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Category Archives: Sport

Water Polo

Water polo is an intense sport that requires athletes to tread water and swim for long periods. There is a version for younger athletes that allows them to stand in shallow water or hang onto the side of the pool, but this is illegal in competitive water polo.

Acute and overuse injuries are common in water polo. Acute injuries usually occur when guarding a player or wrestling for the ball. Overuse injuries are often the result of repeated swimming and throwing motions and treading water. 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 prevent water polo injuries. Also included is an overview of common injuries.

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 well-child checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Athletes with poor stamina are more likely to get hurt both in and out of the water. Also important are proper warm-up and cool-down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should be confident in their ability to swim in close spaces with others. If not, they should begin playing in the shallow end in case they need to stand. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Equipment. Safety gear should fit properly and be well maintained.
    • Polo caps with ear guards to reduce the risk of ear injury
    • Mouth guards
    • Swim goggles
    • Sunscreen protection (sunscreen, lip balm with sunblock) when swimming outdoors
  • Environment. Pool water should be checked by persons in charge of pool maintenance. Excess chemicals and chlorine may cause eye irritation and skin rashes. Hypothermia may occur when playing in cold water.
  • Rules. Water polo can be very rough. Much of the “contact” takes place underwater, where referees cannot see well. These fouls are often missed and can lead to injury. Parents and coaches should encourage good sportsmanship and fair play. For instance, athletes should never dunk an opponent under the water.
  • Emergency plan. Teams should develop and practice an emergency plan so that team members know their roles in emergency situations in or out of the water. 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

Eye injuries

Eye injuries commonly occur in sports that involve balls but can also result from a finger in the eye. Any injury that affects vision or is associated with swelling or blood inside the eye should be evaluated by an ophthalmologist. Water polo players should wear swim goggles during practice and competition. The AAP recommends that children involved in organized sports wear appropriate protective eyewear.

Head injuries

Concussions often occur when an athlete gets hit in the head by another athlete (usually from their elbow). 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.

Shoulder injuries

Shoulder injuries usually occur from repetitive throwing and swimming motions. This may be due to weak muscles in the back and trunk of the body. Usually rehabilitation exercises focused on good posture and muscles of the shoulder blade and core, icing, medication, and rest are all that is necessary for treatment.

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 (NSAIDs), and range of motion exercises are important for treatment.

Knee injuries

Patellar pain syndrome is a common overuse injury from prolonged kicking and treading water. It causes pain in the front of the knee, sometimes associated with a bump, and can be severe. It is treated with ice, stretching, NSAIDs, and relative rest.

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.

Swimming

Swimming is a sport in which there is a great diversity among participants. There are both recreational and competitive swimmers, ranging in age from preschool through college. Most swimming-related orthopedic injuries are related to overuse and are seen in competitive athletes. However, many injuries can be prevented. Use the following tips and guidelines to help keep your athlete safe.

Safety tips

The following are ways to help prevent swimming-related sport injuries:

  • Never swim alone. Make sure the area is supervised.
  • Don’t run on pool decks and wet areas. Abrasions and contusions (bruises) commonly occur from careless falls.
  • Don’t dive in shallow water. Avoid diving into shallow pools less than 3 feet deep. This will help prevent serious head and neck injuries.
  • Find out if the starting block is at the shallow end. Swimmers using starting blocks in the shallow end need to be instructed on proper technique.
  • Prepare for emergencies. Plan what you would do if a player is injured in or out of the water. Know how deep the pool is. Know where lifeguards and first aid stations are.
  • Wear the right gear.
    • Properly fitted goggles
    • Swim caps
    • Sandals in the pool area
    • Sunscreen as necessary

Use of physical therapy

Physical therapy often is useful to strengthen weak muscles and stabilize joints. It can also improve a swimmer’s endurance and ability to train. Physical therapy is necessary to treat all of the medical and orthopedic conditions listed below and should be prescribed by a doctor.

