Keep Youth Athletes in the Game
As the dog days of summer wind down, sports teams - on and off school campuses - are already geared up and well into training for sports such as football, soccer and cross-country. Recent events have made parents keenly aware of the risks involved in team sports and highlighted the need for education and awareness to prevent needless sport-related injury - or even death - many of which are related to heat illness and concussion.
Last year, three North Carolina high school football players died within a matter of weeks after injuries or possible dehydration, prompting concerns about the health and safety of student athletes. The football players were Atlas Fraley, 17, of Chapel Hill High School; Juquan Waller, 17, of J.H. Rose High School in Greenville; and Matt Gfeller, 15, of Reynolds High School in Winston-Salem.
These tragic deaths led to a special meeting of the North Carolina High School Athletic Association, chaired by Kevin Guskiewicz, Ph.D, professor and Chair of the Department of Exercise and Sport Science at UNC-Chapel Hill.
According to Guskiewicz, the committee recommended all state high schools be required to hire a full-time certified athletic trainer and institute an emergency action plan that includes a baseline concussion assessment program for the following contact sports: soccer, wrestling, lacrosse and football. A request for a funded mandate went before the state legislature in March 2009.
Athletic trainers or first responders must be present for all high school football practices and games, according to current North Carolina Board of Education policy.
High school football has by far the most catastrophic injuries for males, and the highest participation rate, according to research by Frederick O. Mueller, Ph.D., director of the National Center for Catastrophic Sport Injury Research and a professor in the Department of Exercise and Sport Science at UNC-Chapel Hill. Cheerleading has the most catastrophic injuries for females, and the most overall.
In the Wake County school system, administrators advise athletic trainers and first responders to be present for all home events if possible, according to Bobby Guthrie, senior administrator for athletics/driver education and certified master athletic administrator in the Wake County Public School System.
Approximately 70 percent of male high school students and 53 percent of female high school students report participating on one or more sports teams in school and/or non-school settings, according to data gathered through a CDC survey on youth risk behavior.
While football has the highest injury rate, athletes in all sports can and should develop certain habits to ensure their safety.
Stay hydrated. Area trainers list proper hydration as one of the top two cardinal rules for any athlete who wants to stay healthy. Susan Trimble of Cary, whose son, Jake, played football at Green Hope High School, says the trainer there always stressed that athletes hydrate from the time they get up in the morning until they go to bed at night.
Young people need to be encouraged to hydrate since they usually will not drink enough on their own without reminders from coaches and parents.
Stretch it out. The second cardinal rule for athletes is to stretch. "One thing I can't stress enough is static stretching at the end of the workout," says Scott Emerson, co-owner of VERT (Velocity Enhanced Resistance Training) in Morrisville. "When a child has done their workout or practice, it's imperative that they stretch because it helps recuperate and restore muscles."
Don't push too hard. Another caution for athletes is to be careful not to train too often or too hard. It's not hard for kids to over-train, Emerson says. "One misconception parents have is that if their child isn't sore or doesn't throw up during a workout they aren't getting a workout," he says, but youth need time to regenerate both mind and body.
Use your head if you suspect concussion. An estimated 300,000 sports- and recreation-related head injuries of mild to moderate severity occur in the U.S. each year, and most can be classified as concussions, which are also called mild traumatic brain injuries (MTBI).
These injuries, which are caused by a jolt to the head, can occur in baseball, gymnastics, softball, basketball, ice hockey, volleyball, field hockey, lacrosse, wrestling, football and soccer.
Signs of concussion can go undetected because the injury does not always involve loss of consciousness. When a concussion is not detected and the player suffers another blow, second impact syndrome can result in serious brain damage or death.
The Centers for Disease Control and Prevention coaches' guide suggests athletes suffering a concussion return to play only after a medical evaluation and permission from an appropriate health care professional. It's better to miss one game than the whole season.
Pay attention to other injuries. Emerson says the following injuries are commonly seen at VERT:
* Pulled hamstrings.
* Shoulder and rotator cuff injury.
* Anterior cruciate ligament (ACL) injury to the knee.
* Iliotibial band (IB) injury to the knee and leg.
"The biggest thing I see is that these younger kids need to develop their hamstrings and do more posterior chain exercises," he says. Posterior chain exercises strengthen the group of muscles that runs from the lower back down behind your legs.
Jeff Hill, a trainer at Life Time Fitness in Cary, says one of the worst things people do is try to come back from an injury too quickly. "When children come back too soon, they will always be 70 percent," he says. "It's hard to do, but it's better to be out one season than a whole career."
Finally, Hill stresses that parents need to learn about their children's sports. Take the time to become familiar with their sports gear and how to use it correctly. Protective gear such as cups and football helmets must be worn properly to be effective, he stresses. He says parents will take children anywhere they need to go, but then fail to understand the use or importance of safety equipment, such as a chest guard to protect baseball players from fatal blows to the chest.
Be sure children have a complete physical before engaging in team sports, and consider a child's emotional maturity to decide whether he or she can meet the social demands and physical discipline of a team sport.
Carol McGarrahan is a Triangle-area health writer and mother who has nursed a few stress fractures and knee problems in her own youth athlete.
Follow the H-E-A-T to Stay Cool
Heat indexes in North Carolina can be brutal. During an August 2007 heat wave, daily temperatures in Raleigh ranged from 96 degrees to 104 degrees in a one-week period, and heat index readings were in the 118- to 125-degree range across most of the state.
Use the "HEAT" acronym below from the National Weather Service hub in Raleigh to help keep athletes safe during hot weather.
H - Hydrate. Whether you feel thirsty or not, drink plenty of water to avoid dehydration, especially when you're working or exercising outside.
E - Educate yourself. Keep up with the latest temperature and heat index forecasts. To determine your city's current heat index, go to www.erh.noaa.gov/rah/heat. Know the warning signs of a heat illness, and how you can stay cool.
A - Act quickly when a heat illness is suspected. Seek medical attention immediately for any of these warning signs: cramping, rapid pulse, heavy sweating, hot red skin, dizziness, confusion, nausea and vomiting. Get the victim to a health care facility immediately.
T - Take it easy. Anyone working or exercising outdoors should avoid overexertion, especially between 11 a.m. and 6 p.m. Take hourly breaks in the shade or in air conditioning.
Know the signs of concussion
All concussions are serious. Recognizing and properly managing concussions when they first occur can help prevent further injury, or even death.
Signs of concussion:
* Balance problems or dizziness
* Double or fuzzy vision
* Sensitivity to light or noise
* Feeling sluggish, foggy or groggy
* Concentration or memory problems
Source: Concussion in High School Sports Guide for Coaches, from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention
Don't rely on thirst as a sign of how much and when to drink. By the time an athlete feels thirsty, fluid loss is substantial enough to impair performance. Youth often sweat and lose body fluid faster than their thirst mechanism can kick in.
Fluid Guidelines for Young Athletes:
* Drink 2 to 3 cups at least one hour before a sports event.
* Drink 1 to 2 cups 10 to 15 minutes prior to an activity.
* Drink 4 to 8 ounces every 15 to 20 minutes during physical activity.
* Drink 2 cups of fluid for every pound lost during activity or until urine is the color of pale lemonade after exercise.
Source: Carol S. Mitchell, N.C. Cooperative Extension, Wake County Center