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6 Ways to Prevent Heat Illness in Athletes

6 Ways to Prevent Heat Illness in Athletes

by | Aug 1, 2024 | Sports Medicine

Summer is the perfect time for outdoor activities and sports. Whether your child is passionate about baseball, football, soccer or track and field, being proactive about preventing heat-related illness can help him or her focus on athletics. Here are six ways to help prevent or respond to heat illnesses.

1. Know Your Child’s Risk Factors for Heat Illness

All children and teens can develop a heat-related illness. Yet still, some have a higher risk. Young children are not able to regulate their body temperature as well as older children and teens, which makes them more vulnerable to heat. Other risk factors for heat injury include:

  • Being overweight
  • Having certain chronic medical conditions, including diabetes and heart conditions related to sickle cell traits
  • Not getting enough rest between games or practices
  • Overexertion during games or training
  • Recently having diarrhea, fever or vomiting, which can contribute to dehydration
  • Taking certain medications

Children and teens have the highest risk of developing heat illness at the beginning of the summer. Acclimating to exercising in hot weather can take several weeks for a young athlete. A step your child can take during the first five days of summer training is to not practice for more than three hours. Discover more heat acclimation tips for your young athlete by Korey Stringer Institute.

2. Encourage Hydration

Hydration is another key component of preventing heat-related illnesses. The amount of water your child needs depends on his or her activity level, age and body size. The outside temperature and humidity also affect hydration needs. Young athletes typically need more water than less active peers.

Encourage your child or teen to drink water before, during and after practices or competitions. The best drink choice is typically water, but sports drinks with a proper balance of electrolytes and carbohydrates for energy may help children involved in vigorous activities lasting more than an hour.

3. Be WBGT Aware

Being mindful of the temperature outside is one way to help protect your child or teen from heat injury or illness. However, monitoring the temperature is only one factor in preventing heat illnesses. Cloud cover, humidity, the angle of the sun and wind speed can also affect how heat affects the body. The wet bulb globe temperature (WBGT) takes all these factors into account to determine whether it is safe for children to participate in outdoor activities like soccer games.

The University Interscholastic League has enhanced guidelines for outside activity by adding the use of WBGT before and during activities in the sun. You can use the WBGT activity guidelines for your region to make decisions, such as how much protective gear an athlete can safely wear during practice, the length of training sessions and the number of rest breaks needed per hour. It also defines rapid cooling zones and supplies to have available when the WBGT readings are above a certain level. A school’s emergency action plan (EAP) includes these and other guidelines for preparation and preventing heat-related emergencies.

4. Keep Kids and Teens Cool During Competition and Training

 In addition to staying hydrated and watching the weather, you can do several things to help kids lower their risk of heat injury and illness: 

  • Apply broad-spectrum sunscreen.
  • Ensure your child has access to a shaded area available for rest.
  • Keep cool towels, fans and misters on the sidelines. 
  • Provide plenty of healthy snacks and water to help young athletes refuel.
  • Request or modify start times for competitions and practices early in the morning or later in the evening to avoid peak sun exposure.
  • Start slowly and gradually build intensity during practices.
  • Wear light-colored, loose-fitting clothing.

5. Recognize Signs and Symptoms of Heat Illness and Injury

There are several types of exertional heat-related illnesses and injuries. Some cause mild symptoms, while others are medical emergencies. Knowing what to watch out for can help keep your child or teen safe during summer sports.
After puberty, teens may experience excessive sweating which can lead to heat rash, a type of skin irritation. Heat rash causes clusters of small, red blisters or pimples. Typically, the rash appears in the elbow creases, groin area, neck, upper chest or under the breasts.
When the body loses electrolytes and water faster than it replenishes them, heat-related muscle cramps may occur. In addition to cramping, symptoms include pain or spasms in the abdominal, arm or leg muscles. Heat cramps can be a sign of heat exhaustion.
Heat exhaustion is the most common symptom due to heat-related illness and happens when the body loses a significant amount of electrolytes and water through sweat. While mental functioning remains intact, it is important to recognize and respond quickly to symptoms or signs of heat illness which may include:

  • Clammy, cold or pale skin
  • Dizziness or light-headedness
  • Elevated body temperature
  • Headache
  • Heat cramps
  • Nausea or vomiting
  • Tiredness or weakness

