Category Archives: sports

Sports physicals – it’s time

Your kids are on the move – literally, and all the time! If they are involved in a fall sport at school, then it’s time for their sports physical. Don’t forget that there is tremendous benefit to getting these physicals at your child’s pediatric office, rather than at a clinic or a school-sponsored physical day. The pediatrician has all your records including vaccinations, allergies, and your individualized and family medical history. He or she can discuss important sports information with you, including nutrition. And, of course, follow-up is always readily available, whether one week or six months from now. We are delighted to be working, with you as our partner, to make a medical home for your family here with us. If your child has a physical at a clinic or the school, that physical is not a part of our records, and we end up with an incomplete picture of his or her development and needs. Read our previous blog post for more reasons on why it’s wise to bring your child to the pediatrician when it’s time for a physical.

Younger children—don’t just focus on one sport

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Summertime is just around the corner, and it’s time for kids to be outside enjoying themselves. Organized sports are often a part of that. Whether you have big dreams for your child’s sports future (college scholarship, pro career) or she has dreams for herself, it’s important not to push too hard too soon. Doing so can cause injury and, perhaps more importantly, can decrease the all-important fun factor.

Most children love to play with a ball even before they can walk. As their bodies mature, they’ll enjoy learning to swim, running short distances, playing physical games like tag in the backyard. Activities like these are great for children’s physical health and for helping them grow into well-rounded people. Staying active prevents obesity, gives a boost to the immune system, improves mental outlook, and fosters the development of social skills (learning to play fair, settling disputes, taking turns, sharing).

Parents should be cautious by not encouraging a child to play one sport to the exclusion of others. Focusing on one sport, whether it’s swimming, soccer, baseball, gymnastics or something else, can lead to specific injuries. Swimmers may develop shoulder problems; gymnasts can damage joints; runners might get shin splints. Keeping a variety of physical activities in a young child’s life enables the whole body to develop, get stronger and more flexible, and decrease the risk for injury.

Eventually your child may decide to specialize in one sport, but doing so too early goes against the recommendations of the American Academy of Pediatrics (AAP) Council on Sports Medicine and Fitness. There’s a great article on the subject here. It’s best for your child’s physical, mental and social development to generalize, try a lot of different sports and activities, and to simply have fun.

Batter up!

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Baseball is here for the summer, for kids of all ages. Grownups, too, for that matter. If you’ve ever had a pitcher in the family, you know that shoulder injuries are common, and if you’ve ever watched a slow motion video of a pitcher’s action, you can see why. It’s not an entirely natural motion, and done repetitively, it can cause injury. Pain and swelling may occur and sometimes even surgery is required if the damage is severe.

Little League Baseball has guidelines in place, designed to prevent injury. These rules govern both the number of pitches allowed per day, and the number of days rest required after pitching. You can read their entire list of pitching rules here.

Both the number of pitches and the number of rest days are regulated by age. Here is their list of pitching limits per day:

17-18 105 pitches per day

13-16 95 pitches per day

11-12 85 pitches per day

9-10 75 pitches per day

7-8 50 pitches per day

And the rest day requirements, again quoting from their website:

Pitchers league age 14 and under

• If a player pitches 66 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 51-65 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 36-50 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 21-35 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-20 pitches in a day, no calendar day of rest is required.

Pitchers league age 15-18

• If a player pitches 76 or more pitches in a day, four calendar days of rest must be observed.

• If a player pitches 61-75 pitches in a day, three calendar days of rest must be observed.

• If a player pitches 46-60 pitches in a day, two calendar days of rest must be observed.

• If a player pitches 31-45 pitches in a day, one calendar day of rest must be observed.

• If a player pitches 1-30 pitches in a day, no calendar day of rest is required.

A game official is required to keep the pitch counts for every pitcher in the game and to let the head umpire know when a pitcher has reached his/her limit.

For other notes on safety and required equipment for ALL baseball players at different positions, please read Little League’s equipment checklist here.

