HEALTH AND NUTRITION FOR THE YOUNG ATHLETE Dr. Diane Dubinsky August 26, 2003

INTRODUCITON • Young athletes are not merely small adults.

• Their bones, muscles, and ligaments are still growing • They grow and develop at different rates • At age 9, the weight of a child can vary as much as 50 lbs.!

• Height and weight discrepancies make them more vulnerable to injury

It is the responsibility of the parents and coaches to ensure that each child’s body is respected for its stage of growth and that no child is pushed to the point of injury.

INJURIES IN THE YOUNG ALTHETE • Federal data indicate that there are approximately 227,000 injuries to children ages 7-17 each year due to soccer alone • 15% of these injuries are due to overuse

Assessing Pain in the Young Athlete • Children often experience some discomfort with athletic activity – usually expressed as minor aches and pains • Due to the risk of serious injury in the child, their complaints always deserve careful attention • Sometimes it is difficult to determine if a child has a “real” injury • PAIN is the body’s response to injury.

Assessing Pain • Each person feels pain differently • “Does it hurt a lot?” – What does this mean?

• Use the Rule of “1-10” to help assess pain in children • This requires advance preparation • Ask child to remember previous injuries and rate the minor pains as a “1” and the worst pain they have ever felt as a “10” • Use this scale when you are on the field or sideline.

Assessing Injury • Does the child “use” the affected area? (e.g. can they bear weight?) • If use or bearing weight increase the pain – DO NOT PLAY • Is it swollen? – R-I-C-E – Rest, Ice, Compression, Elevation – If so, DO NOT PLAY • Is there numbness, tingling, or shooting pain? If so, DO NOT PLAY

Assessing Injury –

Cont.

• Respect a child’s reaction to pain – If crying or scared – reassure and DO NOT PLAY • NEVER expect a child to “work through the pain” • Often injured athletes want to “tough it out” • Coaches and parents must be “tough” to protect young players. • Don’t be afraid to take a child out of the game!

Common Injuries • STRAIN – muscle injury caused by over stretching or over exertion of the muscle • Signs and Symptoms – pain with movement, accompanied with little or no swelling • Treatment – rest, ice if needed (acute) – heat (later) • SPRAIN – ligaments are stretched or torn, usually associated with joint injuries • Signs and Symptoms “pop” or “snap” is felt, inability to bear weight, loss of motion, swelling, discoloration • Treatment – R-I-C-E, medical evaluation, x-ray

When to See A Doctor • Inability to play following an acute or sudden injury • Decreased ability to play because of chronic or long-tern complications following an injury • Visible deformity of the athlete’s arms or legs • Sever pain from acute injuries which prevent the use of an arm or leg

Growth Plate Injuries • Growth plate is a soft area near the ends of the bones that allow the bones to grow • Physics 101 – a force will affect the weakest area first – therefore, in a child, the growth plate is more likely to be injured rather than the ligaments.

• An injury that normally would cause a sprain in an adult, is more likely to cause a growth plate injury in a child. • Sprains in children should be evaluated by a physician

OSGOOD-SCHLATTER • What is it? – The patellar (knee) tendon inserts into the tibial tuberosity (growth plate) just below the knee – Overuse (constant pulling) of the tendon on the soft growing bone causes inflammation, pain, and swelling – Ice massage before and after games helps – Anti-inflammatory medication at the direction of your physician may help – Let the athlete allow the pain to guide their activity

Head Injury • Loss of Consciousness – call 911 – even if child regains consciousness • Concussion – – Dizziness, headache, sensitivity to light – Nausea, vomiting, amnesia, memory loss NEVER ALLOW A CHILD WITH A HEAD INJURY BACK ONTO THE FIELD WITHOUT MEDICAL EVALUATION!

FLUIDS • Water, water, water • Don’t wait for thirst • Sports drinks – Contain high amounts of sodium and potassium – Only needed for endurance athletes - > 90 minutes of aerobic activity – Children like to imitate adult – if they’ll drink, its better than them not drinking • How much water?

– 3-8 ounces 20 minutes prior to game/practice – 3-8 ounces every 20 minutes during game/practice – 6-8 ounces after game/practice

NUTRITION • Teach young athletes about good nutrition • Foods high in carbohydrates provide athletes with the energy their muscles need – Healthy carbohydrates - whole grains, etc • Encourage 4 servings per day of calcium-rich foods like milk, cheese, yogurt • Encourage 4-5 servings per day of fruits and vegetables • SUPPLEMENTS ARE NOT NECESSARY!

HEALTHY CARBOHYDRATE SNACKS • Whole-grain ready-to-eat cereal with low-fat or skim milk • Low-fat fruit flavored yogurt • Peanut butter on whole wheat toast and ½ apple • Lean meat on pita bread with ½ cut orange juice • Graham or animal crackers and box of raisins • Low-fat frozen yogurt and 100% grape juice • Oatmeal raisin cookie and low fat milk • Low fat pudding, bagel, and 100% apple juice