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When a Young Athlete Gets Too Hot

When a Young Athlete Gets Too Hot

by | Jul 26, 2022 | Sports Medicine

As temperatures rise and athletes return to outdoor training and tournaments, recognizing and responding to the signs and symptoms of heat illness is critically important. Though body temperature may not be elevated, heat illness may still be present.

Signs and Symptoms of Heat Illness

  • Weakness
  • Vomiting
  • Excessive thirst
  • Headache
  • Fatigue
  • Sweating
  • Nausea
  • Light-headedness

Keeping cool when exercising in the heat

  • Take rest and water breaks, every 15-20 minutes
  • Avoid the hottest hours from 10 a.m. – 5 p.m.
  • Drink a sports drink with electrolytes and 6-8 percent carbohydrates when training lasts over 60 minutes
  • Avoid training in direct sunlight
  • Take breaks in the shade
  • Encourage removal of equipment during breaks, e.g., helmet
  • Wear loose-fitting, light-colored and moisture-wicking clothing

    Be prepared

    • Prepare ice and water before training sessions
    • Limit consumption of caffeinated and sugary beverages
    • Gradually increase physical activity in the heat
    • Continue conditioning in the off-season
    • Don’t train in the heat while you are sick or have a fever

    Ways to respond quickly to signs and symptoms of heat illness

    • Full body immersion in an ice bath
    • Iced-down towels applied all over the body

    Download this infographic with your team and coaches.

    Overcoming Gymnast’s Wrist – A Tale of a Gymnast Named Delaney

    Overcoming Gymnast’s Wrist – A Tale of a Gymnast Named Delaney

    by | Jun 28, 2022 | Sports Medicine

    Delaney, 12 of Lewisville, has been tumbling and flipping her whole life, well almost. Starting around 18 months old, this level 7 gymnast practices 20 hours per week. She is so happy to be back in her normal rhythm after a season of modified training because of a wrist injury. Delaney credits her occupational therapist, Lindsey Williams, O.T.R., C.H.T., with helping her focus on new goals to work toward while she was getting better.

    After a teammate and her mom described the gymnast’s wrist pain and treatment plan, Delaney and her mom took their advice to see someone at Scottish Rite for Children about her similar complaints. Pediatric sports medicine physician Jane S. Chung, M.D., confirmed that Delaney also had gymnast’s wrist, an overuse injury, in one hand and was showing signs of it developing on the other. The treatment plan started with immobilization, a cast on one arm and a removable splint on the other, and a new approach to training while protecting her wrists. Delaney was committed to this plan. At one point, Delaney even opted to extend her time in the cast just to be sure she didn’t go back too soon. “I wanted to be sure my wrist was ready, so I listened to Lindsey and kept working on my other goals like stretching for splits.”

    “We were very concerned when we learned this could affect her growth. She had only complained of pain for a couple of weeks, we are glad that we received the advice to get it checked out.” Delaney’s mom recalls their initial surprise and hopes others will learn to watch out for signs of gymnast’s wrist.

    Delaney, and sometimes her brother Luke, have enjoyed the activities that Lindsey has given her to increase the use and strength in her hand, wrist and arm. Delaney and her mom appreciate that Lindsey can talk-the-talk. Her mom says, “she knows gymnastics lingo, and she knows the demands of the sport.” Lindsey worked her magic with Delaney, getting to know her as an individual, looking for her motivations and challenging her to find ways to keep moving forward even when she was ordered to “rest.”

    Lindsey says, “I’m excited to see Delaney ready to graduate from occupational therapy and return to her sport. I love my job and seeing kids getting to do what they love makes me love it even more.”

    WE ENJOY HEARING ABOUT OUR CURRENT AND FORMER PATIENTS’ SUCCESS STORIES. TELL US ABOUT YOUR MVP.

    Learn about overuse injuries in gymnasts wrist.

