Summer is the time to assess student athletes' health

July 28, 2014
Student athlete

School may be out for summer, but for kids who participate in prep sports, there's often little break from workouts, tournaments and practices. However, summer is a good time to take stock of a student athlete's health status — both physically and psychologically, says Christopher Kroner, MD, MPH, a UC Irvine Health family medicine and sports medicine physician.

"There is a rapidly increasing understanding in sports medicine that youth athletes are particularly subject to overuse injuries and burnout," he says. "There is a lot more information now on how to prevent these problems."

Before your child starts a new school year, schedule a pre-participation physical exam, Kroner advises. This exam can include discussions about a number of important issues, including:

  • Assessment of the athlete's physical maturity and readiness for contact or collision sports
  • How a student trying a sport for the first time can ease into the activity without risking injury
  • Management of chronic health conditions, such as asthma, during sports participation
  • Guidance on treatment of nagging injuries and/or referrals to specialists
  • Discussion of the student's enjoyment of the sport and motivation to continue playing

"Before any season begins, participants must have a realistic appreciation of their level of skill and physical maturity, especially in contact and collision sports like football, basketball and soccer," Kroner explains. "Pushing too hard to advance to the next level, say from minors to majors in Little League baseball, robs the child of developing fundamental skills and may take them out of a comfort zone with their peers."

A psychological assessment should not be overlooked, he adds. In general, participation in sports is great for kids, helping them stay fit, learn proper physical conditioning techniques and healthy nutrition. Sports participation helps build friendships and lifelong values related to discipline, teamwork and responsibility. However, some kids — and their parents — become so consumed by a sport it can stop being fun or lead to injury.

"It's now apparent that around 50 percent of all injuries treated in youth athletes nationwide are overuse injuries, like stress fractures, shin splints, growth plate inflammation, tendinitis and chronic ligament tearing," Kroner says. "There are several risk factors for overuse injuries, such as poor mechanics and improperly fitting footwear or other equipment. But the clearest risks have to do with parents and other environmental factors outside the athlete."

Every child athlete needs four weeks per year away from organized competition and practice — either four continuous weeks or two different two-week blocks — to rest and rejuvenate, Kroner explains. "You see a significant reduction in overuse injuries and burnout if you do this."

Kroner devotes a significant part of his practice to sports medicine. Moreover, UC Irvine Health is able to expedite referrals to specialists if needed, including physical therapists.

"The benefit of having an evaluation with a board-certified, primary care sports medicine physician is we've been trained in the care of children and adults with acute injuries as well as chronic injuries," he says. "We understand when surgery is needed or not needed. We're also trained in caring for athletes who have chronic injuries or illnesses that need special consideration. It's a balanced and comprehensive evaluation."

Sports injury FAQ

By Dr. Christopher Kroner, UC Irvine Health family medicine and sports medicine physician

Is it ever OK to play hurt?

"Many injuries are OK to play with, though some require additional support such as casts, splints or braces. If a team or school has a certified athletic trainer (ATC), they should be the first to evaluate the injury. Emergencies include head injuries with prolonged loss of consciousness or deteriorating condition. Severe neck or back injuries limiting movement should also be evaluated before returning to the field. Facial traumas with significant disfigurement and bleeding and ear traumas that have immediate swelling should also be evaluated immediately. Any wound that causes bleeding that cannot be stopped with simple pressure and chest injuries causing wheezing or shortness of breath should be evaluated immediately. Concussions should be evaluated in clinic before the athlete returns to play. Any significant low back, hip or leg injury that limits normal walking as well as any neck, shoulder or arm injury that limits its normal use should be seen in clinic, though this is usually not an emergency."

Which injuries can be treated at home and which ones require a doctor's care?

"One of the most common injuries is the ankle sprain. If the athlete can walk immediately, then it should be rested and iced. Ibuprofen or naproxen can be used for pain relief. A few days of rest while walking on it as tolerated then slowly ramping up to normal play should be OK. Severe ankle sprains include those in which the player cannot put weight on it. These should be seen in clinic within a week."

How can summer heat-related injuries be prevented?

"Any time the outside temperature is above 85 degrees, practices should be limited in intensity or moved indoors to an air-conditioned facility, if possible. Extra water breaks should be given to all players and even coaches. When the temperature is above 90 degrees, practices should be delayed into the evenings or moved indoors. The high school sports with the highest risk for heat illness are football in pre-season training (especially in athletes who are in pads and who did not participate in off-season workouts who may not be well-conditioned), as well as cross country. One of the most important ways heat illness can be prevented is  to hydrate adequately — drink plenty of fluids before workouts and games."

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