Heat exhaustion may lead to heat stroke if not treated. Heat stroke happens when the body temperature rises too high and the body cannot cool itself down. This type of heat illness is a medical emergency. Without immediate cooling and other treatment, heat stroke is life-threatening. Signs and symptoms of heat stroke include:

  • Confusion
  • Extremely high core body temperature
  • Fast, strong pulse
  • Loss of consciousness
  • Seizures
  • Skin that feels excessively sweaty or hot and dry
  • Slurred speech

6. Know How to Respond Early to Heat Illness

Even minor symptoms of a heat injury or illness need your attention. However, the appropriate response depends on the type of heat illness or injury. When a child or teen has signs of any heat-related illness, he or she needs to cool off. Have your child move to a cool place, loosen any tight clothing, wipe down with cool towels and sip water. If symptoms continue or worsen, seek medical attention. If the condition progresses to heat stroke, dial 911 and look for ways to safely, but rapidly, cool the athlete with total body cooling.

To learn more ways to keep young athletes safe, sign up for our sports medicine newsletter to learn the latest news from our experts.

Does my child need surgery to fix an ACL tear?

Does my child need surgery to fix an ACL tear?

by | Jul 30, 2024 | Sports Medicine

Anterior cruciate ligament (ACL) injuries, continue to challenge young athletes, many calling it an epidemic. Because of the high cost of care and loss of playing time, Scottish Rite for Children’s Sports Medicine team is actively looking for answers to prevent these injuries. As we study the conditions that may contribute to the risk with programs like the Sports-specific Assessment and Functional Evaluation (SAFE) program, we also continue to evaluate and contribute to the available evidence for caring for ACL injuries in young athletes.

Medical director of clinical research and pediatric orthopedic surgeon Henry B. Ellis, M.D., led a multicenter team including others from the Scottish Rite Sports Medicine team just published a critical analysis of the literature pertaining to the management of pediatric ACL injuries. The article is available on the Journal of Bone and Joint Surgeries (JBJS) Reviews site.

Here are some key messages you should know when considering surgery for an ACL tear:

» Even though these are happening at a high rate, there is very little published evidence for managing ACL injury in a pediatric or skeletally immature case.

Studies suggest that as many as 3 out of 4 athletes return to play after completing a nonoperative plan of care after ACL injury, but there are times that surgery is necessary. A physical therapist or athletic trainer can guide rehabilitation with a comprehensive exercise program to prepare an athlete to return to competitive sports with an ACL tear.

» This review suggests that surgery for an ACL reconstruction is recommended when another condition is present. These include:

  • Repairable injury to the cartilage, soft tissue that covers the surface of the bone.
  • Repairable injury to the meniscus, a disc between the two major bones in the knee joint.
  • Symptoms of instability even after high quality rehabilitation.

Since both paths for care can be successful and come with some risk, a decision for surgical or nonsurgical approaches to care for a pediatric ACL reconstruction should include a broad team considering many aspects of the circumstances.

Learn more about individualized care for ACL injuries at Scottish Rite for Children.
 

Ellis, H. B., Jr, Zak, T. K., Jamnik, A., Lind, D. R. G., Dabis, J., Losito, M., Wilson, P., & Moatshe, G. (2023). Management of Pediatric Anterior Cruciate Ligament Injuries: A Critical Analysis. JBJS reviews, 11(8), 10.2106/JBJS.RVW.22.00223. https://doi.org/10.2106/JBJS.RVW.22.00223
Movement Science + Olympic Sprinter = FAST

Movement Science + Olympic Sprinter = FAST

by | Jul 3, 2024 | Sports Medicine

Previously published in Rite Up, 2024 – Issue 2.

New and novel research that focuses on adolescent sprinters is coming off the blocks at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. FAST, short for Functional Analysis and Speed Training, is a series of data collection clinics led by Sophia Ulman, Ph.D., director of the Movement Science Laboratory. She and her team are partnering with Mechelle Lewis Freeman, USA Track and Field Olympian, Olympic coach and CEO/ Founder of TrackGirlz, a Frisco nonprofit that gives girls access to mentorship and sport through track and field empowerment programs. 