    Gymnast’s Wrist

    Gymnast’s Wrist

    by | Jun 27, 2022 | Sports Medicine

    Success in gymnastics requires a high volume of training and early specialization. Together, these can take a toll on a young athlete’s growing body. Lindsey Williams, O.T.R., C.H.T., is an occupational therapist who takes care of gymnasts with wrist pain. “I really like working with gymnasts because they are motivated and very compliant with their rest and exercises, but knowing this condition is preventable makes me want to help them catch it before it starts.”

    Not too many athletes spend as much time on their hands, so this condition is most common in gymnasts. Because of this, it’s commonly referred to as, “gymnast’s wrist.” Take a few minutes to learn more about this condition and how to recognize early signs and better yet, prevent it.

    What is gymnast’s wrist?
    Gymnast’s wrist is an overuse injury that causes pain and tenderness in one of the forearm bones, the radius. Distal radial epiphysitis is inflammation in the growth plate near the wrist. This injury is seen, not only in gymnasts, but also in active growing children and teens and is more common in girls than boys. This commonly occurs during periods of rapid growth and/or increased activity.

    What causes epiphysitis of the distal radius?
    A growth center or epiphyseal plate is an area near the end of long bones that allows for continued growth of a bone. This area is made up of soft cells called cartilage. These weaker cells are at a higher risk of injury.  Repeated stress or compression in this area causes damage and inflammation that can be painful.

    Activities that require repetitive weight-bearing through the hands, particularly in extension, include:

    • Tumbling or vaulting
    • Impact or loading in wrist extension with cheerleading and stunting
    • High volume or intensity of training

    Treatment is imperative to prevent long-term damage of the wrist. Without treatment, continued trauma to this area can cause the growth plate to become bone (ossify) early which may require surgery in the future to correct. With early and proper treatment, most recover well without surgery.

    The initial treatment is rest from impact and weight-bearing activities. A gradual and guided return to normal movement and activities is important.

    When pain has improved, an occupational therapist (OT) will guide the progression of exercises, and when cleared by the physician, introduce weight-bearing activities and transition back to sport as strength and pain allow.

    How long do symptoms of gymnast’s wrist last?
    Untreated, symptoms may persist until completion of growth in this area. In time, stronger bone cells replace the soft cartilage cells, but pain may still come and go for months to years.
    To prevent recurrence, it is important to continue the recommended exercises and to avoid excessive training and impact. Pain may come back or worsen during sports or strenuous activities and treatment may be started again. With proper management, most athletes can return to their sport within 3-6 months from the start of treatment.

    Can epiphysitis of the distal radius be prevented?
    Any athlete that participates in repetitive weight-bearing and loading of the wrist is at risk for this injury.

    Some actions to help prevent this include:

    • Warming-up and stretching before participating in weight-bearing activities will reduce stress on joints.
    • Limit or vary physical activities to avoid overtraining and overuse. Spread out training for high-impact activities such as tumbling and vault to separate days and allow a day or two of rest between them.
    • Rest when sore or in pain.
    • Maintain wrist and grip strength to help support the joint and absorb some of the impact.
    • Wear wrist braces such as Tiger Paws® wrist supports to prevent wrist hyperextension and help decrease stress on your wrists.
    • Be aware of changes in wrist pain with increases in training time or when training for a higher level of competition.

     Learn about other overuse injuries in gymnasts.

    Unique Considerations for Female Athletes

    Unique Considerations for Female Athletes

    by | Jun 13, 2022 | Sports Medicine

    These are highlights from a lecture provided as part of, Coffee, Kids and Sports Medicine, a monthly lecture series for medical professionals. Using example cases and detailed visuals, sports medicine physician Jane S. Chung, M.D., discussed the evaluation and treatment of the female athlete.

    Watch recording.

    Download PDF.

