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"A Mom's Guide to
Sport's Medicine for Kids"

Here is the table of contents for review!

The Starting Line
Every parent, coach, and athlete will benefit by reading this section.

16.   Introduction
23.   Levels of Competition
24.   Return to Play Guidelines
26.   Psychology of Premier level sport
32.   Pain, why you are likely reading this book!
36.   The Sports Physical
38.   The Sprain/Strain
41.   Radiology- What you need to Know

The Race
Choose chapters that relate to your athlete’s situation.

A.          INJURY- ORTHOPEDIC CONDITIONS

47. Heel Conditions
55. Ankle Conditions
60. Braces and Taping
65. Shoe Wear
69. The Foot
73. Leg Conditions
79. Knee Conditions
     80. Patellafemoral Syndrome
     86. Patellar Tendon Disorders
90. Knee Joint Swelling and Trauma
97. Groin/Hamstring Conditions and Hernia
99. Hip Conditions and Structures around the Hip
107. The Back
     111. “Magic Potion” Theory
116.   Shoulder Conditions
     118. Rotator Cuff Pain and Impingement
     122. Throwing Sports
126.   Elbow
132.   Hand/Wrist Conditions

B.        MEDICAL CONDITIONS

137.   Headache- Acute, Chronic, Non traumatic and Traumatic
146. Concussion
146.   Asthma
153.   ADD, Attention Deficit Disorder/Hyperactivity Disorder
155.   The Heart
159.   Abdominal Pain
166.   The Skin- MRSA, Fungal, Warts
168.   Stress fracture and recurrent stress fractures
174.   Physical Therapy- A Key to Sports Medicine
178.   Is Lifting Weights Safe for a Growing Athlete?
181.   Growth, Development, and Puberty
185.   Nutrition in the Athlete- What to eat Before and After
Competition
187. Calories needed for Success
188. Vitamins, Supplements, and Importance of Calcium
189. Eating, A race car analogy
190. Water vs. Sports Drink
191. Creatine
192. The Female Athlete Triad

The Finish Line

196.     Final Thoughts and “Sports Medicine Rules”

Here is an example of a chapter for review:

“No Pain, No Gain?” The Psychology of getting to the top.

“No Pain, No Gain!” This quote has been used for generations. It is explained by many
pediatricians as parents and coaches pushing kids too hard and the cause for the
increased number of stress fractures, athletic caused injuries requiring surgery, and
potentially eating disorders, and mental health concerns such as anxiety and burn-out
in adolescence.

There is a heightened media awareness suggesting parental pushing of sport on their children, as well as
vicarious living through their children in non-sports activities such as glamour shows, national contests, and
educational goals and scholarships.
Coaches, sports groups, and yes, sports medicine doctors, have made a business out of these often Type-A,
intense, highly motivated, highly talented kids and their, at times, equally intense parents.
So what came first- the parent pushing their child into high-level sport or the child desiring the sport so much-
they eventually became “premier” because of the hours of practice and dedication. Regardless, athletes spending
time getting good at something have the risk of getting injured. Athletes in sports such as gymnastics, swimming,
and dance can practice thirty to forty hours per week. Adolescent long distance runners can log fifty to sixty miles
per week- running seven days a week and twelve months a year. Travel can involve weekend tournaments and
even international competition. It may start as a sport but may become a career.
Studies suggest that the more hours you spend in one sport, the more likely you will have an injury. The American
Academy of Pediatrics recommends a variety of activities rather than concentrating on one year round sport. This
cross-training approach with several sports allows for recovery, less burn-out, and variety. Yet the American
public enjoys seeing the Americans win at the Olympics (and gold-medalists likely didn’t have time to enjoy
several sports), the American public enjoy hearing their city announced as the home town of the popular NFL
quarterback (and with competition in high school today- the quarterback must be careful not to get injured in the
off season while doing another sport such as wrestling), and the American public enjoys the idea of their child
being the next prodigy of the sport their child loves, such as Tiger Woods did in golf.

A true life example:

It normally starts as a recreational activity. At six years old, a soccer team is put together with one of the fathers
coaching. It becomes the school team with a uniform and a once a week practice in second grade. At this point,
mob ball where the ball is hard to find amass the dozen kids tripping each other is played on a dusty field in the
city park. Several of the team members learn in the next year or two that other activities are more fun. They
change to swimming, arts and crafts, or video gaming! Several though eat, sleep, dream, and play soccer. These
kids are asked to be on a more competitive team and at nine years old, they get a new uniform, a new coach, and
two practices a week.
This select level of kids have really connected and not only do they play soccer, but they have sleep overs at
each others homes and the talk at the dinner table is always about soccer team-mates.
By ten years old, your child has decided that soccer is the only thing that matters. You are not even sure it is a
good idea. The premier team practices three times a week and tournaments are often two to three hours away.
You have even asked your child if they would like to try another sport. You have asked your spouse if the Hawaii
Classic is really in the budget. You have even questioned who started this soccer thing… was it you? Your
spouse? The neighbor kid? It all is a blur but your child makes it obvious- there is nothing more important than
soccer- not school, not even family- he has told you that the coach is as important as his parent, teacher, and
religious provider. There is no one more powerful in his life- and when you think about it… the coach has been a
good role model- so you see how the season goes.
With the amount of drugs, violence, and terrible things in society- your child is the lucky one to have a talent, a
good role model, good friends who are also not in trouble, and a potential future in college. Soccer is healthy-
better than video gaming- and has resulted in travel, friends, respect, and an incredible investment for your child.
      All of a sudden you find yourself explaining the time and commitment your child and your family have made to
the sport. It seems strange to the neighbor possibly, but when the coach calls and asks for an emergency practice
before leaving to Dallas- you don’t even think twice. You throw the phone down, yell up to the second floor to get
the soccer ball, and in the SUV you go- almost forgetting to open the garage door before backing up. Five
minutes from kitchen phone to garage door- one minute faster than the last time the coach called in this situation.
Even you are being trained for speed and agility! It’s all part of being on the team! (Quick thought- who is it that is
on the team?) The team depends on your child… it would be a disappointment if you were late- or heaven forbid
not there at all. It is a commitment you have taught your child- your family- and yourself.