The goal of FAST is to reduce the risk of injury in the adolescent sprinting population. To achieve this, Ulman’s team collects data that measures a sprinter’s mobility, stability, strength and power. “A lot of sprinting data in the research community is in collegiate or Olympic athletes,” Ulman says. “No one has really tapped into sprinting at the adolescent level.” Analyzing this data helps determine the mechanical weaknesses or deficiencies that young sprinters have, which could lead to injuries. Athletes receive their data on report cards that include recommended exercises, or correctives, which sprinters can do to improve their specific areas of weakness. By participating in FAST clinics, young sprinters learn how to move correctly so that they can improve their speed and reduce their risk of injuries. 

On the inaugural day of FAST, Freeman brought middle and high school sprinters from TrackGirlz to participate in a variety of functional tests on the track and in the lab at Scottish Rite. A month prior, she completed the tests herself, providing Olympic-level counsel to help identify the appropriate sprinting metrics. “When watching the girls move, it was interesting to see how the data we measured correlated to what I observed with my eye,” Freeman says. “The data gives you confirmation on weaknesses that need to be addressed, removing the guesswork from their athletic development.” 

Beyond movement, researchers surveyed participants on their nutrition habits, sleep routines and training hours. “We can relate mechanical issues and movement deficiencies to these factors as well, which provides a more holistic message,” Ulman says. 

Once a large dataset is collected, the team aims to answer questions that will determine prevalence. “For example, 98% of sprinters have this mechanical deficiency or have a weakness in power that leads to this injury,” Ulman says. “These overarching data points are extremely helpful and will allow us to better target our interventions for these young athletes.” 

Freeman punctuates the importance of TrackGirlz’ collaboration with Scottish Rite. “Through the expertise of the Movement Science team, we are giving these girls world-class information, education and motivation to perform their best.”

Read the full issue.

Making a Game Plan for a Safe Season – Tips for Parents and Coaches

Making a Game Plan for a Safe Season – Tips for Parents and Coaches

by | Jun 18, 2024 | Sports Medicine

The to-do lists for coaches and sports administrators preparing for sports seasons are long. It’s time to meet new players, evaluate the condition and skills of each player, inform the parents of rules and schedules and get the playbook finalized. What may get overlooked is the emergency plan and training. Pediatric sports medicine physician Shane M. Miller, M.D., who has a background as a firefighter and EMT, offers some safety tips for parents and coaches. “Many organizations have the best of intentions to keep athletes safe, says Dr. Miller. “Preparation and practice can make all the difference in emergencies.”

Miller is passionate about helping athletic trainers and others in sports. He conducts training for several school districts including Frisco ISD and Irving ISD. From handling heat illness to spine injuries, athletic trainers are an invaluable resource on the sidelines. Young athletes may be in settings where athletic trainers are not available, so it’s important for parents and coaches to be aware of safety protocols.

Tips for Parents

  • Take the preseason sports physical process seriously. With an accurate and thorough history and exam, the family doctor can identify conditions that may need special attention before and during the season.
  • Get to know the athletic trainer, if available. From emergency care during sporting events to rehabilitation after injury, these health care professionals are knowledgeable about sport-related injuries.
  • Ensure your team/organization has an emergency action plan. These include protocols for lightning safety, preventing heat related illness and communication plans for all emergency situations.
  • Ensure your child’s equipment fits correctly and is worn properly. Poorly fitting equipment misses the mark for protecting the child in the way it is designed. In some cases, this can even cause an injury.
  • Learn signs and symptoms of problems that put young athletes at risk. No one knows your child better than you do. Learn the signs and symptoms of a concussion, heat illness and overuse injuries. Taking the right steps when you recognize these can make all the difference for your athlete.
  • Check the condition of the field and access to emergency personnel. When arriving at practice or a competition, assess the conditions. Is the field in good condition? Is there an automatic external defibrillator (AED) present and accessible? Is there an ambulance or athletic trainer on-site, or will 911 be used for emergencies?

