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Monthly Archives: January 2017

Skiing and Snowboarding

As winter sports are gaining in popularity, young children are hitting the slopes to learn skiing and snowboarding. However, not every young child may be prepared for the experience. Your child’s age, strength, and ability to cooperate are a few factors to consider. Qualified instructors can often help parents determine if they’re ready for these sports. Most resorts begin ski school at 4 years old. Although snowboards are made for children as young as 4 years, some resorts will not teach snowboarding to children younger than 7 years.

With the growing popularity of skiing and snowboarding comes a greater number of injuries. However, the risk of injury can be reduced.

The following is information from the American Academy of Pediatrics (AAP) about how to prevent skiing and snowboarding injuries. Also included is a list of common injuries.

Injury prevention and safety tips

  • Fitness. All athletes need to develop and maintain a good general fitness level. Being physically fit will make these sports more enjoyable and help avoid injury from fatigue. Specific exercises to build muscle, strength, and endurance will also help.
  • Technique. The key to successful skiing and snowboarding is control. To exercise control, one must learn proper skills, be aware of others on the slopes, and be able to adjust to changing snow conditions. It’s also important to learn how to fall safely. Qualified instructors can help children learn the proper skills to participate safely and avoid injury. Age-specific classes can enhance the child’s experience.
  • Skills. If a slope is too difficult for skiers or snowboarders, they should remove their equipment and side- step down the slope.
  • Supervision. Children need to have adult supervision, and teens or young adults need to have a buddy.
  • Equipment. Practicing with the proper gear inside the home and in the backyard can make the transition to the slopes easier. Safety gear should fit properly and be well maintained.
    • Skis and snowboards. The binding setting should be properly adjusted. Rental or sales professionals can help choose equipment that is the proper size and fit.
    • Helmets. Use only helmets that are specifically designed for skiing or snowboarding. They should be professionally fitted to the child.
    • Protective eyewear. Eye protection is important to reduce glare from the reflection off the snow. Goggles should fit with the helmet being used. They should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials (ASTM).
    • Wrist guards and knee pads. Snowboarders may also benefit from wrist guards and knee pads to prevent bruises and fractures.
    • Clothing. Winter clothing needs to be worn in layers with synthetic inner layers for wicking moisture and a waterproof outer layer, or shell.
    • Sun protection (sunscreen, lip balm with sunblock). Altitude and glare from snow make sun damage more likely.
  • Environment. Weather conditions can change rapidly. Bring extra clothing, and plan to quit early if conditions become hazardous.
  • Fatigue and nutrition. Skiing and snowboarding are hard work and require rest and adequate nourishment. Fatigue and dehydration can lead to poor control and injury.

Rules of the slope

The National Ski Areas Association endorses a responsibility code for skiers and snowboarders. Athletes should know the code or “rules of the slope” to help prevent accidents and injury. The code is prominently displayed at ski resorts. The 7 safety rules of the code are

  1. Always stay in control and be able to stop or avoid other people or objects.
  2. People ahead of you have the right of way. It is your responsibility to avoid them.
  3. You must not stop where you obstruct a trail or are not visible from above.
  4. Whenever starting downhill or merging into a trail, look uphill and yield to others.
  5. Always use devices to help prevent runaway equipment.
  6. Observe all posted signs and warnings. Keep off closed trails and out of closed areas.
  7. Prior to using any lift, you must have the knowledge and ability to load, ride, and unload safely.

Common injuries

Because skiing and snowboarding involve rapid speeds, serious injuries can occur. Although rare, life-threatening injuries are possible, sprains and broken bones are the most common types of injuries from these downhill winter sports. The upper parts of the body are more likely to get injured in snowboarding than in skiing because of how the legs are attached to the snowboard.

Upper extremity injuries

Falling on an outstretched hand or shoulder is common for a snowboarder. Acute, severe pain that limits the ability to continue skiing or riding may be a sign of a broken bone. Treatment should include rest, ice, compression, and elevation (RICE). If pain does not go away, or there is deformity or problems with circulation to the arm, see a doctor right away.

Lower extremity injuries

Accidents when using the lift or collisions with other skiers or objects can result in a sprain or a broken leg. Injuries can also happen if bindings do not release when a skier falls. This is why it is important that bindings be adjusted properly so that they release in case of a fall. Anyone with severe pain or who cannot stand should call the ski patrol for help.

