As the summer is coming to a close, preparations commence for the new school year: back-to-school shopping, learning new schedules and classes and preparing for the fresh curriculum that lies ahead. But for high school and middle school athletes, the end of summer means two-a-days, preseason practices and finally unearthing the uniforms, pads and cleats that spent the last three months gathering dust.

To prevent heat stroke, athletes should be properly hydrated before practice and take frequent water breaks in the shade.
(Photo Daniel Friedman)

According to Dr. Matthew Silvis, of the Family and Community Medicine department at Penn State Hershey Medical Center, late summer is the most critical time of the year to take precautions against heat-related illnesses in adolescents.

“These kids have had the summer off, and may or may not have followed their coach’s recommendations for conditioning or may not be acclimated to the heat – so when they go to those first few practices it’s a total shock to their system, whether it’s the hottest part of the day or not,” he said.

In addition to reducing performance, heat can cause illnesses or health complications that can be potentially life-threatening to student-athletes, such as heat cramps, heat exhaustion or heat stroke. The least severe of these is a fatigue or cramping in large muscle groups, but students suffering from nausea, vomiting, abdominal discomfort, shortness of breath or chest pain, and overall weakness or fatigue are more likely experiencing heat exhaustion.

Heat exhaustion is treatable by improving cold air circulation or fanning the athlete, having them rest and drink water and applying ice packs. However, if a student with heat exhaustion goes untreated and they become delirious or reach a core temperature greater than 104 degrees, they’ve progressed to heat stroke and need to seek immediate medical attention.

“Once an athlete starts showing signs of heat stroke, it’s an emergency situation,” said Silvis. “Heat stroke is the leading cause of preventable sudden death in student-athletes. If left untreated, heat stroke leads to multisystem organ failure.”

Silvis says early treatment is critical for preventing damage related to heat stroke. “There’s never been a reported case of death from heat stroke if the athlete’s been treated within 30-60 minutes,” he said. “Even if you make the mistakes leading up to heat stroke, if you can identify and treat it quickly you can reverse it.”

Making sure students are properly hydrated before practice, allowing frequent water breaks in the shade or in air conditioning, avoiding midday practices, wearing appropriate clothing and observing the heat index on practice days are all ways to prevent heat illness.

Players should gradually be acclimated to wearing equipment. (Photo: Jill Knight/MCT)

Additionally, guidelines from the National Federation of High Schools (NFHS) recommend that coaching staff implement a gradual process to allow players to become acclimated to wearing equipment while exercising. Football players may start with just a helmet, then shoulder pads, then work up to full padding over the course of 10 to 14 days.

Ultimately, Silvis maintains that the most important factor in preventing heat illness is awareness.

“We have to educate our kids, coaches and parents about how to recognize the early warning signs and symptoms of heat illness,” he said. “It’s really important because even if everyone is doing the right things, staying hydrated and taking breaks, athletes can still find themselves in trouble.”

Article by Penn State Milton S. Hershey Medical Center

With the growing number of children participating in competitive sports, injuries to the anterior cruciate ligament, or ACL, of the knee are on the rise in young athletes.

According to athletic trainer and physical therapist John R. Wawrzyniak, Penn State Hershey Therapy Services, the best way to avoid this knee damage is proper training. Athletes who participate in flexibility and strength training and use proper form can reduce their chance of non-contact ACL injuries by as much as 50 percent.

Aliya Mustafina of Russia gets assistance after suffering from an injury at the vault. Girls are three to six times more likely to tear the ACL than boys.(Photo: Gero Breloer/AP)

“I tell every parent that I talk to, ‘I would rather be training your kids or talking to you about preventing these injuries than seeing you in the clinic two days after your ACL reconstruction,’” he said.

Wawrzyniak recommends training for children who are in middle school or older who are starting to play competitively.

“I think a big reason a lot of these kids get injured is because they’ve missed the fundamental movement patterns that we used to teach in physical education class,” he said.

Since many have not learned the proper way to jump and land or how to control their bodies, they are predisposed to injuries.

He reminds parents to consider certain factors when allowing their child to participate in any sport.

• Children should want to do the sport.
• Make sure they have the basic skills the sport requires.
• Don’t over train them. Children need off seasons and rest periods.
• Do not rush them to return after an injury.
• Prepare them. “You don’t want to throw them out there into a highly competitive environment without some kind of conditioning base,” he said.

 
Parents of girls should be especially diligent because girls are three to six times more likely to tear the ACL than boys. Girls are known to land a jump more with a stiff knee, predisposing them to abnormal knee motion with the potential for ACL tears.

In addition to potentially sparing them pain, training could help athletes avoid surgical reconstruction from an ACL tear followed by a six-to-12 month rehabilitation period. It can also help athletes prevent the possible long-term effects from injury, such as being unable to return to their previous level of competition or even ending their sports career.

ACL injury is associated with earlier progression of osteoarthritis. If left untreated, an ACL injury can lead to other structural knee damage. Additionally, it has been reported that the overall rate of a second ACL injury, either to the same or opposite knee, within two years of the original injury, is six times greater among those who undergo ACL reconstruction as compared with those with no history of ACL injury.

Article by Penn State Milton S. Hershey Medical Center