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Pre-Exercise Fuel for Morning Training Sessions

Pre-Exercise Fuel for Morning Training Sessions

by | Sep 3, 2020 | Sports Medicine

Many athletes avoid eating anything before early morning practices. This may leave them feeling slow and tired during practice and not eating anything until lunch, causing them to miss out on two key meals for the day: the pre-training meal and the recovery meal. The good news is that the stomach can be trained and there are ways to make sure the young athlete is not running on empty for that early morning practice.  
 
For the athlete just getting started with early morning fuel or who jumps out of bed and is at practice in 30 minutes, try small amounts of very simple carbohydrate foods to prevent upset stomach & cramping during practice.

Examples include:

  • 4 to 8 ounces of juice
  • 4 to 8 ounces of sports drink
  • 1 small or 1/2 a large banana
  • Dried fruit (raisins, mango, apples, pineapple)
  • Slice of white toast or mini white bagel topped with thin spread of jam or honey
  • Snack-size baggie of low-fiber, low-fat dry cereal
    • Try to keep amount of fiber & fat per serving as low as possible (example: choose Cheerios vs. granola)
  • Fruit leather
  • Low fiber, low fat granola bars
  • Handful of pretzels

4 Key Points to Remember:

  1. As the athlete becomes used to these foods or drinks before practice, portions can be increased and a little more variety can be added, which will provide more energy for a longer period of time during his / her training session.
  2. If more time is allowed between the pre-training meal and the training session, then a little more food may be eaten.
  3. Different athletes may also be able to tolerate different foods because their training sessions are different. A football or baseball player may be able to tolerate a little more protein during the pre-training meal, whereas an endurance runner or sprinter will most likely want to limit protein and focus completely on easily digested carbohydrates.
  4. For the athlete that still has trouble with this pre-training meal, remember that the meal the night before can be helpful. Include a balanced dinner and, if dinner was early, include a bedtime snack with quality carbohydrate and some protein so that the athlete will not have to rely entirely on the morning fuel to carry him or her through training.
Pre-Game Meal Guide for Coaches

Pre-Game Meal Guide for Coaches

by | Aug 31, 2020 | Sports Medicine

Eating before a game or competition is important to make sure the young athlete is fueled and hydrated from beginning to end. No matter the time of day, this “pre-game meal” can be a game changer. A poor pre-game meal can leave the athlete tired, dehydrated, or with stomach pains and cramps during the event. An athlete after a well-planned pre-game meal is energized, focused, and sharp. For afternoon or evening events and games on the road, an athlete may be dependent on others to make the right choices. Coaches and parents can use this list of do’s and don’ts for building a performance-boosting pre-game meal for your teams and athletes.

DO INCLUDE:
A variety of carbohydrates: 

  • Complex carbohydrates:  whole grain breads, crackers and rice, fruit, yogurt, white potatoes, sweet potatoes, wheat and corn tortillas.
  • Simple carbohydrate options: dried fruit, white bread, white rice and pretzels.

A few lean protein choices:

  • Grilled or baked chicken, deli turkey slices, hard-boiled eggs, beans, part-skim mozzarella string cheese, low-fat or fat-free Greek yogurt.
  • Peanut butter or seed butter can be a good option for some athletes (note: these are higher fat protein sources, so make sure the athlete already knows he/she can tolerate pre-exercise).

A variety of fluids:

  • Water, sports drinks, fruit smoothies, and flavored waters.

DON’T INCLUDE:
Foods high in fat:

  • Fried foods, baked goods, high fat dairy products, and high fat meats.

Foods high in simple sugars:

  • Candy, sodas, ice cream, and cookies.

High-fiber-only options:

  • Some athletes may need to eat a very simple meal before a game due to stomach discomfort caused by nerves. It’s important for this reason to include some low-fiber options in the meal, as shown in the simple carbohydrate options above.