    What are the unique benefits for girls participating in sports?
    Known benefits of physical activity include cardiovascular fitness, cognitive function, strength and many more. Female athletes have also shown to have these benefits:

    • Higher self-esteem
    • Better grades
    • Higher graduation rates
    • Lower rates of teen pregnancy
    • Lower rates of smoking and drug use
    • Lower rates of depression and anxiety
    • As much as 30% greater bone mineral density than nonathlete counterparts

    What are some sport-related physiological and anatomical characteristics of females compared to males?

    • Higher percent body fat (average 26% vs. 14%)
    • Less lean muscle mass
    • More oxygen consumption with weightbearing exercise
    • Total cross-sectional area of muscle (60% vs. 80%)
    • Smaller heart and faster heart rate
    • Smaller thorax and lungs
    • Lower blood volume and VO2 max
    • Fewer red blood cells and 10% less hemoglobin

    What has changed in the definition of the female athlete triad?
    Female athlete triad was a medical condition initially described as involving these three components: osteoporosis, amenorrhea and eating disorder. Now, the updated definition recognizes that the central cause of female athlete triad is due to low energy availability with the three components being interrelated and each lying on a spectrum.

    Spectra of the Female Athlete Triad

    • Low energy availability
    • Impaired bone health
    • Menstrual dysfunction

    Triad occurs when energy intake does not adequately compensate for exercise related energy expenditure. This is referred to as under-fueling which then can adversely affects reproductive, bone and possibly cardiovascular health.

    What are Risk Factors for the Athlete Triad?

    • Sports that emphasize aesthetics and leanness such as dance, cheerleading, figure skating, gymnastics, long- and middle-distance running, pole vaulting, cycling, wrestling, light-weight rowing (coxswain) and horse jockeying.
    • Early age of sport specialization
    • Family dysfunction, abuse, dieting, stressors from family/coaches

    What is Energy Availability?
    Amount of dietary energy left to support other physiologic functions after subtracting energy used in exercise.

    Energy availability is described using a spectrum:

    • Optimal energy availability
    • Reduced energy availability
      • Unintentional: inadequate dietary intake and/or excessive exercise
      • Intentional: disordered eating behaviors
    • Low energy availability
      • Eating Disorder: clinical mental disorder defined by DSM-V
      • Disordered Eating: various abnormal eating behaviors including restrictive eating, fasting, frequently skipped meals, diet pills, laxatives, diuretics, enemas, overeating and binging and purging

    How much dietary intake is normal?
    Optimal energy availability is 45 kcal/kg fat free mass per day. This is known to support physically active women. Anything less than 30 kcal/kg fat free mass per day contributes to negative metabolic, reproductive and bone health related changes are seen below this level.

    • An athlete’s weight should be >90% of expected body weight.
    • Low BMI is a strong predictor of low bone mineral density and stress fractures.

    What are normal and abnormal menstrual cycles?
    Also called eumenorrhea, the typical cycle occurs every 28 days and lasts about 7 days. In cases where the cycle occurs less frequently, specifically more than 35 days apart, it is called oligomenorrhea. The absence of the cycle, amenorrhea, may be primary or secondary. In cases of low energy availability, the absence is further defined as functional hypothalamic amenorrhea.

    How are estrogen and progesterone associated with musculoskeletal health? 

    Beyond the reproductive cycle, these hormones are also important in bone health.

    • Stimulates osteoblasts
    • Inhibits osteoclasts
    • Muscle activation
    • Ligament and tendon stiffness
    • Suppresses hormones that cause articular cartilage breakdown

    What is peak bone mass and what can positively influence it in female athletes?
    Peak bone mass is a measure of bone mineral density that is used to assess bone health and risk for injury such as fracture, stress fracture and osteoporosis later in life. Ninety percent of peak bone mass is obtained by age 18 in females and age 20 in males. In young adults, bone mineral density 10% higher than the mean may reduce risk of fractures as well as delay the onset osteoporosis as much as 13 years. Therefore, attention to bone mass during childhood and adolescence is of utmost importance.

    Genetics is the main determinant of peak bone mass. The following items also impact peak bone mass:

    • Mechanical forces
    • Gender
    • Hormones
    • Nutrition
    • Physical activity or other outside risk factors.

