Sports are great, but your child can have too much of a good thing. Your child can learn a lot of valuable skills and life lessons on the court or field, but at some point, the physical and mental rigor of sports can be too much, leading to mental and physical fatigue and injury. In this episode of DocSmo.com, Dr Smolen reviews the AAP guidelines for limiting competitive sports and gives you some common sense guidelines of his own.
Thanks for joining me today. This is Dr. Paul Smolen, your pedcast host. Sports season is here and unfortunately that means a lot of injuries for children. They are out there swimming, they’re jumping, they are climbing and running. They’re very very active so I thought today we would provide you with some information to help you navigate your child from the Little League to the Big leagues of life hopefully injury free. Hold on your iPad. Here comes another important pedcast. As always by listening to the speakers you are agreed to my terms and conditions one of those conditions is that the speakers are not intended to be specific health advice or any particular child but rather general learning information for the parents.
The Overuse injury in children
Now pediatricians are frequently presented with children who have an assortment aches and pain‘s and like most problems in medicine, the answer to those aches and pains usually lies in the history, that is the questions that pediatricians ask. I’ve learned after 37 years of practice that asking good questions and carefully listening to the answers will usually lead me to the why of most aches and pains. Your child is growing up in the era of sports camps, personal trainers, and almost constant competition. Many are trained like professional athletes. So today we’re going to talk about the so-called overuse injuries that are so common in school in school aged children and adolescents. I often see young children who play on multiple teams competing daily with year-round competition in whatever pursuit they have chosen. Now, what are their parents thinking about? That kind of intensity would be hard for anyone to maintain especially a child! So let’s explore a little today when it comes to children and athletic injuries.
What Kind of Injuries do Children Sustain?
OK so let’s get into the specifics of the patterns of injury that we see in children. I’m a simple kind of guy and I like to keep things very simple so I always try to find some simplicity whenever possible. In my world there are two types of musculoskeletal injuries; those that happen from when I called the big crash, “I fell off my bike and I know exactly the moment I hurt my arm”. Alternatively, those where no one can even remember when the injury happened. I call these the stealth injury type that probably came from lots of little injuries that were not memorable at the time but one day, Charlie‘s arm started to hurt. It’s that simple. Big crash or stealth injury. That’s what I’m listening for when people are telling me the story of their aches and pains. Now during this talk, we’re going to exclude the big crash kind of injuries and we’re only going to talk about the stealth injuries. The second type of injury; the little hurts that add up over time to something big. Now the child usually tells me what is causing the pain by telling me what their other activities are; soccer daily with travel on a travel team (ding, ding, ding), competition swimming with two practices a day (ding, ding, ding), or I sometimes hear tennis almost daily with coaching followed by tournaments each week or month (ding, ding, ding) or long-distance running adding up to about 40 miles a week (ding, ding, ding,). So, you’re getting the idea that this is not exactly rocket science. Just listen! The location of the pain and the activity that the child is participating in, tells you what is injured. Remember, these are overused injuries, they micro injuries, they are coming from repetitive small injuries. The pain is located where the injuries usually occur; either at the end of strong muscles where the muscle tendons attach to bone (that’s called the apophasis) or maybe the tendon is the weak link and there is pain there. We call that tendinitis. We have all had some experience with that. Or maybe the injury actually happens in them the belly of the muscle. Maybe there has been some tearing or maybe there’s overuse and cramping and fatigue. That’s another type of injury or maybe actually the injury was in the bone, specially the long bones. We call those injuries stress fractures or shins splints. Shins are the most common location for this type of overuse pain. And then very occasionally, we see people who have actual joint pain they have arthritis from overuse.
Some Doc Smo Pearls
Well if you’re a long time DocSmo aficionado, you know I love to come up with what call, DocSmo pearls- little bits of wisdom that make it easy to remember things. So this episode it was rather easy to come up with the DocSmo pearls that I think might be helpful for you. Here’s the first one: “Like all machines, your child’s body has limits and is prone to periodic mechanical failures. All machines do this even our own bodies, particularly little bodies that are not fully grown” and here’s another DocSmo pearl: “Pain in muscles and joints is your child’s body telling you, the parents, that they need repair time.”
Guidelines for Childhood Sports
So as you plan your child’s summer, keep in mind some common sense guidelines for the American Academy of Pediatrics when it comes to sports and you’re young athletes.
First: At least 1 to 2 days off per week for children to who do competitive sports. They need downtime they need rest time. Second: The total amount of exercise time should be increased very gradually with your young athlete. Don’t push him or her child to increase their output to fast. This leads them toward injury, especially overuse injuries.
Third: Young athletes need to take 2 to 3 months off of a specific sport every year. They’re not professionals they need to vary their exercise and vary their activities. They will just burn out if they just keep going at one sport too long.
Fourth: Participate in only team per season. I see this one violated all the time as a kid may be playing on 2 or 3 soccer teams in the same season.
Fifth: Recognize when your child is having overuse injuries or burn out and provide them with some appropriate rest and recovery. This is where parents need to take the bull by the horns, even if the child doesn’t want to. I think this is important since your child to be a long-term durable athlete. If they really are talented and they really are going someplace with that sport, they are just not going to get there if they get injured too much or burn out.
Sixth: Most of all remember the purpose of sports. Your kids are supposed to have fun, they are supposed to learn new skills they are supposed to experience the enjoyment of being on a team and they are supposed to learn sportsmanship. Now I know it’s radical but I have a third DocSmo pearl for you. That’s three in one episode and this one is probably the most important: “If a parent gets more excited about the child’s for participation in a sport than the child does, something is wrong.”
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