Medical conditions

The following is a chart of different treatments for common medical conditions affecting swimmers.

Condition What to do
Swimmer’s ear Use tight-fitting swim caps. If symptoms of ear pain and/or drainage develop, see a doctor. Swimmer’s ear is usually treated with cleaning, antibiotic drops, and 3 to 10 days out of the pool. Acetic acid drops may help prevent swimmer’s ear.
Pinkeye See a doctor. Symptoms may be caused by irritation from chlorine and other chemicals, but viral and/or bacterial eye infections are highly contagious. Treatment includes prescription antibiotic eyedrops and 3 to 7 days out of the pool.
Athlete’s foot and plantar warts Wear sandals on pool decks and locker room floors to help prevent foot infections. See your doctor if you have a cut on your foot.
Exercise-induced asthma Swimmers with asthma vary greatly in their symptoms. Some do better in the warm, humid environment while others do not. Some find heavily chlorinated pools make symptoms worse. If difficulty breathing, cough, chest pain/tightness, or wheezing is present during swimming, then see a doctor. Every swimmer with asthma should have a personal asthma action plan. Swimmers should always have rescue medicine, such as an albuterol inhaler, on hand in case sudden symptoms occur.
Overtraining (excessive fatigue) This is common in swimmers because of year-round swimming and training. Treatment includes medical and nutritional evaluation and rest from swimming during noncompetition seasons.

Orthopedic conditions

Overuse injuries in swimming are related to repetitive stress to the swimmer’s body. Symptoms of an overuse injury usually include pain or discomfort, muscle weakness, alterations in stroke style, and the inability to keep up intense levels of training. Multiple factors must be considered for proper treatment. Workload, defined as either yardage or pool time, may need to be decreased during a time of injury. An evaluation of stroke technique may identify weaknesses, bad habits, or muscle-tendon imbalances that require correction. Lastly, the genetic predisposition to be excessively loose jointed, flexible, or stiff may require special consideration or treatment.

Condition Description Treatment
Swimmer’s shoulder Is a compression or “impingement” of the rotator cuff tendons caused by repetitive overhead shoulder arcs. Overdevelopment of chest muscles and weak back muscles with progressive muscle fatigue can lead to this injury. Treatment is individualized and must address all contributing factors. Most treatment plans include some form of physical therapy to learn correct posture and exercises to strengthen shoulder blade muscles. Although common for swimmers to do, excessive stretching of the shoulder muscles is not recommended.
Low back pain Common in swimmers and caused by repetitive Rest, medicines, and physical therapy to
turns, rotations, and extended back positions. include core (abdominal, hips, and low back)
Common causes include muscle strains, joint strengthening exercises are the usual
irritation and, in rare cases, stress fractures. treatment.
Proper diagnosis by a doctor is essential to
ensure the appropriate treatment
recommendations are made. X-rays or other
testing may be needed.
Rest, medicines, and physical therapy to turns, rotations, and extended back positions. include core (abdominal, hips, and low back) strengthening exercises are the usual treatment.
Breaststroker’s knee A chronic sprain of the medial collateral ligament (MCL) on the inside of the knee related to the frog kick in breaststroke. Kneecap pain (patellofemoral pain) is also common due to other forms of kicking. Treatment is to rest from these types of kicks.
Foot and ankle injuries Occur from repetitive flutter and dolphin kicking. This places the toes and ankle in an extreme pointed position that strains the top of the foot and causes pain. Treatment is rest, ice, medicines, and strengthening exercises.

Wrestling

Wrestling is the oldest known sport, dating back to prehistoric times. Today it’s the fourth most common sport in which athletes from different schools compete against each other. There are more than 50 kinds of wrestling. The most common types include folkstyle, freestyle, Greco-Roman, sumo, and professional.

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 about how to prevent wrestling injuries. Also included is an overview of common injuries.