    Early puberty is the most crucial time to positively influence peak bone mass with weightbearing sports and high-impact exercises. Studies have found that participation in sports can increase bone mass by as much as 10%.

    What problems occur from low energy availability?
    Several systems are affected, and the consequences compound in a cascade. Here are some key messages to keep in mind.

    Bone Health

    • A reduction in bone formation caused by suppression in hormones is possible.
    • Low bone mineral density is known to increase the risk of stress fractures.
    • Changes from low bone mineral density may be irreversible.
    • DXA scans are recommended based on the presence of specific high and or moderate risk factors.

    Reproductive System

    • Functional hypothalamic amenorrhea is a diagnosis of exclusion.
    • Other causes of abnormal menstrual cycles should be considered.
    • Young athletes believe it is a normal response to training, but it is not.

    Tip for young athletes: encourage females to be prepared for their period with supplies (feminine hygiene products, clean clothes, plastic bag) and to monitor their menstrual cycle to adjust training as needed.

    Cardiovascular Health

    Studies have shown that history of prolonged irregular menstrual cycles may negatively affect cardiovascular health and has shown possible association with:

    • Coronary artery disease
    • Endothelial dysfunction
    • Unfavorable lipid profiles and increased LDL

    Performance

    • Triad may reduce performance and training responses, delay or extend healing and cause fatigue.

    What is Relative Energy Deficiency in Sports?
    Also referred to as RED-S, this is an evolution of the concept recognizing impaired physiological functioning caused by relative energy deficiency. This includes but is not limited to impairments of metabolic rate, menstrual function, bone health, immunity, protein synthesis and cardiovascular health.

    How is male athlete triad different than female athlete triad?

    Reproductive suppression is seen in males in these forms:

    • Low testosterone (T)
    • Oligospermia
    • Decreased libido

    When is screening for triad or RED-S most appropriate? 
    Well visits such as during a pre-participation physical evaluation (PPE) or the yearly check-up and any time an athlete presents for a recurrent injury, bone stress injury or other illness. To diagnose the condition, only one of the three components must be present. Evaluate further with any positive finding.

    What are appropriate screening questions?
    The Female and Male Athlete Triad Coalition provides a list of 15 screening questions. These are consistent with the American Academy of Pediatrics 2019 Preparticipation Physical Evaluation recommendations and can help to guide further discussion and assessment.

    • Do you worry about your weight or body composition?
    • Do you limit or carefully control the foods that you eat?
    • Do you try to lose weight to meet weight or image/appearance requirements in your sport?
      • Does your weight affect the way you feel about yourself?
      • Do you worry that you have lost control over how much you eat?
      • Do you cause yourself to vomit or use diuretics or laxatives after you eat?
    • Do you currently or have you ever suffered from an eating disorder?
      • Do you ever eat in secret?
    • What age was your first menstrual period?
    • Do you have monthly menstrual cycles?
    • How many menstrual cycles have you had in the last year?
    • Have you ever had a stress fracture?

    What are other risk factors of RED-S?

    • History of menstrual irregularities
    • History of stress fractures, family history of osteoporosis
    • Depression
    • Perfectionistic or obsessive personalities
    • Overtraining
    • Non-healing injuries
    • Inappropriate coaching
    • Early sports specialization

    What are the treatment and recovery expectations for athletes with female athlete triad?
    The primary goal is restoration and normalization of body weight, to restore menses and to improve bone health. Rest or modified training may be recommended depending on the risk of injury or presence of concerning symptoms. A collaborative treatment approach includes a physician with experience treating athletes with triad, a dietitian, a psychologist and sometimes other specialists. Treatment with a birth control pill may lead to the false belief that the natural process has been restored, however, these do not cause the return of normal menses.