ADVICE FOR YOUR ATHLETES:

  1. Choose what works: In the off-season, learn what your body tolerates best before an event. Try to create that. Learn more.
  2. Try to include at least three different food groups at the meal: This can look like – turkey on whole-wheat hoagie sandwich bread with lettuce, tomato, and mustard + pretzels; and a bowl of fresh fruit.
  3. Don’t skip the carbohydrates: Carbohydrate foods will be your main source of energy throughout the game. Eating carbohydrates in the pre-game meal tops off any muscle stores that are low and stabilizes the blood sugar that could be dipping at the end of a busy day.
  4. Drink up: Drinking water is the best option for the athlete. However, if you have trouble eating before a game due to pre-game jitters, a sports drink may be a good option. This can provide some additional carbohydrates and electrolytes before the event starts. Turn to smoothies, yogurt, fresh fruit, and soups to get fluids in your pre-game meal.

Note: Remember that the closer you get to the event, the simpler your food choices should be.  If your pre-game is closer to your event time than usual, try choosing lower fiber carbohydrate choices in your meal while still getting some protein, and leave higher fat foods for after the event is over.

Nutrition Tips for Dancers

Nutrition Tips for Dancers

by | Aug 19, 2020 | Sports Medicine

Mix it Up

With long practices or multiple sessions a day of different intensities, the young dancer should be sure to include a variety of fuel sources, including protein, carbohydrate and healthy fats in meals and snacks.

  • Protein, carbohydrate and fat are all considered macronutrients. They are the nutrients that provide our bodies with energy.
  • Different intensities of training use different macronutrients for fuel.

Spread it Out

While dance is considered one of the sports that values leanness, it’s important to remember that the young dancer is still going through growth and development that requires extra energy and nutrition. Plus, they are expending extra energy for their sport. Make sure your dancer is getting three balanced meals a day and at least a couple of snacks.

Start Out Right

If your young dancer has trouble eating before a practice or competition, try snacks containing simpler carbohydrates about 30 to 45 minutes before the event. These snacks are easily digested and provide energy for the upcoming event. Snacks ideas include:

  • Fruit
  • Pretzels
  • Crackers
  • Plain mini bagels
  • Small juice or sports drink

Add a Snack

Your dancer might need a pre-event snack if he or she:

  • gets dizzy or light-headed during practice.
  • gets shaky during practice.
  •  is having trouble concentrating.
  • complains of fatigue during practice.

Pack a Lunch

When packing lunch for a long day of practice, mix up items from these categories:

  • Carbohydrates: bread, pasta, quinoa, rice, fresh fruit, potatoes, winter squash, peas, beans, yogurt, milk
  • Protein: turkey, chicken breast, lean ground beef, chicken or turkey, eggs, tofu, beans, yogurt, milk
  • Veggies: greens, carrots, cucumbers, peppers, mushrooms, squash, brussels sprouts, etc.
  • Healthy fats: nuts, seeds, nut or seed butter, olive oil, vegetable oils, avocado, salmon and tuna

End it Right

After a long and intense practice, the best snack is one that provides:

  1. carbohydrate to refill depleted energy stores in the muscle.
  2. protein to repair any damaged tissues.
  3. fluid to rehydrate the body.

For the best recovery, aim to get this snack within 30 to 45 minutes after practice.

Change it Up

A dancer’s nutrition plan and needs will not be the same every day. Remember that needs change based on length and intensity of training sessions. Needs on the day of a performance may not be the same as needs on a day of summer intensives.

Emergency Action Plan: Why It Is Important For Your Child’s Sports Organization To Have One

Emergency Action Plan: Why It Is Important For Your Child’s Sports Organization To Have One

by | Aug 3, 2020 | Sports Medicine

Shane M. Miller, M.D., thinks that every organization that values the health and safety of its athletes should have an emergency action plan. Miller, a pediatric sports medicine physician at Scottish Rite for Children, was invited as a guest expert in a conversation about emergency action plans (EAP) on a recent Healthy Young Athlete Podcast.

Miller’s expertise and experience as a sports medicine physician, team doctor, former firefighter and emergency medical technician and, as a parent and coach of his kids’ teams, together give him perspective in this conversation. He says, “Responding to emergency calls is very different at a school or venue that has an EAP in place vs. others where chaos can cause delays in accessing emergency medical care.”

What is an EAP?
It 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.

