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Monthly Archives: November 2016


Football is a fast-paced, aggressive, contact team sport that is very popular among America’s youth. Football programs exist for players as young as 6 years all the way through high school, college, and professional.

Injuries are common because of the large number of athletes participating. However, the risk of injuries can be reduced. The following is information from the American Academy of Pediatrics (AAP) about how to prevent football injuries. Also included is an overview of common football injuries.

Injury prevention and safety tips

  • Supervision. Athletes should be supervised and have easy access to drinking water and have body weights measured before and after practice to gauge water loss.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Shoes. Football shoes should be appropriate for the surface (turf versus cleats). Laces should be tied securely.
    • Pants. Football pants should fit properly so that the knee pads cover the knee cap, hip pads cover the hip bones, the tailbone pad covers the tailbone, and thigh pads cover a good share of the thigh. Pads should not be removed from the pants.
    • Pads. Shoulder pads should be sized by chest measurement. They must be large enough to extend ¾ to 1 inch beyond the acromioclavicular joint. Athletes should have adequate range of motion, and the pads should not ride up into the neck opening when raising the arms.
    • Helmets. The helmet should be fitted so that the eyebrows are 1 to 1½ inches below the helmet’s front rim. The back of the helmet should cover the back of the head, and the athlete’s ear openings should be in the center of the helmet ear openings. Jaw pads should be snug against the athlete’s jaw. The chin strap should be centered over the chin and tightened to prevent movement of the helmet on the head. The helmet padding and chin strap should be tight enough to prevent any rotation of the helmet on the head. Face masks should be attached to the helmets. Additional protection can be provided by a clear Plexiglas shield.
    • Mouth guards can help prevent oral or facial injuries but not concussions.
  • Environment. A safe playing field is level and cleared of debris, equipment, and other obstacles. Field goal posts should be padded.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations. The plan would include first aid and emergency contact information. All members of the team should receive a written copy each season. Parents also should be familiar with the plan and review it with their children.

Common injuries

Ankle injuries

Ankle sprains are some of the most common injuries in football. They can prevent athletes from being able to play. Ankle sprains often happen when an athlete gets blocked or tackled with the foot firmly in place, causing the ankle to roll in (invert). An ankle sprain is more likely to happen if an athlete had a previous sprain, especially a recent one.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor as soon as possible if they cannot walk on the injured ankle or have severe pain. X-rays may be needed.

Regular icing (20 minutes) helps with pain and swelling. Weight bearing and exercises to regain range of motion, strength, and balance are key factors to getting back to sports. Tape and ankle braces can prevent or reduce the frequency of ankle sprains and enable an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is struck by the ball or an opponent’s hand or body. The “jammed finger” is often overlooked because of the myth that nothing needs to be done, even if it is broken. If fractures that involve a joint or tendon are not properly treated, permanent damage can occur.

Any injury that is associated with a dislocation, deformity, inability to straighten or bend the finger, or significant pain should be examined by a doctor. X-rays may be needed. Buddy tape may be all that is needed to return to sports; however, this cannot be assumed without an exam and x-ray. Swelling often persists for weeks to months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory drugs, and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting, pivoting, landing from a jump, or contact with another athlete. If the athlete feels a pop or shift in the knee, then it’s most likely a ligament injury.

Treatment begins with RICE. Athletes should see a doctor as soon as possible if they cannot walk on the injured knee. Athletes should also see a doctor if the knee is swollen, a pop is felt at the time of injury, or the knee feels loose or like it will give way.

Medial collateral ligament sprains can be treated in a hinged brace and allowed to return to play. Athletes who return to play with a torn anterior cruciate ligament (ACL) risk further joint damage. Athletes with an ACL tear should not return to their sport until the ligament has been reconstructed and they have been cleared by the surgeon.

Shoulder injuries

Shoulder injuries can occur from diving for a ball or from blocking or tackling.

Athletes usually feel their shoulder pop out of place when it is dislocated. Most of the time the shoulder goes back into the joint on its own; this is called a subluxation (partial dislocation). If the athlete requires help to get it back in, it is called adislocation. Risk of dislocation recurrence is high for youth participating in football. Shoulder strengthening exercises, stabilization braces and, in many cases, surgery may be recommended to prevent recurrence.

Pain from repetitive use is common in football, usually due to weak muscles of the back and trunk. Often rehabilitation exercises and rest from excessive blocking or tackling drills are all that is necessary to treat this type of pain.

Eye injuries

Eye injuries commonly occur in football usually due to a finger poking through the face mask. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, is due to overuse from high-impact and repetitive arching of the back. Symptoms include low back pain that feels worse with back extension activities. Treatment of spondylolysis includes rest and physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. Athletes are advised to limit repetitive arching of the spine (blocking and weight lifting) and high-impact activities (running and jumping). Athletes with low back pain for longer than 2 weeks should see a doctor. X-rays are usually normal so other tests are often needed to diagnose spondylolysis. Successful treatment requires early recognition of the problem and timely treatment.