    Returning to sports should be considered using a cumulative risk assessment. Recovery occurs first with energy status, then menstrual status and then bone health. Earlier diagnosis reduces the length of recovery and hopefully prevents irreversible changes. Resumption of normal menses can sometimes take months or longer, reversal of low bone mineral density can sometimes take year or longer, and sometimes may be irreversible.

    What are strategies to optimize bone health in young athletes?

    • Focus on risk factors to address biological risk factors for low bone mineral density
    • Ensure adequate calcium and vitamin D, nutrition and overall energy availability
    • Encourage adequate sleep as it may promote bone health
    • Appropriate loading activities during the “critical period” of youth (early puberty)

    About the Speaker
    Jane S. Chung, M.D., is a pediatric sports medicine physician at Scottish Rite for Children Orthopedics and Sports Medicine Center in Frisco, Texas. She is passionate about the health and safety of young athletes and cares for pediatric sport-related medical and musculoskeletal conditions. Chung loves to teach other provider, parents and athletes about the unique needs of female athletes during crucial growing years.

    Pediatric Sports Neurology Perspective on Headaches and Migraines

    Pediatric Sports Neurology Perspective on Headaches and Migraines

    by | Apr 28, 2022 | Sports Medicine

    Mathew Stokes, M.D., is a pediatric sports neurologist and headache specialist at UT Southwestern Medical Center and also sees patients at Scottish Rite for Children in Frisco. These resources are designed to help medical professionals recognize and manage sport-related concussions and headaches in children and adolescents.

    Sports Neurology: Concussion and Headache in Young Athletes

    Mathew Stokes, M.D.

    Watch now

    Stokes presented this lecture as part of a monthly education series for medical professionals. He described common symptoms including physical, emotional and cognitive changes associated with sport-related concussion. He presented risk factors associated with delayed recovery from concussion. Finally, he provided criteria for diagnosis, management and prevention of common headache types in athletes including migraines.

    Non-Pharmacological Management of Migraines

    Victor Kaytser, M.D., and Mathew Stokes, M.D.

    Stokes, M.D., co-authored this article with UT Southwestern Medical Center neurology fellow, Victor Kaytser, M.D. The article was originally published in a recent newsletter of the Pediatric Society of Greater Dallas.

    Download the PDF of this article.

    What Is a Migraine and How Are They Treated?

    Migraines are a common neurological disorder affecting one in 10 children, with a higher incidence in teenage girls. (Symptoms of migraine or what is not considered a migraine?)

    As we learn more about migraines, we are finding new and innovative ways to treat them. This is especially important for patients who cannot take or do not respond well to the traditionally prescribed pain-relieving and preventive medications. In addition, parents may feel hesitant to medicate their children and will seek non-pharmacological remedies first. Therefore, we will discuss some non-pharmacological options for the treatment of migraines including lifestyle modifications, supplements and devices.

    Lifestyle Modifications

    Lifestyle modifications are recommended regardless of what other treatments may already be in place and can be remembered using the mnemonic SEEDS: Sleep, Exercise, Eat, Diary, Stress.

    Sleep
    Migraines can be caused by too much or not enough sleep, and disruptions in the normal 24-hour sleep cycle, or circadian rhythm. Poor sleep habits can trigger migraines, and migraines, in turn, make it difficult to sleep, further exacerbating the pain cycle. A few sleep hygiene tips are as follows:

    • Schedule a consistent sleep time and wake time, including weekends.
    • Do not use the bed/bedroom for other activities, such as studying, watching TV, etc.
    • Avoid staying in bed if wide awake; rise and do something else for a few minutes before trying to fall asleep again.
    • Take time outside to help set a natural circadian rhythm.
    • Do not exercise before sleep.
    • Avoid stimulants, such as caffeine or nicotine.

    Exercise
    At least 30 minutes of moderate-intensity exercise, three times per week can help reduce migraine frequency and severity. Patients should note that overexertion can worsen headaches. Those involved in contact sports need to be mindful that injuries and head trauma can also worsen headaches.