Why do you need one?
Fortunately, the majority of injuries we see in our sports medicine practices are relatively minor. Musculoskeletal injuries like ankle sprains and fractures or overuse injuries such as knee pain or stress fracture are more common, but catastrophic injuries and emergencies do occur. These may include cardiac events, severe neck or spinal cord injuries and exertional heat stroke.

What is covered in an EAP? 

EMERGENCY TEAM Who is involved when the plan is activated and what role each plays. This may include leaders in the organization (director/administrator), athletic trainer, team physician, etc. IT also addresses the training requirements for those roles – CPR, AED, first aid, concussion recognition or management. If no medical personnel present, who takes charge?

EMERGENCY EQUIPMENT, STATUS AND LOCATION 
For example, an automatic external defibrillator is only helpful if it is easy to find, charged, stocked with appropriate pads and readily accessible. Make sure personnel or attendees know where to find first aid supplies or a STOP THE BLEED® kit. 

COMMUNICATION Organized contact information for local emergency response systems including “9-1-1” and the address of the facility improves response time for calls. Additionally, a plan should include important people to contact in case of an emergency (athletes’ emergency contacts (parents), leaders of organization, medical team, etc..

MAPS Finding an injured athlete quickly requires access to venue-specific information including address, directions, maps, field numbers, location of gates and locks/keys, access points for emergency responders.

ROLES OF FIRST RESPONDERS Clearly defined personnel roles who provide first aid, equipment access and retrieval, calling EMS, directing EMS to the scene, removing equipment etc. 

TRANSPORT PLAN Local emergency facilities may or may not accept traumatic injuries. Collaborate with local EMS to decide and communicate where an injured athlete will be taken and how. 

DOCUMENTATION Record-keeping plans for all emergencies and near-emergencies and debrief discussions and findings. This helps with clearly documenting what occurred and provides information to help improve for the future. 

Making youth sports a safe experience is on the minds of many health care professionals, parents and coaches. An EAP is not a new idea, but unfortunately, may be new to some organizations. Don’t hesitate to speak up for safety and share these ideas with your children’s sports organizations.
Listen to a recording of the podcast hosted by Miller’s peer, Mark Halstead, M.D.

Need some more information? Check out these resources:

  • The Inter-Association Task Force Document on Emergency Health and Safety: Best-Practice Recommendations for Youth Sports Leagues I Learn more
  • National Athletic Trainers’ Association Position Statement: Emergency Planning in Athletics I Learn more
  • USA Recognize to Recover I Learn more
Ellen’s Healing Process is Going Swimmingly

Ellen’s Healing Process is Going Swimmingly

by | Jul 30, 2020 | Sports Medicine

Ellen has always been a competitive person, especially in the pool. “Even when I first started swimming competitively in sixth grade, I would tell myself that no matter who was in the lane next to me, I was racing against them,” says Ellen. That fierce competitive spirit has always pushed her to be the best she can be in all that she does. When an injury forced her out of the pool and into surgery, Ellen competed with herself to be her best at physical therapy to get back to doing what she loves.

Ellen-swimming-2-(1).jpg

When Ellen was 9, her favorite sport was soccer. After an injury on the field, she began swimming for physical therapy. She returned to soccer once she had recovered, but Ellen quickly went back to the pool because she realized how much she loved swimming. “I could tell Ellen was a natural swimmer from the second she hopped into the pool,” says Ellen’s mother, Bonnie. Ellen swam with a local club team in Southlake, the North Texas Nadadores, for a couple of years until pain began to slow her down. She spent about a year in and out of the pool, visiting different doctors, but there wasn’t a definite diagnosis until they visited Scottish Rite for Children.
Pediatric orthopedic surgeon Henry B. Ellis, M.D., diagnosed Ellen with labral tears in her hips. “Labral tears are not commonly associated with swimmers, but we are seeing more and more of this, and they may be underreported,” says Ellis. In addition, Ellis explains that hip impingement and labral tears like Ellen’s primarily occur in adults, but our team is seeing it more in young athletes. “We initially treated Ellen’s injury with physical therapy while trying to balance in-water training with cross-training and dryland exercises. Eventually, she took a break from swimming for a short time to help with the pain.” 