Head injuries

Concussions occur if the head or neck hits the ground, equipment, or another athlete. A concussion is any injury to the brain that disrupts normal brain function on a temporary or permanent basis.

The signs and symptoms of a concussion range from subtle to obvious and usually happen right after the injury but may take hours to days to show up. Athletes who have had concussions may report feeling normal before their brain has fully recovered. With most concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a concussion can lead to another concussion or even death. An athlete with a history of concussion is more susceptible to another injury than an athlete with no history of concussion. If a concussion has occurred, it is again important to make sure the helmet was fitted properly. If the concussion occurred due to the player leading with the head to make a tackle, he should be strongly discouraged from continuing that practice.

hysical Activity and Your Child’s Safety

Do you live in a neighborhood where you aren’t comfortable having your child play outdoors unsupervised? These days, millions of parents feel this way. They’re convinced that it simply isn’t safe for their youngsters to be active outdoors, particularly on their own. And if parents are working during the day, it’s not surprising that they don’t want their youngsters spending time outside when they’re not home.

One of the best options for you to explore is whether there’s a formal after-school program in your neighborhood in which your child can participate that involves physical activity. For example, call the YMCA in your community, or the Boys & Girls Club. Enroll your child in a dance class to learn jazz or tap. Support your child in joining a youth bowling league. Be on the lookout for activities that are available in your community that include boys and girls.

Remember that participation is the key. Your child will be supervised while staying active, and you can pick him up on the way home from work. Keeping him busy after school is the key to making sure he stays away from the television set.

If your youngster is old enough to stay home by himself in the afternoons until you return from work, help him plan that time in advance. He doesn’t have to watch TV, play video games, or eat. In fact, there are many ways in which your child can stay active indoors.

Sit down with him and let him choose some after-school activities such as

  • Dancing to his favorite music on the CD player or tape deck
  • Jumping rope
  • Spending a few minutes with an exercise bike or treadmill (if you have either)
  • Doing some chores that you assign him—from cleaning up his room to emptying the dishwasher
  • Turning on a children’s exercise video and working out for 30 minutes

Many children are more likely to put an exercise video into the VCR or DVD player if siblings or parents can work out with them. They may simply find it more fun to participate in physical activity with someone else. So if your child has brothers or sisters, get them involved as much as possible.

What Does Your Child’s School Offer?

When you were in school, was physical education (PE)—or recess—your favorite “class”?

In many US schools, things have changed. Primarily because of budget cuts, PE programs have been sacrificed. Most states no longer mandate that their public schools offer PE. In some schools, PE classes are limited to once or twice a week, or they’ve been eliminated completely. Children are paying the price.

Physical activity is crucial to your child’s health and the management of his weight. If your youngster’s school district has reduced or eliminated PE programs, you need to let the district know that you want these classes back. Tell your child’s school principal. Write a letter to the members of the local school board. If you and other parents raise your voices, it might make a difference.

Aerobic Capacity and Training Ability

Aerobic capacity refers to a child’s ability to sustain a certain level of aerobic activity for a certain length of time. An aerobic activity is one that requires oxygen exchange in the blood to a greater degree than other activities, such as running versus strength training. Being able to sustain aerobic activity for longer periods of time depends on the body’s ability to transport oxygen to the tissues and muscles of the body and then use it efficiently once it gets there. In the scientific world, our aerobic capacity can be measured and is called VO2 max.

In a broken nutshell, VO2 max is the maximum level of the body’s ability to effectively take up oxygen, transport it, and use it for sustained exercise energy.

Normally, in adults, this ability to use oxygen can be improved with training and exercise. Improvements can be made with as little as 15 to 20 minutes of exercise 3 times a week. If you exercise more, your aerobic capacity can continue to improve to a certain point before it levels off. The interesting point about children is that even when recommendations for adult exercise are used, only small improvements (approximately 5%–10%) in aerobic capacity are seen until your child reaches puberty. Additional improvements can result simply from their ability to do the movements more easily, more efficiently, and with more motivation.

On the other hand, some youngsters do not show any improvement with the amount of training that often leads to predictable gains in adults. Don’t despair! Once your active youngster goes through puberty, aerobic capacity can blossom. So let me reemphasize—training kids as adults does not necessarily lead to adult results and can often lead to adult injuries. Training kids as kids within their bodies’ boundaries can lead to their best potential results. Another important concept is that your child may genetically have a better ability for aerobic activity, but she still has to have the motor development and motivation to use it for a positive effect on ability and the sports experience.