Fun and safety are the twins of any sport. Insuring your child’s safety and health increases the fun quotient!

Back to school ALREADY???

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It seems as though summer just started, and we’re already talking about going back to school. That’s because now is the right time to be thinking about getting your child’s medical exams and immunizations covered.

Exams and physicals. Most sports (both school and community) will require that your child or teen have an annual physical. You’ll see ads for retail clinics in stores and also physicals being held at the schools, but keep these things in mind:

Those places don’t have your child’s medical records. Medical and immunization histories aren’t available to the person doing the physical or administering the immunizations.
They haven’t developed a relationship with you to know what is normal and appropriate for your family.
Follow up is minimal or altogether unavailable.
No nutritional counseling is available, which we believe to be extremely important.

For all those reasons and more, we highly recommend that you see your own pediatrician for back-to-school exams and immunizations. (Check out our 2013 blog on store-based clinics here.)

Immunizations. Many immunizations are required by the state, and there are some additional ones recommended by the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC). For example, Kentucky requires the meningitis vaccine for the 6^th grade; we also are doing a booster at the age of 16 which isn’t state required but is recommended by both the CDC and AAP. A printable immunization schedule for parents is available here from the CDC.

Concerned about immunizations? Read the article, “Why Immunize?” at the CDC website. Also, find here a series of articles from the AAP about a variety of immunizations.

Plan to arrange your pediatric appointments soon, so your teens and children will have everything they need before school starts.

In between your summer travel plans, pool days and sporting events, don’t forget to make room for health.

Sunburned!

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As the summer gets going into full swing with Independence Day weekend, days by the pool and in the backyard, and lots of sports, sun exposure is always a concern.

How do you keep your kids healthy, happy and sunburn-free while still giving them lots of time outdoors? And when sunburn does occur, how should you treat it?

Prevention. Check out our blog from last summer about sunscreens here. Bottom line: use sunscreen liberally and limit sun exposure. You don’t have to get a sunburn to cause long-term skin damage.

Babies and toddlers. See this detailed article from the American Academy of Pediatrics (AAP). Very young children are especially vulnerable to sunburn and heat stroke. Under 6 months they should be kept out of direct sunlight and in the shade as much as possible. Use the sun cover on the stroller. Take a canopy to the older kids’ soccer games—it’s not only a good place to put the infant, but the rest of the family can get out of the sun, too. Be aware that reflective surfaces, like sand or the concrete around pools, can still allow for sunburn even when you’re under an umbrella or other cover, no matter what your age.

In addition to limiting time outside in the hot part of the day, here are other considerations for the very young:

Dress them in lightweight, light colored clothing that covers arms, legs and the head.
Use sunscreen on any exposed skin. There are several types that are appropriate for tender baby skin. Don’t ever spray directly onto the face, but into your hand first.
Put a brimmed hat on babies and toddlers, or spray their scalps with sunscreen. A fully-brimmed hat can protect scalp, ears, and partially protect face and neck.

Possible skin damage. Don’t forget that everyone, even those with darker skin, are at risk of skin damage from the sun. Exposure over time can lead to skin cancers later.

Treatment. Sooner or later, most everyone will have a sunburn no matter how hard you try to prevent it. What to do? It depends on the severity.

Minor burns (red, warm to the touch) can be treated with cool compresses, acetaminophen and rest.
More serious burns can cause blisters, fever and chills, headache or other feelings of malaise, even infection. If the burn is very serious, call your pediatrician.

So, by all means enjoy the summer sun, just be careful of getting too much exposure!

When testicle pain can be a surgical emergency

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Sudden, severe testicular pain should always be taken seriously. It can be a sign of testicular torsion, a dangerous condition that requires immediate surgery.

Testicular torsion occurs when the spermatic cord inside one testicle becomes twisted, which cuts off blood supply to the testicle. If surgery isn’t performed within 6 to 12 hours, then the testicle might have to be removed. There is even the danger of permanent infertility.

