S1: Welcome in San Diego. It's Jade Hindman. The beginning of the school year is underway and so are youth sports. We'll tell you about the pros and cons of playing. Plus , flag football is among the five new high school sports programs for girls at San Diego Unified. We'll introduce you to one of the teams. This is Midday edition connecting our communities through conversation. With the end of summer comes the start of fall sports. Many youth and school sports seasons are now underway , including popular sports , football and soccer played by youth across the region. With all the practices and games comes risks of injury for young athletes. But we wanted to talk more about what families should be keeping in mind as kids return to sports this fall. I'm joined by Dr. Suraj Acar. He is a sports medicine specialist with Rady Children's Hospital 360 Sports Medicine Program. And Dr. Acar , welcome to Midday Edition.
S2: Well , thank you for having me.
S1: We're so glad to have you here. So school is back in session and that means fall Sports are back to football and soccer among them.
S2: It's important for their self-esteem. It's very good social environment for them to be in helps communication skills. But for parents , I think especially with football , injuries are important also to prevent injuries and to look out for signs of injuries.
S1:
S2: We'll kids sometimes will dive for a ball and maybe their shoulder , their kids are maybe more loose ligaments and so their shoulder may move in the socket. We might see labral injuries in the shoulder. That happens , knee injuries. We can see cruciate injuries. We can see collateral ligament injuries. And for kids who are doing cross country this time of season when they're running a lot , we see bone stress injuries.
S1: How do they heal from those ? I mean , we always talk about the resiliency of children.
S2: The younger the faster the remodel. And so basically for like bone stress injuries , we want to offload the bone. So we might move to swimming or maybe eventually biking and just not load as much until they start healing on their own. And as soon as they're ready , we try to get them back into their team sports.
S1: Well , in recent years , concussions have become a major point of concern , especially in children. There's been a lot of focus on minimizing head injuries.
S2: So the key with concussions , the younger the children , the more risk they have , probably because their neck size is smaller compared to their larger head when they're born. And so the head moves and the inside the brain gets wobbled around a bit and gets swollen. And so the key is recognition of any sign or symptom of of head injury , a concussion. So they could be dizzy , they could have headache with they turned their eyes. They could have just a temporary photophobia where the light bothers them. Any symptom or sign after a head injury is a concussion. And what we want to do is hold them out so their brains recover until they're fully recovered. And this is actually California law that they must be held out for at least a week in football before they can go back. And they have to be seen again and make sure they're completely asymptomatic and follow a protocol.
S1: One of the first things we often think about when we hear about concussions is tackle football. But it's not the only sport where head injuries can occur , right ? Yeah.
S2: The worst two sports are probably tackle football and hockey , probably because the helmet makes kids feel invincible. So with the helmets , they don't get skull injuries , they don't get facial trauma , but their brain still moves a lot , especially if they're hit with on the side or they don't know about it and they can't hold their necks tight. So unfortunately , those are the two biggest. But we'll see it in soccer. We see it in gymnastics. We see it in all sports. If a child falls and hits their head , they can have a head injury. Yeah.
S1: Yeah.
S2: In fact , we got to have more flag football because flag football gets all the benefits of of football with less of the contact. Kids are not wearing a helmet. So like rugby , they don't get as much head injuries. So it's amazing. It's equivalent to soccer or basketball for sports and fitness and social communication and happiness and thriving children. But with less head injuries.
S1: You know , though , things are starting to cool down a little bit , probably just for a day. It's been pretty hot outside. How can athletes practice and play safely in the.
S2: Heat so more and more that athletic trainers that are certified at our schools , they have technology that they can measure both the temperature , the wind and the humidity , and they create this thing called wet bulb globe temperature. And if it's very high , the risk of heat illness is much greater. So we have to be prepared , like with ice and water and maybe even sometimes adjusting the the the experience outside , maybe doing it earlier in the morning , later in the evening or shortening the course if we have to do it outside. So if you get a bad day where you have too hot plus very humid and not enough wind and the wet bulb globe temperature. Sees like 90. The risks are tremendous for our kids in terms of heat illness.