Acceptable levels of training will accomplish many good results and allow your child to progress nicely when the appropriate levels of development have been reached. I feel you tapping me on my shoulder.

Yes, there are kids whose development is so progressed that they can train as adults even when they are young, and I have seen many of them. Think about teenagers in the Olympics, for example. It was very exciting for me to be one of the Olympic doctors and see some teenagers produce stellar performances. I realized that they had been able to train at significant levels even at younger ages because their bodies had matured earlier and were ready to handle such training, and also because of genetic influences. The timing of puberty obviously has a profound effect on gaining aerobic improvement, among other things. Sports readiness such as this will be significantly different among youngsters of the same age. Some will be ready a lot earlier than others because they develop and reach puberty more quickly. In some cases, their motor development is already capable of responding to the early maturation of aerobic development, as was the case with those young Olympians. In other cases, youngsters go through puberty early, but still need their motor skills to catch up with their new and improved aerobic abilities. Each athlete is different.

Some improve at an early age; some improve much later. Some improve a lot; some barely improve at all. How far and in what direction these improvements occur still depend on the genetic makeup of your child and where along the genetic spectrum she lies—anywhere from pure strength and power sports, to medium strength and aerobic sports, to very aerobic sports and anywhere in between.

The general concepts still apply—until puberty, there is a limited ability to improve aerobic capacity just by training alone. Once puberty is reached, improvements in your child’s ability to use oxygen occur rapidly and progressive gains can be made. Although it appears that there is a certain unseen upper limit to improve aerobic capacity before puberty, this does not reduce or lessen the need to train aerobically.

This is a very important distinction. There is strong evidence that young athletes with a good foundational base of aerobic exercise can have even better improvements in aerobic ability once they reach puberty than those who start aerobic training at a later age. For example, a swimmer or runner who has already had some years of moderate training before her growth spurt has a better aerobic base from which to improve once puberty arrives. Kids who train in aerobic sports also better their performance because of improved technique and efficiency of movement, advancing skill level, maturing coordination, and growing motivation.

Understanding the place of aerobic development in the bigger picture is important in the younger years to take the focus away from competition, time or speed qualifications, and excessive training schedules. This understanding allows your child to focus instead on having fun, improving technique, learning different sports skills, and developing a strong base level of aerobic conditioning.

Hopefully this is clear. Read my lips—there is no need for elaborate, excessive, and exhaustive training programs for children and pre-pubertal athletes. This does not suit their needs or interests.

Parents, coaches, and kids who are not informed about this process may be the victims of discouragement when children do not get significantly faster as their level of training increases. Unfortunately, in those circumstances, increased training continues to be enforced with the thought that more is better and necessary to get the desired effect. When these training loads increase beyond a certain point, young bodies and minds start to break down. On the other hand, when training is kept at the right level and combined with positive reinforcement, support, emphasis on technique, opportunities for participation, new skill trials, and a focus on having fun, young bodies and minds can develop and accomplish their maximum potential ability more successfully.

What’s the “right” level of aerobic training, you ask? Every child will be different because of stage of development and chemical makeup. The important thing is to pay attention to your child’s development. If puberty has not started to show signs of its debut, maintaining moderate aerobic training loads is adequate. Your athlete can still improve by perfecting technique, consistent training, and maintaining good nutrition. When the chemical bonanza of puberty arrives, then ta-da! At that point, increased aerobic training will have much more potential to add to motor skills and enhance ability if there has been enough patience in you, your child, and the coach to avoid the temptation to over-increase training.

Finding Time to Be Active

See if this scenario sounds familiar—your child has come home from school with 2 hours of homework, including studying for a math test the following day. He also needs to start working on a science fair project. And don’t forget the clarinet lesson that’s on his calendar as well. There seems to be barely enough time to fit in dinner and a bath.

No wonder some kids feel that they just don’t have time for physical activity. Their schedules are filled to overflowing, and when they’re overbooked, it’s easy for physical activity to fall by the wayside.

As a parent, you need to intervene to make sure your child has time for all the things that are important. Whether he’s overweight, physical activity needs to be a priority.

Sit down with your child and structure his time after school so he can fit in everything that’s most essential. For example, in planning the following day, you might say something like, “You have a block of after-school time tomorrow.

Maybe the time immediately after school isn’t the best time for homework, because it will take up the daylight hours you could be outside playing.Why don’t you think about choosing to play outdoors for 30 minutes or an hour after you get home? Then we’ll go to your clarinet lesson, and once you’ve eaten dinner and it’s dark outside, you can do your homework.

The evening is the time when you used to watch TV anyway, so it’s a good time to get your homework done. And let’s think about rescheduling your clarinet lessons for the weekends.”