While testicular torsion can occur at any age, it is most common between the ages of 12 and 20. Rapid growth of the testicles during puberty can cause torsion, as can exercise or an injury. However, torsion can occur during inactivity, even while asleep.

If your son complains of extreme testicular pain, even if it goes away, report this to your pediatrician. According to the American Academy of Pediatrics (AAP), up to 50 percent of patients with testicular torsion have had scrotum pain before.

Other symptoms: the scrotum can become enlarged, red, and very painful; abdominal pain may accompany torsion, along with nausea and vomiting.

The AAP article also tells how the condition is diagnosed:

“Physical examination by a urologist;
Urinalysis, to detect presence of white blood cells;
A radionuclide scan or scrotal doppler ultrasound, to assess blood flow to the testicles;
Some urologists will take a patient with typical symptoms of torsion directly to the operating room.”

The bottom line: take testicular pain very seriously. It could be an emergency.

I’m thirsty!

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School is almost out and warmer weather is on its way. Hydration is always important, but never more so than when you’re active in warm temperatures. What are the best things to give your kids to drink, and are there drinks they should avoid?

First, drinks to avoid completely:

Energy drinks. Make sure you know the difference between sports drinks and energy drinks. Energy drinks contain stimulants like caffeine and are not appropriate for children and teens. According to the American Academy of Pediatrics: “Caffeine… has been linked to a number of harmful health effects in children, including effects on the developing neurologic and cardiovascular systems.” Caffeine is a drug, and is addictive.
Caffeinated soft drinks. (See bullet point above about the ill effects of caffeine on children and teens.)

Drinks that are okay for occasional use:

Sports drinks. These replace electrolytes and calories lost from prolonged exercise.
Non-caffeinated soft drinks. They are okay on special occasions, but only for older children. Sodas are acidic and therefore are harmful for teeth. Add sugar to that equation and you could be creating some real dental health problems.
Sugary drinks, carbonated or not. These have been linked to childhood obesity in children as young as 4. As with soft drinks, all sugary drinks can cause tooth decay.
Fruit juices. Better options than carbonated drinks, and often a good source of vitamins, they are still calorie rich and shouldn’t be overused.

Drinks that are best:

Water. Always the best way to hydrate, water can be a great part of the healthy child’s diet throughout the day, even when they’re not thirsty. Your kid doesn’t like water? Check out the flavor packets and squirts that add flavors to water.
Low fat milk. If your child or teen can tolerate milk, it is an indispensable source of calcium. If she is unable to drink milk, talk to the pediatrician about alternate sources of calcium.

Finally, a note about very young children.

Nothing but breast milk or formula should go in a baby’s bottle. Even fruit juice is too sugary and can lead to tooth decay. Read here about beverages for the very young.
Children can start learning to use a cup at about 6 months. Still, limit juice to 4-6 ounces per day until the age of 2.
Wean completely from bottles at about 12-15 months of age.

What we drink becomes habit, and starting good drinking habits in childhood is an excellent way to build healthy bodies and teeth for a lifetime.

Our own dietician on staff!

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Did you know that Georgetown Pediatrics has our very own dietician? Amy Crist has been with us for about 9 months and is available by appointment through our office.

Working part-time for us, Amy is a registered dietician (RD) with a master’s degree, has also worked at Georgetown Community hospital, and makes her home right here in Georgetown.

Amy loves working with infants, children, adolescents and their parents in developing healthy eating habits, including those who have dietary restrictions. She is a frequent speaker at local elementary schools to teach children about healthy eating and nutrition. She’s even led a support group on breast feeding. She is happy to have an appointment with you and your child or teen to discuss:

breast feeding,
dietary restrictions and planning as a result of disease or condition (diabetes, drug therapies, etc.),
concerns about weight or eating disorders,
helping the whole family develop healthy eating habits,
diet and sports,
picky eaters,
and anything else you want to talk over with a dietician.

Call our office and set up an appointment soon!

Amy Crist, our dietician