How to keep young athletes healthy and competitive

Heather Menzer, MD

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Exertional heat stroke, or over-effort in hot, sunny conditions, is the most serious type of heat illness and is considered a medical emergency. If a child loses consciousness, is behaving strangely or seems confused, they may be suffering from heat stroke. Exertional heat stroke is an emergency. Call 911 right away.”

Participation in sports offers myriad benefits for children and teens, from cardiovascular health and reduced risk of chronic diseases to enhanced cognitive function, increased self-confidence and better social skills.

However, during the excessively hot summer season, children are at a much higher risk for developing several heat-related illnesses, no matter their conditioning and experience level. Those in ultra-competitive leagues and clubs are also at risk of overuse injuries and burnout.

Heat-related illness

Heat-related illness is a broad term that encompasses several different conditions, including heat cramps, heat exhaustion and exertional heat stroke.

Heat cramps are a mild heat illness where muscles stiffen and clinch. Generally, they occur after a child has been exercising and has lost fluids from sweating. If heat cramps are suspected, it is important to move the child to a cool, shaded space and remove excess clothing and accessories such as kneepads and helmets to help them get relief quickly. Stretching can help relieve the pain, and the child should rest before heading back to the game, match or practice.

Hydration at this time is also crucial. Sweat lost during sports must be replaced with equal amounts of fluids for each hour of intense sports activity. A child should drink fluids before, during, and after each practice or game. To prevent stomach cramps from drinking large amounts of fluids at once, drink about one cup of water or liquids with sodium or a low amount of sugar — such as a sports drink with electrolytes — every 15 to 20 minutes. Avoid carbonated and caffeinated beverages altogether. Children and teens should also wear light-colored, loose-fitting clothing when participating in sports during the summer months.

Heat exhaustion is more severe than heat cramps. Heat exhaustion occurs when children continue to exercise or play after they start experiencing the effects of the heat. Whereas heat cramps are muscle spasms, heat exhaustion means the entire body is struggling to cool itself. Symptoms of heat exhaustion may include headache, nausea, weakness, unsteadiness and dizziness.

Anyone can get heat exhaustion, but those at a higher risk are children and teens with a previous illness or medical condition, poor sleep, lack of proper hydration, training during the hottest hours of the day, increased stress levels, high body mass index and lack of rest between activities.

If left untreated, heat exhaustion can become heat stroke. As with heat cramps, moving to a cool place and hydration are imperative to treating heat exhaustion. A cool shower or bath can also help, as can cold compresses and ice. If symptoms continue or worsen over time, seek immediate medical help.

Exertional heat stroke, or over-effort in hot, sunny conditions, is the most serious type of heat illness and is considered a medical emergency. If a child loses consciousness, is behaving strangely or seems confused, they may be suffering from heat stroke.

Exertional heat stroke is an emergency. Call 911 right away.

In addition to hydration — which is the best way to avoid heat illness — acclimatization is important to help prevent any issues. The Arizona Interscholastic Association recommends a 14-day period of acclimatization for high-intensity sports like football or soccer. Athletes also need time to rest and recover between bouts of exercise, especially if they have more than one practice or game on the same day.

Overuse injuries

It was not too long ago that most organized sports primarily occurred during the school year, but today’s young athlete is likely training and competing all or most of the summer months as well. This can lead to overuse injuries.

Overuse injuries happen when athletes overwork muscles and tissues in the body. Repetitive running, jumping, throwing or kicking can cause small tears — also called microtraumas — in muscle fibers and soft tissues. Without adequate time to heal, microtraumas can get worse and cause weakness, inflammation and pain. Growth spurts, softer bones and developmental changes can put children at risk for overuse injuries. Warning signs of overuse injuries include pain that increases while playing and continues when resting, pain in one specific area, playing or walking with a limp or pain that does not stop within two to three days.

The Good News: overuse injuries often heal quite quickly in children with some good, old-fashioned R.I.C.E. — rest, ice, compression and elevation. However, if the pain persists for more than three days, have the injury evaluated by a medical professional who can determine if the issue requires other interventions such as medicine, a splint or case, crutches or a wheelchair, physical therapy or surgery.

Heather Menzer, MD is a board-certified orthopedic surgeon who is fellowship trained in sports medicine. She specializes in treating young athletes at Phoenix Children’s. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.