Peds21 at the American Academy of Pediatrics: Youth Sports Medicine

imagesThis past weekend, I attended the American Academy of Pediatrics National Conference imageshere in San Diego. There were almost 10,000 pediatricians from all over the world, and they offered literally hundreds of  educational sessions reviewing the latest research and evidence-based medicine on many topics, including newborn medicine, pediatric neurology, pediatric emergency medicine, cardiology and many, many more. But this year, the Peds 21, or Pediatrics for the 21st century special symposium, designed “to address emerging issues that will affect the practice of pediatric care in the 21st century”, was dedicated to Youth Sports Medicine! The program was named “Peds 21: 1,2,3 Go!: Sports in the World of Pediatrics- Playing it Safe and Making it Fun! There were over 50 sessions dedicated to the subject; from the Pre-participation sports physicals and the ethics of kids and sports, to several talks dedicated to the identification and management of concussions, overuse injuries and protective sports equipment. It was an INCREDIBLE conference for me!

So I thought I would highlight some of the key points I took away from the conference, to help you keep your kids safe, injury free and having fun!

  • Heat Related Illnesses- Heatstroke
    • Case: young athlete, playing tennis outside in the heat for hours, becomes confused, combative, and with hallucinations
    • Heatstroke –defined as a “serious condition that happens when someone has been in high temperatures for a long time and that causes a person to stop sweating, have a very high body temperature, and become exhausted or unconscious” (Merriam-Webster Dictionary)
    • Key features: life-threatening, core temperature of >104F, mental status changes
    • Treatment: must take temperature RECTALLY, and cool FAST! ice bath, ice packs under arms, cold, wet blankets, call 911 but start cooling first!
  • Overuse Injuries
    • An overuse injury is defined as “damage to a bone, muscle, ligament, or tendon due to repetitive stress without allowing time for the body to heal”. Overuse injuries are on the rise in the US, mostly due to overtraining and sport specialization
    • How to avoid overuse injuries
      1. Do NOT specialize before puberty (play multiple sports, and try to avoid playing sports with the same types of overuse injuries)
      2. Play only on 1 team at a time (not school and league and club at the same time!)
      3. Take 1-2 days off/week from playing your sport
      4. Take 2-3 months off from any one sport. Think about it: paid professionals have an “off-season,” but kids are playing year-round! (including mine, yikes!)
  • Concussions
    • This one was a biggie at the conference! Lots of discussions regarding pre-participation physicals, return to play, return to learning, imaging, testing, etc.
    • Realize that a concussion is indeed a form of traumatic brain injury
    • Only 10% of children with concussion will have loss of consciousness
    • Protective equipment (helmets) will protect the skull form a skull fracture but do NOT protect the brain from a concussion.
    • Imaging studies (CT, MRI) are NORMAL in an athlete with a concussion.
    • Important to establish a plan with your physician and your child’s school for return to play as well as return to learn (the brain needs immediate rest from sport but also from TV, phone, iPad and school)
    • No return to school (or sports) until symptoms are completely gone or much improved
    • Return to learning is a process; OK to go to school but NO tests or homework at first, start with short days and have your child take breaks during the day. Reading and math will usually worsen symptoms
    • If your child does not improve significantly or is still having symptoms after 3-4 weeks, seek the help of a sports medicine/concussion specialist and consider migraines, depression or other conditions
    • More to come on this! (I’ll be writing a full blog on concussions soon)
  • Supplements in Sports Medicine
    • I was VERY interested in this one, for obvious reasons! Check out my Blogs, Performance Enhancing Drugs, Part 1, and Performance Enhancing Drugs, Part 2
    • The problem with supplements is that it is literally a “roulette,” you don’t know what you’re gonna get! There is NO regulation and even false claims are legal! (thanks to the 1994 Supplement Act)
    • Studies have shown that almost 100% of samples tested were contaminated with mercury, arsenic or lead (big name brands, yes, even Muscle Milk!)
    • Protein powders: young athletes eat more than adequate amounts of protein in their diets! Powders are expensive and NOT necessary. Even CREATINE can be easily consumed in food (16 ounces of chicken/day will do the trick!)
    • Maximum usable amount of protein= 1 gram/pound of body weight/day. More than this cannot be stored for later; the body spends a great deal of energy processing the excess, and can strain the liver and kidneys
    • BOTTOM LINE (and music to my ears!): The is no substitute for REAL FOOD! A well balanced diet and good hydration are the keys to success, and no pill or shake or bar will be able to replace a poor diet! 

Hope this helps! For more references, go to:

HealthyChildren.Org

cdc.gov/concussion

 

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