    Eat
    Both high and low blood sugar levels can affect migraines. Therefore, eating smaller meals, increasing protein, fiber and healthy fat intake while also reducing processed foods can help maintain healthy glucose levels and reduce migraine frequency.

    Maintaining a caffeine-free diet is ideal; however, if patients currently consume caffeine, stopping the consumption suddenly can lead to caffeine-withdrawal headaches. Therefore, a slow weaning of caffeine products is recommended. Other foods that are commonly migraine triggers include aged cheese, chocolate and MSG.

    Water intake is also important. The daily goal is one ounce per kilogram of body weight. (1 KG = 2.2 pounds)

    Diary
    A headache diary can help to identify migraine triggers. Triggers can vary from environmental (e.g., bright lights, weather changes) to nutrition, sleep changes or stressors. Identifying migraine triggers can help patients focus their lifestyle change efforts. Options include Migraine Buddy and iHeadache mobile apps.

    Stress
    To effectively manage stress, many turn to cognitive behavioral therapy, meditation, mindfulness, massages and yoga. There are free websites, like www.dawnbuse.com, that provide various relaxation audio files, articles and podcasts.

    Supplements

    Nutraceuticals
    Riboflavin (vitamin B2), CoQ10, magnesium, curcumin and feverfew (Tanacetum parthenium) are the most commonly used for migraines. These nutraceuticals have positive effects on mitochondrial metabolism, antioxidant properties and are vasoconstrictors, helping to prevent or relieve pain in migraine sufferers. Several proprietary products, like Migrelief and Dolovent, combine these supplements in a single formula.

    Magnesium acts as a calcium channel antagonist and has the most robust body of literature supporting its effects on migraine with a relatively low side effect profile (abdominal discomfort and diarrhea).

    Therapies

    Essential oils
    Peppermint oil contains menthol, which can help ease pain by relaxing the muscles around the head. Rosemary oil has anti-inflammatory and pain-easing characteristics. Lavender and chamomile oil is used to help relax and reduce stress. Eucalyptus oil helps to open and clear the sinuses, which, if congested from allergies, may provoke headaches.

    Heating and cooling pads
    Placing a hot compress on the neck can help relax tense muscles and relieve pain. A cold compress or ice pack can provide relief through its numbing effect, temporarily dulling the sensation of pain when placed on the neck and/or forehead.

    Acupuncture
    Used for centuries to treat pain and manage stress, acupuncture has been shown to be at least as effective as some standard drugs like beta blockers and topiramate, and it is safer and more cost effective.

    Devices

    Medical devices like gammaCore, an external vagus nerve stimulator, can also help. The device is held against the skin of the neck and transmits small electrical currents to stimulate the vagus nerve and block pain signals. The device works in as little as 30 minutes, and 30% of patients were pain-free at two hours. About one-third of patients achieved a 50% reduction in headache frequency.

    Nerivio is a neuromodulation device for patients 12 and older, worn on the upper arm to stimulate small nerves that send pain signals to the brain. A third of patients were completely pain-free at two hours.

    Cefaly is an external trigeminal nerve stimulation device for patients 18 and older and does not need a prescription. The device is magnetically connected to a reusable self-adhesive electrode that is placed on the center of the forehead and sends micro-impulses to the trigeminal nerve. Studies reported that 32% of patients were pain-free at one hour, and 38% saw at least 50% reduction in migraines per month.

    Allay Lamp emits a precise narrow band of green light that helps reduce the light sensitivity associated with migraine, which can also help reduce stress, anxiety and improve sleep.

    Conclusion

    Helping patients identify migraine triggers and follow daily headache hygiene tips can go a long way in composing an effective treatment plan. In some cases, lifestyle changes may be enough to reduce migraine frequency considerably and avoid the need for devices or medications all together. For others, a combination of lifestyle changes with a device, supplement or medication may be the most effective. For the latest migraine management tips, the American Migraine Foundation website routinely publishes new articles to better manage migraines.

