Study Notes

Children and Young Athletes

It is important that all athletes, parents, coaches, and support staff are aware of any conditions that children or young athletes suffer from. There needs to be a greater focus on debilitating medical conditions such as asthma, epilepsy and diabetes, which are increasing in number.

– Medical Conditions

ASTHMA

Asthma can affect an athlete if not managed properly. However, it is not an excuse to avoid doing any exercise at all.

Asthma is characterised by a person having difficulty breathing, wheezing, coughing or shortness in breath. Exercise can induce an asthma attack (exercise induced asthma).

During this event, the airways leading to the lungs become dilated during the exercise but constrict once the activity has finished causing a tightening in the chest and therefore leading to an asthma attack.

Many people suggest that exercise is actually a benefit to asthmatics rather than doing no exercise at all. Swimming is seen as the most beneficial sport as there is less impact on the nerve endings within the passageways, which cause the constriction of the airways.

Measures to control asthma:

– Always use a gradual warm up and cool down when exercising

– The use of the preventer medication (ventolin) is required before exercise

– Gradual increase in intensity of the activity is also recommended so you can monitor the athlete as best as possible.

– Avoid any potential triggers such as colds/flu, environmental factors (pollen)

– Stay hydrated

Management of the condition:

– Encourage and talk to the person to relax

– 4 puffs of reliever (use spacer if available)

– Wait for 4 minutes – if the person isn’t breathing normally, in a controlled manner, provide another four puffs of the reliever. If this doesn’t work, call an ambulance and repeat the initial treatment.

DIABETES

There are two types of diabetes that can affect children and young athletes.

Type 1 – this type of diabetes is a result of the body’s lack of ability to create insulin. This is known as an insulin dependant diabetes. The hormone insulin is created in the pancreas and is needed to help glucose move through to the body cells to enable energy production.

Type 2 – is more common and is a lack of ability to create enough insulin for the body or the body’s lack of ability to use it efficiently.

Two main reactions that can occur for young athletes and children who suffer from diabetes include:

Hypoglycaemia (low blood sugar) is a condition, which means that there is a lack of insulin for the cells in the body to produce energy. If blood glucose levels fall below normal, athletes need to consume sugary foods (lollies, soft drink) to help raise the levels quickly. Someone who suffers from this will be seen to be shaking, dizzy, confused, has a raid pulse. Monitor this athlete and call 000 if the condition doesn’t improve.

Hyperglycaemia (high blood sugar) is a condition where too much insulin is created. Eventually, the insulin levels increase and pass through urine however, the athlete will show signs of thirst from being dehydrated and be constantly urinating.

Diet is important to monitor for a diabetic athlete.

The athlete must balance their insulin levels by way of food intake, injection and exercise to maintain a high level of performance in any activity

Exercise increases the amount and rate of sugar utilised by the body meaning that a young athlete must monitor their insulin levels to maintain their blood sugar levels.

EPILEPSY

It is a neurological disease that is marked by seizures.

Seizures are episodes where there are disturbed messages from the brain to the body.

Petit Mal (which looks like a short loss of consciousness or someone looking off into the distance).

Grand Mal (which presents a violent, uncontrolled shaking).

The first step in management is to protect the person suffering the seizure from any potential harm to themselves.

If an athlete is suffering a grand mal seizure, do not restrain, allow the seizure to finish, just ensure the athlete is a safe as possible.

Children or young athletes need to make coaches, trainers and other parents aware of their condition and to make sure that the people around them know how to respond to an attack.

It is important that the athletes works with their doctor to understand the type of activities that they can participate in, in terms of risk and what activities should be avoided (such as water and contact sports).

– Overuse Injuries (stress fractures)

Overuse injuries occur as a result of repeated use to any area of the body causing stress to the tissue and resulting in discomfort.

These type of injuries develop over a longer period of time because in effect, smaller injuries have had little time to recover and heal properly.

This type of injury is commonly found in children due to the different rates of growth between the bone and muscles within a young person’s body.

These injuries occur in young athletes and children as a result of a growth spurt, extra long training sessions for elite athletes (training load and intensity), poor technique or using equipment which may be the wrong size and or weight for that athlete.

These types of injuries are becoming more frequent due to the demand that is being placed on young athletes who are excelling in their sport at an elite level as well as playing multiple sports year-round.

