Bryce’s Treatment is a Home Run

Bryce’s Treatment is a Home Run

by | Sep 30, 2024 | Sports Medicine

Header image courtesy of Eddie Kelly/ProLook.

When an injury threatened to keep Bryce off the baseball field for nine months, he and his family turned to Scottish Rite for Children to get him back in the game.

Bryce has always loved baseball. “I’ve been playing baseball pretty much ever since I could walk and get a ball in my hand,” he says. His mother, Johnette, first saw glimpses of Bryce’s outstanding athletic ability when he was 4. “When the other team was batting, it didn’t matter where Bryce was playing, he would go all over the field to get the ball,” she says. “He was kind of like a one-man-team.” Bryce started pitching when he was 8, and Johnette saw a drive and a passion that were unlike what she saw in other young athletes. When Bryce became a teenager, he played on select baseball teams, and he spent several summers traveling for games. Bryce’s drive and determination paid off his freshman year at McKinney High School when he made the varsity baseball team.

Like many star athletes, Bryce played several sports, and enjoyed football when he wasn’t playing baseball. Sport diversification can help prevent injuries caused by overuse, but unfortunately contact injuries are harder to prevent. In his junior year, he and his team had made it to the second round of the playoffs. During practice, to get ready for the big game, Bryce went for a block and, after contact, felt his arm go completely numb. “I thought it was just some bumps and a bruise because it’s football,” says Bryce. “So, I played that second round, and played every snap on offense and felt fine, but it turns out, it wasn’t too great.” The day after the game, he and a friend went to the baseball field to throw the ball around, but Bryce quickly realized that there was a problem. “I couldn’t even throw the ball five feet, because it was hurting so bad,” he says. 

Bryce had sustained a labral injury to his shoulder, which likely occurred when he subluxated (shoulder almost dislocated) or possibly dislocated (shoulder completely out of the socket) his shoulder. When the shoulder joint is injured this way, it can cause damage to the structures around the joint, including the labrum. The labrum is a ring of cartilage around the socket part of the ball and socket joint of the shoulder. When torn, the labrum is commonly thought to need surgery, but not always. 

Bryce,-MVP-(1).jpg

Initially, Bryce was told that surgery was necessary in order to return to sports and may take as long as nine months. This news devastated Bryce, so when his parents returned, they turned to the Scottish Rite for Children Orthopedic and Sports Medicine Center for another opinion. Pediatric orthopedic surgeon Henry B. Ellis, M.D., reviewed Bryce’s files and MRI, and felt that they could get him back to baseball with physical therapy instead of surgery. He felt with proper rehabilitation (physical therapy) and allowing enough time to allow the labrum to heal, Bryce could avoid a surgery and possibly be back to baseball sooner. However, this did mean that Bryce would have to give his shoulder enough time to heal before throwing a ball again.

Though encouraged by the option to avoid surgery, Bryce remembers being a little shocked at how difficult physical therapy was from the start. “It kind of killed my confidence a little bit and frustrated me, because I’ve always played a lot of sports and I always want to be the best that I can be. But once I saw improvement in how my body and my shoulder felt, I finally started getting back my confidence, so it was good.” Scottish Rite coordinated with the McKinney High School athletic trainers on a program to get Bryce back on the field as soon as possible.

Bryce was cleared to play in February, right before the team began preparing for the upcoming season. After all the hard work he had put into building back his shoulder, he was very excited to be with his team again. They were glad to have him back too – in Bryce’s first week back, he hit three home runs. Things were going great until COVID-19 forced an early end to the season. “All this is a little different,” says Bryce. “It’s like a curveball being thrown at us. But you just have to adapt and be able to adjust and focus on what you are there for.”

Bryce has complete confidence in his shoulder now. “I feel like I can do anything and everything that I’ve always been capable of doing,” he says. “If it wasn’t for Scottish Rite, I wouldn’t be where I am now.” Bryce recently verbally committed to play baseball at Northeast Community College in Mount Pleasant, Texas, and plans to continue his journey to Major League of Baseball.