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 well-child checkups.
  • Fitness. Athletes should maintain a good fitness level during the season and off-season. Preseason training should allow time for general conditioning and sport-specific conditioning. Also important are proper warm-up and cool-down exercises.
  • Technique. Athletes should learn and practice safe techniques for performing the skills that are integral to their sport. Athletes should work with coaches and athletic trainers on achieving proper technique.
  • Equipment. Wrestlers should wear headgear with ear protectors. Mats should be cleaned daily with antibacterial cleaner.

Healthy weight loss

Excessive or improper weight loss can result in various health problems including delayed physical growth, eating disorders, depression, increased risk of infectious disease, and heat illness. Wrestlers may also have less strength, slower reaction time, and less endurance; school performance may be affected too. Extreme exercise or rapid weight loss can contribute to heat stroke, kidney failure, or death.

Junior high athletes are still growing, and most should not lose weight to participate in wrestling. High school and college wrestlers may wish to lose weight to participate at their minimal weight.

When losing weight, athletes should not lose more than 1.5% of their body weight each week. If they lose that amount, they will mostly lose fat. However, athletes that lose any more weight will also begin to lose muscle mass. Losing muscle will make the wrestler weaker.

A healthy diet is important during any period of weight loss. Athletes should eat a variety of foods from all food groups. The diet should also provide enough energy (calories) to support growth, daily physical activities, and sports activities. They should also drink enough fluids to stay hydrated.

Once the weight is lost and the desired weight is met, that weight should be maintained. Athletes that maintain their weight have a higher resting metabolic rate than those whose weight fluctuates regularly. As a result, they can eat more without gaining weight.

For more information about a healthy weight loss program contact the National Wrestling Coaches’ Association Internet Weight Classification Program (717/653-8009). Consulting a sports nutritionist also may be helpful.

Warning: The use of rubber suits, steam baths or saunas, prolonged fasting, fluid restriction, vomiting, drugs, laxatives, diuretics, diet pills, stimulants, ergogenic aids, and supplements for weight loss should be prohibited at all ages.

Skin conditions

The National Federation of State High School Associates 2006–2007 Rule Book states that “if the participant is suspected of having a communicable skin disease, the coach must provide written documentation from a doctor that the condition is not communicable and that the athlete’s participation would not be harmful to any opponent.” It does not list specific skin conditions. However, herpes gladiatorum, methicillin-resistant Staphylococcus aureus, and chickenpox all may cause severe disease, and infected wrestlers should be disqualified.

Common Injuries

Head/face injuries

Nosebleeds occur frequently in wrestling. The bleeding may be stopped by putting pressure on the nose, placing a plug in the nose, or using an pro-coagulant, a medicine that helps the blood clot, into the bleeding area of the nose.

Cuts or scrapes usually occur on the face and often require suturing or glue. Sutures should remain in longer for wrestlers than for non-wrestlers, because of repeated injuries in the same location.

Concussion. Wrestlers with a concussion should not wrestle any more that day. They can return to wrestling only after they are symptom-free and have seen a doctor.

Cauliflower ear is the result of recurrent friction to the ear. It is best prevented with the use of properly fitted headgear with ear protectors during practice and competition. Cauliflower ears should be treated early (within 24 hours) by draining the ear and using compression dressings. They tend to reoccur with further trauma to the ear. Most athletes who have wrestled for many years without proper headgear have them.

Shoulder injuries

Acromioclavicular (AC) separation or clavicle fracture occurs when the wrestler falls on or is thrown directly onto the shoulder on the mat. Treatment of both is rest to allow healing; usually 3 to 4 weeks for AC sprains and 2 to 3 months for clavicle fractures.

Anterior shoulder dislocation is the result of forced abduction and rotation (pulled up and away from the body) of the arm and should be relocated as quickly as possible by the athlete or an athletic trainer or doctor.

Elbow injuries

Elbow dislocation is caused by a fall on an outstretched arm and hand. It should be relocated by an experienced athletic trainer or doctor as soon as possible.