An example is: Osgood-Schlatter Syndrome which is a growing pain that affects teenagers and often presents as knee pain. If you become aware that your child or young athlete may have a suspected overuse injury, it is important to get them checked out by a medical professional and seek treatment.

Adequate treatment can include:

– Initially use RICER

– Up to 8 weeks of rest

– Icing the injury to reduce inflammation

– Continuing to exercise using low impact activities such as swimming or cycling

– Learning correct technique to improve the body’s mechanics.

– Thermoregulation

The body tries to regulate the heat loss with heat gain in a process called thermoregulation.

Children are at a greater risk of hypothermia (cold) and hyperthermia (hot) due to the lack of ability to maintain their body temperature.

Children rely more on radiation and convection to cool them down which is not as effective as sweat evaporation.

Children are also known to have slower rates of acclimatisation, which means that dehydration can likely occur due to the shorter tolerance they have in extreme heat or cold conditions.

It is important that appropriate clothing is worn, there needs to be sufficient hydration and shade available on hot days and avoiding any intense activities when the air temperature is over 34 degrees.

– Appropriateness of Resistance Training

When designing a resistance training program or children or a young athlete, a sports trainer should check and evaluate every child’s prior experience, goals and their mental capacity before a program is created and attempted.

Resistance training can have a benefit to young athletes however, young athletes need to be fully supervised at all times by qualified instructors

Heavy lifting should be avoided until the athlete has finished growing.

Perfect technique first as damage to growth plates can occur. Focus should be on technique for non developed young athletes.

Not all athletes are the same. Some young athletes mature at quicker rates and can engage in more advanced resistance training programs.

Full Written Notes

Critical question 2: How does sports medicine address the demands of specific athletes?
Children and Young Athletes

Young athletes and young children have particular needs and require additional attention when performing in any sport or physical activity. It is also important that all athletes, parents, coaches, and support staff are aware of any conditions that children or young athletes suffer from.

Specifically, there needs to be greater focus on managing debilitating medical conditions such as asthma, epilepsy and diabetes, which are increasing in number.

Medical Conditions

Asthma
Asthma is characterised by difficulty breathing, wheezing, coughing or shortness in breath and can negatively affect an athlete if not managed properly.

Exercise can sometimes induce an asthma attack. Attacks are triggered by the way airways leading to the lungs become dilated during the exercise but constrict once the activity has finished, causing tightness in the chest area and breathing difficulties.

However, asthma should not be used as an excuse to avoid doing any exercise at all; many elite athletes are asthmatic. Regular exercise may actually be beneficial to asthmatics as it improves their endurance and lung capacity. Swimming is particularly effective as there is less impact on the nerve endings, which can cause the constriction of the airways.

Measures to control asthma include:

– Performing a gradual warm up and cool down when exercising

– The use of the Ventolin medication before exercise

– Gradually increasing exercise intensity

– Avoiding potential triggers, such as colds, and environmental factors, like pollen

– Staying hydrated

To help athletes manage their condition or deal with an attack it can help to:

– Talk to them and encourage them to relax

– Ensure they have 4 puffs of reliever (use spacer if available)

– Wait for 4 minutes; if the person isn’t breathing in a normal controlled manner after that, provide another four puffs of the reliever. If this doesn’t work, call an ambulance and repeat the initial treatment.

Diabetes
There are two types of diabetes which can affect children and young athletes.

Type 1: Type 1 diabetes, also known as an insulin dependent diabetes, and develops when the body is unable to produce insulin. Insulin is a hormone, which facilitates the movement of glucose through the body, enabling energy production.

Type 2: Type 2 diabetes is the more common variety and occurs when the body cannot create sufficient amounts of insulin or cannot use it efficiently.

Young athletes and children who have been diagnosed with diabetes may also suffer from the following conditions:

Hypoglycaemia, or low blood sugar, is a condition, which is triggered low insulin and energy levels. If blood glucose levels fall below normal athletes need to consume sugary foods, like lollies and soft drinks, to help quickly return levels to normal. Symptoms of hypoglycaemia include shaking, dizziness, confusion and a rapid pulse. When an episode occurs, athletes should be carefully monitored as it will be necessary to call emergency if their condition doesn’t improve.