 
Tips for Coaches

  • Review safety guidelines provided by the league and other reputable national sports organizations. These are designed to keep all participants safe.
  • Know your athletes’ major medical conditions and injuries. Because each athlete is unique, it has become more important to recognize individual needs. For example: An athlete with exercise-induced asthma may require use of an inhaler. For someone with an overuse injury, ignoring activity restrictions can shorten his or her season rather than improve performance.
  • Plan rest and water breaks for all activities, these should be modified when the environment is hot. Learn the signs and symptoms of heat illness and heat exhaustion.
  • Review and practice critical decisions and emergency procedures. Establish a plan for making and communicating decisions about weather conditions from heat and humidity to lightning. Identify what resources are available for first aid at each event and how to respond in various emergencies. In many organizations, this is documented in a comprehensive Emergency Action Plan (EAP).

 
“Teamwork is as important in the game as it is in when it comes to emergencies,” says Miller. “When the game plan is clear, situations can be avoided or handled with the best possible outcomes. Take time to prepare for the upcoming season.”

Understanding Hip Impingement in Teens: How it Happens and How to Prevent It

Understanding Hip Impingement in Teens: How it Happens and How to Prevent It

by | Jun 17, 2024 | Sports Medicine

Also commonly referred to as hip impingement, femoroacetabular impingement is a painful condition that occurs in the hips of adolescents and young adults. Two bones fit together to make up this “ball and socket” joint including the head of the femur (ball), which is part of the thigh bone, and the acetabulum (socket), which is part of the pelvis.

Impingement, or pinching, causes pain when the bones in the hip joint pinch the labrum, the soft tissue on the perimeter/edges of the acetabulum.
There are three types of FAI:

  • Cam impingement occurs when the shape of the femoral head or ball is abnormal.
  • Pincer impingement occurs when the shape of the acetabulum or socket is abnormal.
  • Combined impingement occurs when both the ball and the socket are abnormal.

Pediatric orthopedic surgeon Henry B. Ellis, M.D., says, “Repetitive activities make changes in the joints. In the hip, either the soft tissues become damaged, the bone actually changes its shape or both of these occur.” The reason for abnormal bone shape is not known. It may occur during development or may be in response to activity.

Symptoms of hip impingement are more likely to occur in those who perform:

  • Repetitive maximal flexion (bending) of the hip, such as deep squatting or high kicking.
  • Repetitive movements in activities, such as running, dance, gymnastics and hockey.

What are the symptoms of femoroacetabular impingement?

  • Pain in the hip or groin, typically in the front.
  • Tenderness and/or swelling of the hip or groin area.
  • Stiffness or pain after sitting for long periods of time.
  • Aching or pain that worsens with certain activities.

How is it diagnosed?
A thorough history and physical examination are used to diagnose a hip impingement. In most cases, X-rays are used to further assess the shape and fit of the bones. If symptoms do not improve or worsen, additional imaging such as an MRI or MR arthrogram may be recommended to further evaluate the soft tissue, the acetabular labrum. An MR arthrogram uses MRI, fluoroscopy and sometimes an injected medication to show the structures inside the joint.
 
How is it treated?
Treatment depends upon the severity of the condition and typically begins with a nonoperative approach which typically includes resting from activities that cause pain or changing to activities that do not. Other treatment options include physical therapy, joint injections or arthroscopic surgery may be required.
 
In a recently published article “Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient”*, Ellis and others reported findings after reviewing 126 hips (114 patients) under the age of 18 who were being treated for symptomatic FAI. This work helps Ellis and his colleagues around the country provide better counseling to patients considering surgery for FAI.
 
Early recognition and treatment are important because hip impingement has been shown to be a risk factor for early development of osteoarthritis of the hip.
 
How can hip impingement be prevented?
Overuse injuries like hip impingement and FAI occur with a high volume of training, repetition of certain movements and early specialization in a sport.
 
“Hip impingement in a growing child is bad news. We need to help them monitor and modify their volume of repetitive activities to prevent the condition from worsening, or even better, developing.”

  • Henry B. Ellis

These suggestions can help to prevent FAI and other similar overuse conditions:

  • Avoid sports specialization and play multiple sports throughout high school.
  • Emphasize moderation with load and training.
  • Encourage free play and lifetime sports like cycling and hiking.
  • Avoid year-round participation and encourage weekly and seasonal rest from activities requiring repetitive maximal flexion of the hip.
  • Perform proper warm-up and conditioning for all activities.                                                           

Learn more from Ellis about Hip Injuries in Young Athletes.
 