Olecranon bursitis (irritation of the fluid-filled sac that protects the bone) is caused by repeated trauma to the point of the elbow. Swelling of the point of the elbow is the main symptom. It should be treated with rest, ice, compression, and an elbow pad. If that does not work, it may need to be drained and/or injected with medicine.

Knee injuries

Prepatellar bursitis is the result of a fall on a bent knee or from repeated kneeling. The main symptom is significant swelling on the front of the knee. It can be treated with rest, ice, compression, and a knee pad. It may also need to be drained and/or injected with medicine to reduce the swelling.

Patella dislocation is when the kneecap comes out of place causing instant disability and swelling. Treatment is reduction (putting the kneecap back in place) followed by physical therapy to strengthen the thigh and hip. A patella stabilizing brace may also be needed.

Medial collateral ligament sprain is caused by a direct blow to the outside of the knee. Treatment is usually brace support and physical therapy.

Anterior cruciate ligament tears usually occur from a strong twisting or hyperextension of the knee. A pop is usually heard or felt, and significant swelling occurs within 24 hours. Referral to an orthopedic doctor is required.

Meniscal tears are the result of a twisting injury while weight bearing or squatting. Symptoms may include painful popping or locking, and swelling in the knee. These can be initially managed with rest, ice, compression, and elevation, but most will eventually require surgery.

Back pain

Muscle strains are common causes of back pain. The pain is usually located in the lower back, but if it radiates to the buttock or down the leg it should be evaluated immediately. Once the cause of the pain is identified, rest, bracing, and/or physical therapy may be needed.

Sports Physiology

Refining and perfecting motor skills, developing visual precision, and improving mental sharpness are just a few of the many achievements happening in the young, growing body that contribute significantly to your youngster’s enjoyable and successful reality sports experience. Think about shaking up a soft drink can and not opening the top—there is so much rapid change just waiting to happen in these kids. Sometimes they can sense that they are close to gaining a new skill and they just about burst trying.

Suddenly it happens, and they cheer not only with excitement, but relief. Hopefully you can see that each stage of development varies in the length of time it takes to gain accomplishment with a certain skill and also in the completeness of skills actually developed. Some youth will acquire a skill fairly quickly, while others take longer. Some youth will develop a certain skill very well, while others struggle. That’s why certain kids gravitate toward certain activities—the beauty of the variability of human beings.

Think back to your childhood for a moment. Did you excel at catching and hitting baseballs, or were you hand-eye challenged and avoided that type of activity altogether? Did you throw well, or did you hate dodgeball in PE class when you had to display your lack of ability in front of the whole class? Ah, now you remember. You may see that mirror image in your child, or you may be wondering how on earth he inherited abilities you do not have.

Even with this variability among children of skills for exercise and sports, it is important to allow each child to individually maximize each skill level in his own time before moving on to the next. Each child is unique and should not be pushed faster than the time required to refine a skill needed to acquire a future skill.  Remember not to become impatient and rob your young one of the chance to gain a particular skill that he has been working on so diligently. Sure, your child can occasionally be trying more advanced parts of a sport, but he should not be rushed to get there before the current skills are mastered.

When we were kids in school, next year’s classes were usually built on knowledge from the previous year. Taking calculus before algebra and geometry would not have made as much sense (although for a non–math wizard like me, I am not sure if calculus would have made sense at any time). It is the same with acquiring the different advancing levels of sports techniques, movements, strategies, and training. One step at a time. One throw at a time. One serve at a time. One jump at a time. One kick at a time.

Motor, visual, and mental skills, along with physical growth, only make up part of the overall picture. They are each contributing parts that all fit together. Have you ever searched for that missing piece that allows you to start to assemble the next large chunk of a complicated puzzle? Advancing maturation of the body and brain allow your child to benefit from advancing physical growth.