    Muscle Strain Q&A

    Muscle Strain Q&A

    by | Apr 22, 2022 | Sports Medicine

    Our world-renowned sports medicine experts are ready to help your injured athlete get back in the game. We have unparalleled experience providing nonoperative and arthroscopic care to treat common sport-related injuries including concussions, ligament injuries and cartilage conditions in the knee, ankle, shoulder, elbow and hip in young and growing athletes.

    Sports Medicine expert Jacob C. Jones, M.D., RMSK, shares information about muscle strains and how to handle these types of injuries in young athletes.

    What is a muscle strain?
    A muscle strain is a disruption of the muscle fibers in a certain muscle group. Muscle strains can be mild or they can be severe, causing muscle tearing.

    What causes a muscle strain?
    Muscles are constantly being pushed and pulled, but when a muscle contracts at the same time that it is being pulled, a strain can occur. This type of muscle movement is called an eccentric contraction. 

    What are the symptoms of a muscle strain?
    In mild strains or low-grade muscle disruptions, the most common symptom will be pain in the area. Severe disruptions or tears can also cause swelling, more noticeable weakness, and even bruising.

    Should you seek medical treatment for a muscle strain?
    It is definitely wise to seek medical treatment for muscle strains. In mild cases, a young athlete may want to consult with their athletic trainer for advice and recommendations on reducing the pain. Athletic trainers can also help determine whether the athlete needs to see a physician for the injury.

    Relative rest, in combination with muscle rehab, is the best treatments for a strain. It is important to allow the muscle to heal while also building strength and flexibility to avoid further injury. Even in high grade muscle tears, surgery may not be commonly recommended. 

    Are certain muscles more at risk for strains?
    Yes, muscle groups that are at the highest risk for strains are those that cross multiple joints. For example, some hamstring and quadricep muscles cross both the hip and knee joints and calf muscles cross the ankle and knee joints. Any muscle can be strained, but those groups are more likely to be injured.

    How can you avoid muscle strains?
    Muscles are less likely to have a strain if they are flexible and strong. Stretching daily can help provide your muscles with more flexibility and strength. Additionally, it is important to also warm up your muscles before working out or playing a sport. Muscles are less likely to strain or tear when they are warm, so it is important to not skip warm-ups before practice.

    What does recovery from a muscle strain look like?
    Once pain allows, it is important to do some rehabilitation to the muscle before returning to regular activity. In mild strains or low-grade disruptions, recovery time may take weeks. In more severe cases that lead to muscle tears, recovery time may take months. We look for good range of motion, minimal to no pain, and good strength prior to return to sport.

    What happens if an athlete returns to sports or activity before the strain is healed?
    The biggest risk of returning to athletics or sports too soon is re-aggravating the muscle and extending the recovery time. Additionally, having a strain may cause you to favor one leg or arm and could lead to further injury.

    How can ultrasound be used to diagnose and treat muscle strains?
    Specially trained experts can use musculoskeletal ultrasound to evaluate injured joints, ligaments, tendons, muscles and bones. Ultrasound can visualize soft tissues like muscle well with a high level of detail. When looking at a muscle using ultrasound, a low-grade strain may show some edema, swelling caused by fluid in tissue, while a more severe strain that has already torn will clearly be visible. Using ultrasound can also allow physicians to determine where additional treatment or care is needed in treating muscle strains. Ultrasound can also be used for treatment of chronic muscle tears not improving with other conservative measures.

    Sports medicine is a medical and surgical specialty that considers the comprehensive needs of athletes and provides management for sport-related injuries and conditions. Young and growing athletes are highly competitive and have unique conditions that require care by a pediatric team of experts. Learn more about our Center for Excellence in Sports Medicine and how board-certified pediatricians, pediatric orthopedic surgeons, physical therapists, athletic trainers, psychologists and other sports medicine specialists work side-by-side with each athlete, their parents and coaches to develop the best game plan for treatment, rehabilitation and safe return to sport.