Bryce is very grateful to Dr. Ellis. When others were recommending surgery, Ellis presented the pros and cons of a nonoperative plan. Bryce says he learned a lot from his experience. “When you go through hard times, you always have to keep your head straight and focus on the main goal, because you are going to go through ups and downs, but you just have to focus on the end result, and that was big for me. Not focusing on the negatives, but on getting back to where I needed to be.”

 

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How to Help Your Kids Prevent Football Injuries

How to Help Your Kids Prevent Football Injuries

by | Aug 27, 2024 | Sports Medicine

Even as awareness of concussions and other problems has grown, football remains the most popular sport for adolescent boys. While participation has dropped, Texas still has the most high school football players of any state – totaling more than 170,000. That’s almost double the number of players in California, which has the second largest population of players. It’s no surprise that the sport remains so popular in a state known for “Friday Night Lights.” Yet while rule changes have modified risks, football injuries are still common. Scottish Rite for Children has advice to help your kids avoid some of these common sport injury problems.

Common Injuries in Football

Football has the highest injury rate among school sports. Most youth sports injuries are muscle, joint or bone injuries including:

Other common injuries in football are concussions and heat-related injuries, such as dehydration and exertional heat stroke.

Protective Equipment Is Key

Tackle football players wear pads for a reason. If your child is playing on a team that does not have the resources of a varsity-level squad, make sure they practice with the correct gear including:

  • Properly fitting helmet approved by the National Operating Committee on Standards for Athletic Equipment
  • Leg (thigh and knee) pads
  • Mouthguards
  • Cleats that are the correct size and fit
  • Shoulder pads
  • Protective cups

Some players may also wrap their wrists, ankles or knees with tape or bracing. Protective braces (i.e. knee brace or ankle brace) may decrease the risk of injury in some athletes. However, custom outer knee braces have not yet been proven to lower injury outcomes.

Practice Makes (Almost) Perfect

Proper training may also reduce injury risk. While your child’s coach determines what happens at practices, you can help your child learn ways to reduce the risk of football injuries all year long by:

  • Encouraging moderate off-season conditioning. Staying in shape throughout the year with cardiovascular exercise and strength training is great for your child’s health overall and may reduce the risk of injuries when they head back to the field.
  • Getting a physical. A pre-season assessment by your child’s pediatrician or sports medicine specialist can ensure that your child is healthy enough to play and raise any areas of opportunity for addressing musculoskeletal complaints before training begins.
  • Promoting hydration. Not only does proper hydration help prevent heat-related injuries, it’s also important for peak performance and maintaining a proper tackling technique. 

Encouraging your child to play different sports during the offseason can also help prevent overuse injuries while keeping them active and conditioned. Playing multiple sports has been shown to be associated with improved performance and reduced injury risk.

What About Concussions?

Whether your kids are linemen or quarterbacks, concussions are a risk during games and practice. Although some full contact drills have been banned from youth practice to reduce concussion risk, 63% of concussions in high school football players do happen from tackling, even during practice. Helmets do not prevent concussions, regardless if they are the best rated helmets on the market. Delaying tackling until the age of 14 is advised by some, however, there are ways to make the sport safer for young athletes. If your child is playing tackle football, make sure the coaches:

  • Limit tackling during practice.
  • Teach safe tackling tactics.
  • Remove the child from play immediately whenever a concussion is suspected.
  • Always follow established return to play guidelines after a concussion.
  • Have a doctor and/or athletic trainer on the sidelines to evaluate players during games after a possible concussion.

Talk to the Coaches

Coaches are an important part of football injury prevention. Before signing your child up for a league, ask the coaching staff questions to ensure injury prevention is part of their philosophy such as:

  • Do you encourage injured players to keep playing or take time off to recover?
  • If my child has a possible concussion, what is the protocol at the time of the injury and when it is time to return to play?
  • Does your child have their own water available?
  • How do you teach sportsmanship and fair play?
  • What type of tackles and drills do you run during practice?
  • Will practice be rescheduled or held indoors if the weather is extremely hot or severe storms are expected?