Sure, these physical changes of growth are obvious. No one is blind to the fact that when friends get your holiday picture this year, Johnny is 6 inches taller than last year’s picture (which is still on their refrigerator). They usually double-check to make sure you did not skip a year. Girls change shape and start looking at boys; boys start to shave, get more muscles, and look at girls.

These physical changes certainly have an effect on their abilities to perform against their opponents as they become stronger, faster, and more skilled. Just growing, however, is not the only answer in the game of sports Jeopardy. Another crucial factor that goes through a process of development is the more invisible chemical realm—physiology, in fancy medical terms.

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.

Martial Arts

More than 6 million children in the United States participate in martial arts. Martial arts are known to improve social skills, discipline, and respect in children. Children can also improve their abilities to concentrate and focus on activities, as well as bettering their motor skills and self-confidence. Martial arts can be fun and beneficial at any age.

While the martial arts are relatively safe, injuries can happen because there is physical contact between opponents. The following is information from the American Academy of Pediatrics (AAP) about how to prevent martial arts injuries. Also included is an overview of martial arts forms.

Injury prevention and safety tips

  • Instructors. Experienced instructors will teach at a level appropriate for your child’s age and maturity. Lessons should emphasize technique and self-control. Experienced instructors will carefully advance your child through more complex training. Lessons should also be fun. Visit a variety of instructors and ask about their experiences with young children and their teaching philosophy.
  • Technique. An instructor’s emphasis on technique and self-control is very important in limiting the risk for injury. Children should learn to punch and kick with their hands and feet in proper position and using the appropriate amount of force. Kicks and punches with the hand or foot in the wrong position can cause injuries to fingers and toes. Punches or kicks that are too hard can cause pain or bruises. Contact to the head should be discouraged.
    • Equipment. Safety gear should fit properly and be well maintained.
    • Headgear. When the rules allow, protective headgear should be worn for sparring or for activities with risk of falling, such as high jumps or flying kicks.
    • Body pads can help protect against scrapes and bruises and limit the pain from kicks and punches. Arm pads, shin pads, and chest protection for sparring.
    • Mouth guards.
  • Environment. Mats and floors should be safe to play on. Gaps between mats can cause sprained ankles. Wet or worn floors can cause slips and falls.

Common injuries

Scrapes and bruises

Scrapes and bruises are by far the most common injuries seen in the martial arts. They often result from falls onto mats, kicks and punches that are “off target,” or when proper padding is not worn. All scrapes and cuts should be washed with soap and water and bandaged before returning to activity. Bruises are best treated with ice applied for 20 to 30 minutes. They will slowly get better and fade over 2 to 3 days.

Sprains and strains

Sprains and strains become more common as children get older. Ankles, knees, and elbows are the joints most often sprained. Muscle strains usually happen in the front (quadriceps) or the back (hamstrings) of the thigh. Most knee and ankle sprains occur either by landing awkwardly after a jump or by improper contact with a partner. Elbow and wrist injuries happen with falling, punching, or blocking. Muscle strains can occur with trying to kick too high or punch too hard without using correct form or having properly warmed up.

Finger and toe injuries

Finger and toe injuries are often due to the large amount of kicking and punching of padded targets. They may also happen when sparring with a partner. These injuries are usually the result of poor kicking and punching technique. Contact with the target should never be initiated with the fingers or toes. Jammed fingers result from holding the hand in the wrong position (fingers spread) or if the toes are used to hit the target(instead of the heel or top of the foot).

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 are usually 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.

Head injuries

Concussions can occur in martial arts if children fall and strike their heads, or if they are kicked or punched in the head. 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. Once a concussion has occurred, it is important to make sure the helmet is 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.

Types of martial arts

The term martial arts can be used to describe any number of styles or disciplines of self-defense practices. There are many different styles practiced around the world, with the most popular forms being karate, tae kwon do, and judo.