It began as recreational soccer- but now with your child identifying themselves as “a soccer player for the Premier’
s” and when the neighborhood conversation becomes “are you applying to colleges for soccer scholarships or for
academic scholarships” and your answer is “both”. The game is still just a game--- but now a little more. There is
time, money, your child’s goals… and even your goals to think about. And overall, it is a lot of fun! Even the rules
make some sense now during the game, “HEY, that kid is off sides ref!”

       Then, out of nowhere, there is the injury, the burnout, the grief of possible failure that must be addressed.
Because every high level athlete is met with each at some point in their career. And for some athletes, it is a
career ending injury, a mental burn out that just doesn’t go away, or a missed opportunity that ends that
scholarship or elite level dream. Premier level sport is incredibly rewarding and under the safety of supportive
parents, there is an incredible life education as well as great fun, travel, friendship building, and respect for a
sport. And who is to say which young athlete will make it all the way to his or her dream… the Olympics, KU
Jayhawk Basketball, the New York Yankees Baseball Team? Some indeed will find different desires, different
goals, and different non-athlete dreams- probably as rewarding in the long run as their initial Olympic dream. But
an injury is a terrible way to end a chapter on a good season, or a good eight or more years in the sport.

An injury is an unpleasant and unplanned event- and one that is out of control for the athlete

something the athlete and parents aren’t probably used to. And so the correct information as well as the most
sports friendly information is what you and your child and your child’s coach desires.
Regardless of the neighbor or teacher who can’t understand why soccer is so important- you have lived an
experience that can not be completely understood by the “normal” public. And in a time of need, during an injury
to your child- a simple- “just stop the sport for two weeks” is as if the doctor was not listening, not caring, and not
understanding the last eight to ten years of your child’s life. By the way, the doctor was most likely listening- and
may even have given the correct diagnosis and treatment- but unplanned injuries result in unplanned visits to a
doctor and typically result in unwanted, albeit, possibly necessary recommendations!
_______________________________
As for the quote, “No pain, no gain”… I’ll let you decide for yourself.

There is also a psychology in the young athletes thought process during an injury or illness. Let’s, for example,
consider a sixteen year old elite level gymnast who has trained for eleven years and is currently on the national
team- awaiting the chance to prove her desire to be on the Olympic team in the upcoming year. A recent pain in
her ankle has been a bother during practice the last several days. Her coach is reluctant to make a big deal of it-
as it may not only result in missed practice but a change in her incredible current confidence and unbeatable
attitude. Finally, with a limp noticed during her run, the parents take her to the doctor. The x-ray shows nothing
but the MRI obtained later that day reveals a stress fracture in the ankle- the talus- the bone just below the tibia
leg bone. A discussion begins between the coach, parent, athlete, and doctor. To rest the ankle will result in a
return to pain free activity and a normal run- but missing next week’s championship meet. To compete in next
week’s meet without treatment could result in a worsened injury, poor scores, or a prolonged time of treatment
needed with more pain. While the decision is being discussed- the athlete may be thinking-
      “Twelve years of training coming down to this. I am not going to lose my dream because of a stress fracture.
      The money, travel, and time that have gone into everything- I’m not going to disappoint my family because of
this amount of pain- which I most likely can bear.
      The expectations I have accomplished and the struggles I have overcome over the last several seasons- I
can’t let this disappoint my coach.
      The dances I’ve missed, the parties I couldn’t go to, the friends at school that identify me as “the gymnast”- I
can’t have them see me less than perfect or lose this important designation.
      My teammates that are fighting for the same dreams, the ones looking up at me for being on the national
team, and the ones that have already been there that are cheering me on- I can’t disappoint them.”

      Within minutes, a struggle of the realization that the athlete is not as capable while injured but unable to say
“stop”. The coach does not want to miss the opportunity for an Olympic spot. The parents don’t want an injured
child- but can’t comprehend stopping for something she may have had for days- even weeks- a stress fracture.
Questions are asked such as- “what are the chances that this can get worse”, “will it cause permanent damage”,
“can it cause another injury”- all good questions that the doctor just can’t answer for sure. But it would be nice for
him to understand where everyone is coming from--- and where the athlete is trying to get to.
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