S1:
S2: They've done kinesiology here at San Diego State , and then they get certified and they understand this and they have some of the technology available and they'll set it up at in events where it's required , you know , especially important in events where kids are wearing lots of gear. So like football , if you're playing in a hot and humid environment , the kids have a hard time getting the heat off their body and evaporating heat. And so their risk of heat illness is higher in the NFL. What they do is they have the linemen actually swallow temperature probes in the summer and that they keep track of their temperature on the sidelines because these probes will stay in their body for up to ten days. And they know what their internal temperatures are. For us , if we have any child with any symptom , we take them out , cool them down immediately , get them in the shade. And then if we need to , we measure their rectal temperature.
S1: They swallow temperature bulbs in the NFL. Yes.
S2: Yes. For the linemen because they had one die. Corey Wheeler died and from Minnesota. And after that , they set a policy to keep track of the internal temperature for the overweight athletes. Like the linemen. Yeah.
S1: Yeah. Yeah. Is it like a pill or.
S2: Yeah , it's like a pill. And it'll go through their system and just they'll poop it out , but they'll during the time that's inside , we have constant temperature recordings that help us know if it's time to pull them into the shade. Yeah.
S1: Yeah.
S2: But we can like we said , we can measure the wind temperature , wind , temperature and humidity to create that wet bulb temperature and just keep track of athletes with any symptoms. Get them in the shade right away.
S1: You know , I want to switch gears a little bit here and talk about the mental health crisis that youth are facing. We've seen more mental health discussions from professional athletes , you know , people like Simone Biles and Michael Phelps , for example.
S2: And it's become worse since Covid , the Covid pandemic. We lost a lot of social connectivity. Now team sports helped that. So one of the best things we can do is help our kids get back to their sport as soon as possible. And because of the mental health benefits of team sports , I'm letting some of my children return to sport even before their injuries are fully healed. Because I think the benefits of mental health and wellness and social communication with team sports is so big. But we do need to keep track of these kids. So what we'll do at Brady's is we'll do AQ9 when they come in and ask them questions about their well-being and if they have high scores or they're thinking of hurting themselves , we'll get the social workers involved and find team support for them in the community to help them.
S1: And , you know , a tough game or match can chip away at a kid's confidence.
S2: It's the parents. We need to step back and be supportive. I think our role on the sidelines is to cheer on our kids and not worry so much about the score. If we can pull away from the score and just enjoy the experience , the kids love that. High five. Win or lose , it should be the same. And our kids respond , win or lose. And they do. Well , I think if we can get every child to play , including kids who don't normally get this opportunity like kids on the spectrum , if we give them a chance. I have a website called Every Child plays.org. You can look at what we're doing. If we give these kids a chance , they love it and it improves their self-esteem. I don't think they remember the score.
S1: Yeah , and there are real benefits to for children who are on the spectrum in terms of playing organized sports. Talk a bit about that. Yeah.
S2: So we did a study in 2016 and we found tremendous benefits in the school. Both their social and communication scores went up by about 50% if they do intensive team sport. So team sport is good for all of us , children and adults , but our children especially thrive with this.
S1: You know , for youth who may be playing on a more competitive level , are there any ways they should be thinking about building confidence in their abilities ? Yeah.
S2: You know , one of the concerns we have about the super competitive athletes is the overtraining. And so we get a point where if you train too much , the performance actually goes down. We need to give them a break. So Major League Baseball has some guidelines for pitchers. They have pitch guidelines on the website and they want all of our kids who are pitching to be out of baseball four months , a year and two months consecutive so they can rest and recuperate. It doesn't mean they don't do sport. Maybe they play soccer or basketball. Or swim or do track , but just to give them a little break. Yeah.
S1: Yeah. You know , because a lot of kids who play sports maybe on travel or club teams and kids can play one sport at a young age , you know , for a long , long time.