In some kids, like Ellen, non-operative treatment doesn’t allow the labral tears to heal. Because of this, Ellis and his team proceeded with surgery to fix the labrum and address the bone around the hip to prevent it from happening again. 

Ellen returned to physical therapy the day after her surgery. It was tough at first, but her competitiveness kept her motivated. “There was another kid about her age that was doing physical therapy at the same time, and Ellen was quietly competing with her in her head,” says Bonnie. “We worked with several physical therapists. We found that God provides what you need at the right time. We had perfect people for the different stages of healing that she was going through.” As physical therapy continued, Ellen joined the Grapevine Faith Christian School swim team. Just 13 months after her second surgery, she qualified for the Texas Association of Private and Parochial Schools (TAPPS) State Swim meet. She swam in the medley relay and individually in the 200 breaststroke.

Ellen says that she has learned a lot from her experiences. “I think, most of all, I learned that God has a plan for my life. Even when I didn’t understand why I was in so much pain, I grew in other areas and realized I could do more than sports,” she says. Ellen also loves art, and this experience has helped her to figure out her art style. “She’s being pretty humble when she says she loves art. She was at the VASE (Visual Arts Scholastic Event) regional art competition and qualified for state. She ended up winning a Gold Seal at the state competition, which is the highest ranking!” says Bonnie joyfully.

Ellen is now training with her team, and she is excited to swim in her junior year, but she also wants to continue with her art. “It’s been good to do something different since I used to just swim all the time,” she says. “That balance is good.” Ellen encourages other young athletes to find that balance and not to rush their physical therapy. “Be determined, but don’t hurt yourself from trying too hard, because that’s kind of what I did. I tried pushing through it, and it just made it worse. I’m not back to swimming as many hours a week as I used to yet, but I’m definitely healed.”

Bonnie shares that they loved their time at Scottish Rite. “The care and the love shown by everyone was amazing. As a mom, when the doctor looks straight at your child and really talks to them and takes the time to get to know them as a whole person, it makes the experience incredible.” Ellen adds, “Dr. Ellis was really good about telling me what was going on instead of just telling my parents. He helped me understand why we were doing all the things like injections and physical therapy, and why everything needed to happen, and he told me about how my surgery was going to be.”

Ellen-art-(2).jpg

Get to Know our Staff: Jane S. Chung, M.D.

Get to Know our Staff: Jane S. Chung, M.D.

by | Jul 20, 2020 | Sports Medicine

Where did you go to college? Medical school? 
College: University of California, San Diego
Medical School: St. George’s School of Medicine 
 
What is your role on the sports medicine team? How does your role overlap or differ from an orthopedic surgeon?  
I am a non-operative pediatric sports medicine physician. I treat sports injuries that do not require surgery. 

Why did you want to become a doctor? Have you always wanted to work in pediatrics?
The seed was planted during mission’s week in my fourth grade Sunday school class, when a missionary pediatrician from Burkina Faso shared her story and work. In college, I traveled to Nairobi, Kenya on a medical mission trip with my church and worked at a hospital helping young children, which solidified my passion for working with kids and the field of medicine.
 
Is there anything you want parents/kids to know about sports safety or returning to sports during/after COVID?
As with any return to play or return to sport following a prolonged period of rest and inactivity, it is important to take a slow and gradual approach to safely re-introduce the body back to activity.
What led you to Scottish Rite for Children? 
I’ve worked at Scottish Rite for about four and half years now. The people and values of the institution are what led me here. The well-being of patients and families always come first. It is amazing to work with a like-minded team that also shares a similar passion to advance pediatric orthopedic medicine through research.

What are your specialties? 

How do you help your patients feel comfortable and confident? 
My belief is to treat the whole child, not just their physical injuries. It is important to also treat their emotional and mental well-being and health.

What is your favorite part of your job?
Working with young athletes to help them get back to their sport. 

What was your first job?
Working at a local surf shop in California.

Tell us something that might surprise us about you:
I don’t cook, but my husband enjoys cooking, so it works out well!

What is your favorite thing to do when you’re not working?
Spending time outdoors with my husband and our rescue dog. My husband and I also enjoy traveling the world and finding new spots to surf.

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