Only you can decide if a coach’s temperament and attitude toward the game is the right fit for your child — or if football is even a good option for your family. But with a proactive coaching staff, a supportive home and your sports medicine team at Scottish Rite, you can help limit the risk of a sports injury in football for your child.

Want more advice on preventing or treating football injuries for your child? Call 469-515-7100 to schedule an appointment with one of our sports medicine specialists at Scottish Rite for Children Orthopedic and Sports Medicine Center.

Do Kids Need Sports Drinks to Stay Hydrated?

Do Kids Need Sports Drinks to Stay Hydrated?

by | Aug 23, 2024 | Sports Medicine

Do Kids Need Sports Drinks to Stay Hydrated?

When your kids are out of school for the summer, you want them to have plenty to do. Day camps, sports leagues and time at the swimming pool are all great ways to keep your kids active (and off their screens). However, if your kids are outdoors in the summer heat, it’s important to ensure they stay hydrated. While sports drinks replace electrolytes lost during physical activity, they may not be the best choice for most children’s hydration. In most instances, water may be just what the doctor ordered.

Why Hydration Matters

The amount of water that makes up the body is usually within the 45-75% range. Getting enough water each day is important for your body to function properly. Drinking water regulates your body temperature, helps with digestion and brain function, and can also help prevent cavities if the water is fluoridated.

We lose water through the course of normal activities, such as breathing, urinating and sweating. During the hotter summer temperatures, drinking fluids helps keep your body from overheating by replenishing what you lose from sweating.

How Much Water Does a Child Need?

Your child’s ideal daily water intake varies depending on their age and activity level. If you’re worried your child isn’t drinking enough plain water, remember they are also getting water in other beverages, such as fruit juice and milk, and in fresh fruits and vegetables at meals.

More About Sports Drinks

Sports drinks do have some benefits. Electrolyte replacement can also be beneficial when your child is sick. However, for kids engaged in normal levels of activity, additional fluid from sports drinks may not be necessary.

Most sports drinks contain high levels of added sugar, which are beneficial for long duration games and activities where food cannot be consumed. Kids and teens not participating in these types of activities likely don’t benefit from a sports drink if they consume water with regular meals and snacks.

Sports drinks and electrolyte replacement drinks can also have high levels of sodium. In short, sports drinks are not the healthiest option for your child to consume on a daily basis, nor are they considered a requirement for adequate rehydration in children and teenagers.

Download this guide on hydration drinks from our Certified Sports Dietitian

Hydration Drinks – Choose Wisely (English)
Hydration Drinks – Choose Wisely (Spanish)

If Your Child Is Picky About Beverages

If your child only likes certain drinks or would always reach for sugary soda if given the chance, you can try different strategies to boost hydration while limiting sugar. Try these tips for staying hydrated:

  • Encourage fruit intake. Most fruits have high water content. Serving fresh fruit, such as watermelon or oranges, at meals and for snacks can improve hydration.
  • Flavor their water. Put fresh fruit or herbs in water to add flavor without calories or sugar. You can also freeze fruit in ice cube trays and toss it in fresh water to cool it down. 
  • Make reusable water bottles special. Have your child decorate water bottles with stickers. Personalized bottles are more fun to use and show off.
  • Pop in some popsicles. Pour fruit puree or a blend of low-fat or sugar-free yogurt and fruit into popsicle molds for a refreshing treat.

Signs of Heat Illness

Hydration is particularly important when exercising in hot and/or humid environments. These can increase the need for replacing carbohydrates and electrolytes with sports drinks. Proper planning and hydration can reduce the risk of consequences from dehydration. A sign of dehydration is being thirsty.

Recognizing the signs and symptoms of heat illness and responding quickly is critical to your child’s health.