S2: So we have data from the NBA and the NFL , as well as Major League Baseball and soccer. We published where we looked at the top draft picks in the NBA. And after five years , the ones that played three sports in high school or two sports in high school are more likely to be still in the NBA versus the ones that did just one sport. So the data shows reduction in injuries and improved performance if they play multiple sports. So we're trying to move from this super specialization world to letting our kids play multiple sports.
S1: One other thing that's a big concern is sudden cardiac arrest and it's the leading cause of death for young athletes , it seems. And we've we've seen recent cases in the news. You know , we just had a 12 year old who passed away playing youth sports at school and also playing in the heat. And then you'll remember LeBron James son , Bronny. James recently had a heart issue discovered while playing basketball.
S2: So for parents , I wouldn't get too worried about the news. And this is unfortunate and tragic , but we have more and more. We have automatic external defibrillators on the sidelines so the trainers know where they are. So if a kid suffers a sudden cardiac arrest and we get that on them right away , we can restart their heart and get them in a safe position. The goal is to ultimately , with the pre participation , physical determine with the history , mostly who is at highest risk. So children with family members who've had sudden cardiac arrest or family members who have died of cardiac causes young at age. These need to be carefully screened with electrocardiogram and maybe echocardiography and maybe see a pediatric cardiologist to help sort out the the higher risk cases. But the vast majority of children can play successfully with never having a cardiac issue.
S1: Defibrillators are a great tool to have if everyone knows how to use them and find them.
S2: It'd be good that if every school had it , I don't actually know if every school has them , but the ATCs that schools have are trained to use them and they know how to do this. They just apply it onto the chest and the computer inside reads the cardiac rhythm and it'll tell you what to do. And so this saves lives and we want these available every place. Now in high school football. We have them available at every game because we have paramedics at every game or BLS. So we we have it there. But in other sports , maybe we don't have it and we'd love to have this available at all our big events if possible. Yeah.
S1: Yeah. And you know , for certain students who play sports , especially at a high level , senior year , can bring additional pressure to show success on the field. Maybe they're trying to get a scholarship or stand out to colleges.
S2: So they have to decide themselves. Is it the pathway that they want to take ? We want children to be doing sports , and young adults should be in sports for the joy of the sport as much as possible. And very , very small number will become professionals. So for for those at the highest level , injury prevention is key. And taking time to recover from injuries before returning to sport is critical. And especially with concussions , we have state laws that protect them from returning. So if we identify it , we'll hold them back until they're fully better.
S1: And , you know , in your practice , I imagine you see a lot of young athletes with an injury that may prevent them from playing the sport that they love.
S2: About 20%. Like if they tear their ACL , about 20% of these kids get depressed. So mom and dad and the whole family and the team got to rally around and we got to amuse the our young athlete until they tell nature takes this course and they get better or we can help them get better. And it's a. And sometimes we need resources in the community. School counselors can be very helpful team coaches , teammates to rally. I try to get these kids back onto the field as soon as possible because it makes a big difference for their quality of life.
S1: Finally , what's the most common misconception you think people have when it comes to youth sports.
S2: That the risks outweigh the benefits ? Our kids love sports. Their parents love the experience. This is a misconception that it's dangerous. Even high school football. Outside of concussion , the benefits far outweigh the risks.
S1: All right. And I want to circle back. Tell me more about the benefits.
S2: So the big benefits , I think of team sports , to tell you the truth , are fitness , of course , But more importantly is social connectivity. It's the opposite of saying on Instagram , which is really dangerous for our kids. So getting them with their other friends and running and playing a sport or doing a cross-country event afterwards , their dopamine goes way up and stays up naturally. Unfortunately , if they take a drug to make their dopamine go up like methamphetamine , it drops super low afterwards and they struggle. So the natural best way to improve our natural endorphins and feel happy and thrive is exercise. In fact , if you exercise before you go to school , your test scores are 20% higher.
S1: Oh , wow. Okay. And that's something hopefully we'll people will take with them into adulthood. All right. I've been speaking with Dr. Suraj Ashar from the 360 Sports Medicine Program from Rady Children's Hospital. Dr. Ashar , thank you so much.
S2: Thank you for having me. Appreciate the opportunity.
