Protecting Young Athletes’ Hearts For a Stronger Game

Protecting Young Athletes’ Hearts For a Stronger Game

by | Feb 26, 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. We encourage anyone to seek CPR training and certification to be more knowledgeable and better prepared.

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.

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.

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. Read more about common hockey injuries here.

    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.

     

    Back on Beat: Alyson’s Determination to Heal Her Knees

    Back on Beat: Alyson’s Determination to Heal Her Knees

    by | Jan 16, 2025 | Sports Medicine

    Alyson, a 17-year-old of Dallas, TX, has a passion for the fine arts! She has performed in her school’s musical productions, such as “Chicago” and “Mean Girls,” and even sings in the choir. Her most beloved hobby is dancing, but Alyson’s love for dance was threatened at age 9 when she began to feel frequent pain at dance practice.

    Prior to visiting Scottish Rite for Children, Alyson was diagnosed with osteochondritis dissecans (OCD) in her knees. OCD causes the bone and cartilage at the joint surface to separate due to a lack of blood supply. It is common in young athletes, and may cause symptoms whensport requires running or jumping frequently. Alyson also has a condition called genu valgum, commonly known as knock-knees.

    “I found myself needing frequent breaks from dance class, often icing my knees afterwards,” Alyson says. “In choir, I was often told, ‘Aly, stand with your knees straight.’ I physically could not.”

    When Alyson’s paid did not improve, a pediatrician referred her to Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. Philip L. Wilson, M.D., assistant chief of staff, director of Sports Medicine and pediatric orthopedic surgeon, met Alyson and her family and recommended surgery as the best course of action to heal Alyson’s knees.   

    “My world came to a standstill,” Alyson says. “My afternoons that I previously spent laughing with my friends or learning techniques from my dance teachers were now spent crying and feeling sick to my stomach with the dread of potentially not dancing again.”

    Already familiar with Dr. Wilson from a fracture years before, Alyson decided to proceed with surgery. Dr. Wilson performed a double knee surgery, which involved placing plates and screws in both of her knees. The plates stabilized her knees and assisted in helping her knees grow straighter. The road to recovery required Alyson to stop dancing until she was fully healed.

    “All of the doctors and nurses were so helpful,” Alyson says. “My determination to return to my sport fueled me through months and the challenging journey of learning how to walk again.”

    Once the screws were removed, Alyson began working hard to heal her knees through physical therapy. What began as a painful setback has transformed into a triumphant comeback, and Alyson’s determination has led her to become her school’s drill team captain this year.

    “When the ability to not move freely was taken away from me, I realized how much dance shaped me — not just on the stage and field, but in all areas of my life,” Alyson says. “Scottish Rite will always be remembered as an amazing environment for me. Not only were all of my nurses and doctors encouraging, but I also truly felt open to share what I was feeling with them.”