutrition are probably two things we don’t talk enough about. If an athlete sleeps less than eight hours, they have a higher risk of becoming injured and may have delayed recovery from injuries.

    Nutrition is also vital to preventing injuries such as stress fractures, a concerning overuse injuries. Proper fueling after training and competition help athletes recover and prepare for the next session or game.

     

    To watch Dr. Ellis’ full webinar, please visit the National Council on Youth Sports on YouTube.

     

    When Can I Return to Sports? Concussion Recovery for Athletes

    When Can I Return to Sports? Concussion Recovery for Athletes

    by | Jan 23, 2025 | Sports Medicine

    Over 7 million teens play high school sports in the U.S., and millions more kids play in youth and recreational leagues. Athletics are a great way to make friends, stay active and learn life lessons. However, sports can also lead to dangerous concussions. Just like a sprained ankle, concussions take time to heal. Parents and young athletes need to understand how long concussion recovery takes and why returning to play takes time.

     

    Understanding Sport-Related Concussions

    A concussion is a type of brain injury that happens after you are hit in the head or body by another person or an object. This blow can cause the brain to bounce around, leading to chemical changes in the brain. A concussion is a mild traumatic brain injury (TBI), and just like any TBI, it can be serious.

    As soon as you suspect your child or teen has experienced a concussion, speak up. Learn the symptoms of concussion, and remove your athlete from a practice or game if you notice any of these signs after an injury:

    • Appearing confused, dazed or stunned
    • Balance problems
    • Changes in behavior
    • Losing consciousness
    • Memory issues, such as forgetting plays
    • Seizure, particularly with tension or stiffness in the arms or legs

     

    Early Diagnosis for Successful Concussion Recovery

    The first crucial step to healing after a concussion is getting athletes the medical care they need as soon as possible. Early intervention, and an accurate diagnosis from a physician who specializes in concussions, can help children and teens get back in the game sooner.

    A pediatrician or concussion specialist can provide an assessment for treatment and may refer you to a neurologist or sports medicine expert, depending on symptoms. Young athletes may need neurocognitive testing to evaluate the extent of their injury.

     

    Steps to Ease Healing

    Concussion recovery can differ from athlete to athlete, but it typically takes weeks, not days, for the brain to heal. Taking the time needed to recover from a concussion is crucial to ensure proper healing.

    Your young athlete’s medical provider will give you a treatment plan to help them gradually return to physical activities. It’s important to recognize that complete rest is no longer recommended. Concussion researchers, including those at Scottish Rite for Children, have found that returning to daily activities within two to three days helps children and teens feel better and recover faster than with total rest.

    When your child or teen returns to school, talk to teachers and school administrators about the learning environment and any necessary schedule modifications.

    Other steps to improve concussion recovery include:

    • Avoiding caffeinated drinks
    • Limiting screen time, which can worsen symptoms
    • Spending time with family members and friends to avoid isolation
    • Staying hydrated
    • Taking pain relievers such as acetaminophen or ibuprofen as recommended

    Also, help your child or teen get sufficient sleep every night. Contrary to what many people think, sleep should not be avoided after a concussion. Our researchers have found that insufficient or poor-quality sleep slows recovery.

    Athletes should get:

    • Nine to 12 hours of sleep per night if they are ages 6 to 12
    • Eight to 10 hours of sleep per night if they are ages 13 to 18

    Most children and teens recover from a concussion within a few weeks. However, scheduling an appointment with an experienced doctor who has managed concussions is recommended if symptoms get worse instead of better. Some children develop post-concussive syndrome, a condition that can last months after the concussion.

     

    Ready to Get Back in the Game?

    Returning to play should be approached with caution for athletes of all ages. The University Interscholastic League recommends a health care provider with experience managing concussions should clear an athlete before he or she starts the progression to return to play. Your child’s school or coach may have additional protocols.

    Typically, after an athlete is symptom-free, back in school and handling daily activities, he or she can start steps to return to sports, including:

    • Light aerobic exercise, such as riding a stationary bike or light jogging for 10 to 15 minutes
    • Sport-specific activity for 20 to 30 minutes with increased exertion, such as a running drill
    • Non-contact training drills with resistance training, such as ball handling or passing drills

    Progression to the next step should occur only if no symptoms return during this activity or for 24 hours after. With a physician’s clearance, athletes can start full-contact practice, such as scrimmages. They may be cleared for competitive play after being symptom free for 24 hours after a vigorous practice.

    Talk to a health care provider if symptoms return at any stage of these steps, either during training exercises or within 24 hours after.

    Throughout your child’s or teen’s recovery, work closely with the school’s athletic trainer, if one is available, and ensure your athlete follows the provider’s directions closely before returning to sports, especially contact sports.

     

    If your young athlete has recently experienced a concussion, Scottish Rite for Children sports medicine specialists are here to help. Request an appointment today.