*Yen, Y. M., Kim, Y. J., Ellis, H. B., Sink, E. L., Millis, M. B., Zaltz, I., Sankar, W. N., Clohisy, J. C., Nepple, J. J., & ANCHOR Group (2024). Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient. Journal of pediatric orthopedics, 44(3), 141–146.

Nutrition for Injury Recovery in Young Athletes

Nutrition for Injury Recovery in Young Athletes

by | Mar 19, 2024 | Sports Medicine

Nearly 60 million American children play sports, and many of them experience sports injuries. If your child gets injured, the path to healing starts in the kitchen. Proper nutrition for injury recovery may help your child spend less time on the sidelines. The key is knowing which foods to choose. 

Foods to Avoid After an Injury  

Sports injuries force athletic kids to do one of their least favorite activities: sit around. As they watch their teammates run back and forth, children may forget about habits that keep them on their game. Instead of healthy eating, they may want to fill up on unhealthy snacks and sweets. 

Don’t let your children fall into this trap. Encourage them to eat the same foods they rely on when playing sports to ensure the best nutrition for injury recovery. 

After a sports injury, your child should avoid the following: 

  • Inflammatory foods. White bread and pastries are refined carbohydrates, which have much of their nutritional value stripped away. They are also associated with inflammation, which slows the healing process. Similarly, saturated fats found in butter, full-fat dairy, fried foods, and red and processed meats can raise inflammation but don’t offer additional nutrition value.  

  • Sports drinks. Full of electrolytes, sports drinks help your child rehydrate when they sweat excessively during activity. While your child is resting and recovering from injury, however, sports drinks are just another sugary drink. Like refined carbs and fried foods, sugar is associated with inflammation. 

Proper Nutrition for Injury Recovery 

To help your injured athlete maintain muscle mass, feed them healthy, nutrient-dense foods, including: 

  • Complex carbohydrates. Along with providing energy for your body to heal, complex carbs are full of vitamins and minerals. Good sources of complex carbs include lentils, brown rice, quinoa, and whole wheat breads and pastas. Rotate these different options into evening dinners to add variation to your family meals.  

  • Fruits and vegetables. The vitamins and minerals found in fresh produce have many benefits. They heal wounds, aid in tissue growth and repair, and more. Fill your child’s plate with a variety of fruits and vegetables. Find various ways to prepare and present produce to keep things interesting. Dust vegetables with exotic spices like turmeric or crumble berries over Greek yogurt for a creamy afternoon treat.  

  • Healthy fats. Eating healthy fats gives your child an energy boost. Additionally, healthy fats can have anti-inflammatory properties. Add healthy fats to your child’s diet by offering flax or chia seeds, avocado, or fish. Make these options intriguing by mixing avocado into a spicy guacamole or blending chia seeds into a fruit smoothie. When cooking other foods, use olive or sunflower oil for even more healthy fat.  

  • Lean sources of protein. Protein intake protects against muscle loss. Foods rich in protein include lean meats, fish, low-fat dairy products, and nuts and seeds. Think turkey sandwiches, peanut butter toast and grilled chicken over colorful vegetables. The amount of protein your child needs varies, so talk with their provider to determine the right amounts during injury recovery.  

  • Water. Complete nutrition for injury recovery requires hydration to help joints heal. Encourage your child to drink lots of water. To add bright flavor to your child’s beverage, consider spritzing it with slices of lemon or other types of citrus fruit.  

Let your child help you as you prepare their meals and snacks. You may even consider using your child’s time off from athletics to plant a garden filled with fruits and vegetables they can enjoy throughout the year. Building healthy dishes together helps your athlete stay connected to their wellness as they recover. It is also a great opportunity to set and achieve goals as a family.    

A Word on Concussion Nutrition 

When young athletes experience a sport-related concussion, they also seem to benefit from proper nutrition for injury recovery. Research has shown that certain nutrients may benefit children after a concussion. They include:  

  • Protein 

  • Magnesium 

  • Omega-3 fatty acids 

  • Vitamin D 

Additional research is needed on the effects of nutrition on concussion recovery. These nutrients can be found in many healthy foods but talk with your child’s provider before giving your child any supplements after a concussion.  

Is your young athlete sidelined with a sports-related injury? Our expert team at Scottish Rite for Children is ready to get them back in the game. Call 469-515-7100 to learn about our sports rehabilitation services.