Hyperglycaemia, or high blood sugar, is triggered when too much insulin is created. As insulin levels increase they pass through the urine. As a result, the athlete will likely show signs of thirst due to the dehydration and constant urination.

It is extremely important to manage and monitor the diet of a diabetic athlete. Athletes with this condition must use a mixture of food, injections and exercise to balance their insulin levels and ensure they are able to perform athletically. Exercise increases the amount and rate of sugar utilised by the body meaning that a young athlete must carefully monitor their insulin levels to ensure they maintain their blood sugar levels.

Exercise is beneficial for young people who suffer from diabetes. However, the condition must be monitored closely and controlled through changes to activity intensity so that any associated risks are minimised. Working with a doctor to create a management plan can be an effective strategy.

Epilepsy

Epilepsy is a neurological disease, which triggers seizures, or episodes, where disturbed messages are sent from the brain to the body. They are classified as either petit mal, which presents like a short loss of consciousness or disconnection, or grand mal, which are characterised by violent, uncontrolled shaking.

Being epileptic should not discourage a young person from exercise or becoming involved in sport. The first step in epilepsy management involves protecting people suffering seizures from any potential harm to themselves. If an athlete is suffering a grand mal seizure, they should not be restrained. Instead it important to ensure the area is as safe as possible and allow the seizure to finish.

Children or young athletes with epilepsy need to ensure that their coaches, trainers and other parents are aware of their condition and know how to respond to an episode. It is important that the athletes work with their doctors to assess the type of activities that they can participate in and the risks involved. Certain sports, such as water and contact sports, may not suitable or safe for patients who suffer from regular seizures or episodes.

Overuse Injuries (stress fractures)

Overuse injuries occur when repeated movements cause stress to soft tissue, resulting in discomfort and damage. These stress fractures develop over a period of time and are the result of smaller injuries, which have had insufficient time to recover and heal properly between sessions.

Overuse injuries are commonly experienced by children due to the different rates of growth between bone and muscle. They can be caused by growth spurts, extra-long training sessions for elite athletes (training load and intensity), poor technique or using equipment, which is the wrong size or weight.

Due to the increased demands placed on young athletes, especially those who excel or participate in multiple sports year-round, overuse injuries are becoming more common. Athletes are expected to train more frequently and at a higher intensity, placing more stress on pressure on the body.

‘Shin splints’ are an example of an overuse injury. This condition causes discomfort as a result of constant training or running on harder surfaces. Osgood-Schlatter Syndrome, a growing pain, which affects teenagers and commonly causes knee pain, is another example of an overuse injury.

If a child or young athlete has a suspected overuse injury, it is important seek assistance and treatment from a medical professional. Typical treatments include:

– The application of RICER principles

– Up to 8 weeks of rest

– Icing the injury to reduce inflammation

– Continuing to exercise using low impact activities such as swimming or cycling

– Learning correct technique to improve the body’s mechanics

Thermoregulation

The body tries to regulate the heat loss with heat gain in a process called thermoregulation. Children and young athletes find it more difficult to regulate their body temperature, which means they are at greater risk of hypothermia (cold) and hyperthermia (hot). Because children and young adults have underdeveloped sweat glands they are less responsive to temperature changes. Less sweat being produced, meaning less ability to cool the body down. Instead, children must rely on radiation and convection to cool them down which is not as effective as sweat evaporation.

Children also possess slower rates of acclimatisation, which means that dehydration is more likely to occur due to their shorter tolerance for extreme heat or cold conditions.

To lower the risk, it is important that appropriate clothing is worn, there is sufficient hydration and shade available on hot days and intense activities are avoided when the air temperature is over 34 degrees.

Appropriateness of Resistance Training

When designing a resistance training program for children or young athletes, it is important to remember that each individual is different. Professional sports trainers should check and evaluate the prior experience, goals and their mental capacity of each child before developing a program.

Resistance training can be beneficial for young athletes, reducing body fat percentage and increasing lean muscle mass. However, precautions should be put in place. Young athletes must be fully supervised at all times by qualified instructors and heavy lifting should be avoided until the athlete has finished growing. It is important to perfect technique first, rather than lifting for absolute strength, as the growth plates can be easily damaged.

Some young athletes mature at quicker rates and can engage in more advanced resistance training programs. Other adolescent athletes, who haven’t physically matured at the same rate, may need to focus on technique and beginner workouts.