Knee injuries

Twisting injuries to the knee can result from skiing out of control or falling off the lift. Serious injuries, such as a tear in the anterior cruciate ligament, usually require transport by the ski patrol to a medical facility. More minor sprains, like the medial collateral ligament, can be treated with RICE. Skiers or snowboarders with severe swelling, persistent pain, and difficulty walking and moving the knee should see a doctor as soon as possible.

Head injuries

Collisions at high speeds can cause serious head injuries. While helmets are helpful at preventing head injuries, they need to be the right size and properly fitted to be protective.

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 athlete is notknocked 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. Once a concussion has occurred, it is important to make sure the helmet is fitted properly.

Racquet Sports

Racquet sports (tennis, racquetball, squash, badminton, and paddle tennis) are sports of speed and agility and involve athletes of all ages. As in many sports, the risk of injury increases with age due to the style of play, contact forces, and size of athletes. However, the risk of injuries can be reduced.

The following is information from the American Academy of Pediatrics (AAP) about how to choose a racquet and prevent racquet sports injuries. Also included is an overview of common injuries and treatment.

How to choose a racquet

Racquet choice can affect an athlete’s performance. The appropriate head and handgrip size are important. Athletes may need to test out different string tensions before deciding what is right for them.

  • Racquet head size. The head size refers to the hitting
    area. The following are general racquet sizes based on age:

    • 21-inch—4 to 6 years of age
    • 23- to 25-inch—5 to 8 years of age
    • 25- to 26-inch—8 to 11 years of age
    • 27- to 29-inch (adult size)—11 years of age and older
  • Handgrip size. Handgrip size ranges from 3 to 5 inches (measured in eighths of an inch). There are many ways to assess proper grip size. One way is to measure the tip of the ring finger to the last palmar crease, or one “shakes hands with racquet.” And one finger breadth should fit between the thumb and second digit. The following are average handgrip sizes. If you measure between sizes, buy the racquet with the smaller grip and use an overgrip to increase grip size.
    • Smaller than 4 inches—juniors
    • 41/8 to 43/8 inches—women 18 years and older
    • 41/2 and 43/4 inches—men
  • String tension. Average string tension runs anywhere from 55 to 65 pounds. A good rule of thumb to remember: higher tension equals more power and less control; lower tension equals less power and more control.

Injury prevention and safety tips

  • Sports physical exam. Athletes should have a preparticipation physical evaluation (PPE) to make sure they are ready to safely begin the sport. The best time for a PPE is about 4 to 6 weeks before the beginning of the season. Athletes also should see their doctors for routine checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sportspecific conditioning. Also important are proper warmup and cool-down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Examples of poor technique include not fully extending the elbow on forehands or backhands, hitting the ball too late, and serving behind one’s head. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Training. A good rule of thumb is not to increase training by more than 10% per week. That means if an athlete is playing 10 hours per week, the following week could be 11 hours not 20 hours.
  • Exercises. Some young athletes are weak in their shoulder, trunk, or leg muscles. It is wise to do appropriate strengthening exercises for these muscle groups. Others are inflexible in the hamstrings, hips, or shoulders and need appropriate stretching exercises. A certified strength and conditioning coach or athletic trainer can demonstrate appropriate exercises.
  • Equipment. Safety gear includes
    • Protective eyewear. Glasses or goggles should be made with polycarbonate or a similar material. The material should conform to the standards of the American Society for Testing and Materials (ASTM).
    • Sun protection (ie, sunscreen, lip balm with sunblock)
      when outdoors
  • Environment. Athletes used to playing on a soft surface (clay or grass) should gradually change to a hard surface. For example, 10 hours per week on soft surface; 1 hour per week on hard surface. Also, extra balls on the playing surface should be cleared away so that no one steps on them.

Common injuries

Shoulder injuries

Shoulder injuries result from too many serves or overheads in a short period. The result is that the muscle fatigues and then doesn’t function properly. Treatment consists of strengthening the muscles that support the shoulder. Athletes are advised to avoid the serving or overheads until the activity is pain-free.

Elbow injuries

Tennis elbow (lateral epicondylitis) is not common in children and teens. However, irritation of the growth plates in the elbow can occur. This is often the result of a new service motion involving topspin. Treatment consists of rest from painful activities (hitting or throwing), ice, medicines, and stretches.

Wrist injuries

Wrist injuries often result from hitting too late, changing grip, or ground strokes. Athletes may have pain with use and loss of range of motion.