  • Karate (KAH-rah-teh) means “empty hand,” as it
    is normally practiced without weapons.
    Karate is a traditional Japanese form. The hands and feet are trained and prepared for use in a weaponless form of self-defense.
  • Tae kwon do (tahy-kwon-doh) means “the way of foot and fist.” This is a traditional Korean martial art. It is also the most popular. This form highlights discipline, respect, and personal growth and focuses on the use of the feet for powerful kicks in self-defense.
  • Judo (joo-doh) means “gentle way” and is known for a variety of throwing techniques. It uses many methods to control an opponent while on the ground. In many ways it is more similar to wrestling than to the other martial arts.
  • Kung fu (kung-foo) most commonly translates to “hard work” and is one of the oldest forms of martial arts. The term may be used to describe all of the hundreds of Chinese martial arts. Kung fu is mainly a “stand-up” form of the martial arts, known for its powerful blocks. Wushu is the most popular and modern form of kung fu.
  • Aikido (eye-key-do) means “way of harmony.” This Japanese martial art is known as a throwing style. It teaches a nonaggressive approach to self-defense, focusing on joint locks, throws, and restraining techniques, rather than kicks and punches. While aikido may be learned at any age, it is especially popular among women and older adults. Aikido is not practiced as a competitive sport.
  • Jujitsu (joo-jit-soo) means “the art of softness” and emphasizes techniques that allow a smaller fighter to overcome a bigger, stronger opponent. First practiced in Japan, jujutsu is considered a ground fighting or grappling style of the martial arts. Many of the forms have been incorporated into other martial arts such as judo, karate, and aikido. The arm lock and submission techniques have been taught to police all over the world.

How to Get Fit

What can I do to get more fit?

Any type of regular, physical activity can improve your fitness and your health. The most important thing is that you keep moving!

Exercise should be a regular part of your day, like brushing your teeth, eating, and sleeping. It can be in gym class, joining a sports team, or working out on your own. Keep the following tips in mind:

  • Stay positive and have fun. A good mental attitude is important. Find an activity that you think is fun. You are more likely to keep with it if you choose something you like. A lot of people find it’s more fun to exercise with someone else, so see if you can find a friend or family member to be active with you.
  • Take it one step at a time. Small changes can add up to better fitness. For example, walk or ride your bike to school or to a friend’s house instead of getting a ride. Get on or off the bus several blocks away and walk the rest of the way. Use the stairs instead of taking the elevator or escalator.
  • Get your heart pumping. Whatever you choose, make sure it includes aerobic activity that makes you breathe harder and increases your heart rate. This is the best type of exercise because it increases your fitness level and makes your heart and lungs work better. It also burns off body fat. Examples of aerobic activities are basketball, running, or swimming.
  • Don’t forget to warm up with some easy exercises or mild stretching before you do any physical activity. This warms your muscles up and may help protect against injury. Stretching makes your muscles and joints more flexible too. It is also important to stretch out after you exercise to cool down your muscles.

Your goal should be to do some type of exercise every day. It is best to do some kind of aerobic activity without stopping for at least 20 to 30 minutes each time. Do the activity as often as possible, but don’t exercise to the point of pain.

A healthy lifestyle

In addition to exercise, making just a few other changes in your life can help keep you healthy, such as

  • Watch less TV or spend less time playing computer or video games. (Use this time to exercise instead!) Or exercise while watching TV (for example, sit on the floor and do sit-ups and stretches; use hand weights; or use a stationary bike, treadmill, or stair climber).
  • Eat 3 healthy meals a day, including at least 4 servings of fruits, 5 servings of vegetables, and 4 servings of dairy products.
  • Make sure you drink plenty of fluids before, during, and after any exercise (water is best but flavored sports drinks can be used if they do not contain a lot of sugar). This will help replace what you lose when you sweat.
  • Stop drinking or drink fewer regular soft drinks.
  • Eat less junk food and fast food. (They’re often full of fat, cholesterol, salt, and sugar.)
  • Get 9 to 10 hours of sleep every night.
  • Don’t smoke cigarettes, drink alcohol, or do drugs.