Treatment begins with rest, ice, compression, and elevation (RICE). Athletes should see a doctor if their wrists are swollen or painful the next day. X-rays may be needed.

Low back pain

Spondylolysis, stress fractures of the bones in the lower spine, are usually the result of too many serves (particularly topspin) or overheads in a short period. Symptoms include low back pain that feels worse with hyperextending the spine (doing back bends). Treatment of spondylolysis includes rest, physical therapy to improve flexibility and low back and core (trunk) strength, and possibly a back brace. 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.

Hip and groin injuries

Hip and groin injuries are common in tennis. They usually result from quick side to side changes of direction. They can be muscle injuries or avulsion fractures (when muscles or tendons pull away from the bone). If the athlete is limping or hears a pop, or there is immediate swelling, an x-ray should be done. Treatment consists of RICE along with hip strengthening and flexibility exercises.

Heat-related illness

Many tennis athletes suffer from muscle cramps. This may be due to fatigue and excessive sweating, which causes salt loss and dehydration. Athletes who are dizzy, confused, or complain of a headache are most likely suffering from heat exhaustion or heat stroke. These athletes must be taken to a shaded area, cooled, and evaluated by emergency medical services (call 911).

Heat-related illnesses can be prevented when athletes are given time to get used to exercising in the heat (usually takes 1 to 2 weeks). Drinking water or a sports drink before, during, and after training, and avoiding stimulants including caffeine, can also help.

Ankle sprains

Ankle sprains are some of the most common injuries in racquet sports. They can prevent athletes from being able to play. Ankle sprains often happen with quick side to side changes of direction, 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 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. Tape and an ankle brace can also support the ankle, enabling an athlete to return to activity more quickly. However, athletes should not return too quickly or more serious ankle injuries can occur.

Eye injuries

There are reported cases of retinal injury and blindness in the eye secondary to the ball striking the eye, especially in squash and racquetball. 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 all children involved in organized sports wear appropriate eye protection.

Mental Skills Needed for Sports

It’s not enough to understand the developmental milestones of growth and the maturation process of skills for sports activities. Nor is it enough to appreciate the chemical development that affects ability. Yes, all the physical changes, chemical changes, and developmental sequences must be considered and incorporated into the challenges of accomplishment and performance in the youth sports experience. Yet even all of those ingredients do not make up the whole enchilada. There is still more that is necessary to complete the menu – the rice, beans, and salsa.

The development of mental (psychological) skills is also incredibly important for these youngsters and completes the third part of the triangle of components that all mesh together to influence the athletic potential of your child. All 3 are of major significance and really cannot function maximally without the other 2 being in place.

Your child may be ready for intense competition from a standpoint of muscular control, technique, and skill level, but not from a mental or emotional standpoint. Your child may have successfully mastered how to integrate skills with maturing chemical processes of speed, strength, and endurance, but still be insecure or immature when it comes to advancing levels of performance.

If the child is subjected to competition and heavy training before psychological development is ready, the results can be disastrous. If parents, coaches, teachers, and instructors understand these principles and how they can connect the dots, we are definitely on our way to a positive sports experience for everyone involved.

Choosing Healthy Snacks for Kids

While meals make up the majority of a child’s nutritional intake, most children eat at least one snack per day. While many of the most commonly offered kids’ snacks tend to be of lower nutritional value than meals, snacks still can support—or even enhance—your child’s overall healthy eating plan. Here’s how:

  • Use snack times as a way to increase fruits and vegetable intake. Most kids do not eat the recommended amount of fruits and vegetables. Snack times offer a great opportunity to increase access and exposure to these nutrient-dense foods. Consider pairing them up with dairy products or dairy substitutes (such as grapes and cheese) lean proteins (such as celery and peanut butter), or whole-grain cereals and bread (such as banana sandwich on whole grain bread).
  • Keep a range of healthy foods handy at home. It is much easier to make easy, healthy snacks when you keep a few key items stocked at home. Ideas include different types of raw vegetables and fruit, yogurt dip, hummus, and cheese sticks.
  • Avoid processed foods and added sugars. Processed foods (made in a factory and sold in bags and boxes) do not have many nutrients and often have a lot of added sugar and salt. In addition, children may become hungry faster after eating processed foods. See Snacks & Sugary Foods in School: AAP Policy Explained for more information.
  • Teach your children to eat a rainbow of colors. Arrange your children’s foods to show the beauty of fresh, brightly colored foods. Talk about the farms where food comes from and the farmers who help grow it.