  • Weakness
  • Vomiting
  • Excessive thirst
  • Headache
  • Fatigue
  • Sweating
  • Nausea
  • Light-headedness

Preventing heat illness is important for young athletes. You should call your pediatrician or seek emergency care if your child is lethargic, has a high temperature, is vomiting or complains of abdominal pain.

Find more tips for hydration and nutrition from our Certified Sports Dietitian on our sports nutrition page.

Need more advice on keeping active kids healthy? Call 469-515-7100 to schedule an appointment with a Scottish Rite for Children Sports Medicine specialist.

6 Ways to Prevent Heat Illness in Athletes

6 Ways to Prevent Heat Illness in Athletes

by | Aug 1, 2024 | Sports Medicine

Summer is the perfect time for outdoor activities and sports. Whether your child is passionate about baseball, football, soccer or track and field, being proactive about preventing heat-related illness can help him or her focus on athletics. Here are six ways to help prevent or respond to heat illnesses.

1. Know Your Child’s Risk Factors for Heat Illness

All children and teens can develop a heat-related illness. Yet still, some have a higher risk. Young children are not able to regulate their body temperature as well as older children and teens, which makes them more vulnerable to heat. Other risk factors for heat injury include:

  • Being overweight
  • Having certain chronic medical conditions, including diabetes and heart conditions related to sickle cell traits
  • Not getting enough rest between games or practices
  • Overexertion during games or training
  • Recently having diarrhea, fever or vomiting, which can contribute to dehydration
  • Taking certain medications

Children and teens have the highest risk of developing heat illness at the beginning of the summer. Acclimating to exercising in hot weather can take several weeks for a young athlete. A step your child can take during the first five days of summer training is to not practice for more than three hours. Discover more heat acclimation tips for your young athlete by Korey Stringer Institute.

2. Encourage Hydration

Hydration is another key component of preventing heat-related illnesses. The amount of water your child needs depends on his or her activity level, age and body size. The outside temperature and humidity also affect hydration needs. Young athletes typically need more water than less active peers.

Encourage your child or teen to drink water before, during and after practices or competitions. The best drink choice is typically water, but sports drinks with a proper balance of electrolytes and carbohydrates for energy may help children involved in vigorous activities lasting more than an hour.

3. Be WBGT Aware

Being mindful of the temperature outside is one way to help protect your child or teen from heat injury or illness. However, monitoring the temperature is only one factor in preventing heat illnesses. Cloud cover, humidity, the angle of the sun and wind speed can also affect how heat affects the body. The wet bulb globe temperature (WBGT) takes all these factors into account to determine whether it is safe for children to participate in outdoor activities like soccer games.

The University Interscholastic League has enhanced guidelines for outside activity by adding the use of WBGT before and during activities in the sun. You can use the WBGT activity guidelines for your region to make decisions, such as how much protective gear an athlete can safely wear during practice, the length of training sessions and the number of rest breaks needed per hour. It also defines rapid cooling zones and supplies to have available when the WBGT readings are above a certain level. A school’s emergency action plan (EAP) includes these and other guidelines for preparation and preventing heat-related emergencies.

4. Keep Kids and Teens Cool During Competition and Training

 In addition to staying hydrated and watching the weather, you can do several things to help kids lower their risk of heat injury and illness: 

  • Apply broad-spectrum sunscreen.
  • Ensure your child has access to a shaded area available for rest.
  • Keep cool towels, fans and misters on the sidelines. 
  • Provide plenty of healthy snacks and water to help young athletes refuel.
  • Request or modify start times for competitions and practices early in the morning or later in the evening to avoid peak sun exposure.
  • Start slowly and gradually build intensity during practices.
  • Wear light-colored, loose-fitting clothing.

5. Recognize Signs and Symptoms of Heat Illness and Injury

There are several types of exertional heat-related illnesses and injuries. Some cause mild symptoms, while others are medical emergencies. Knowing what to watch out for can help keep your child or teen safe during summer sports.
After puberty, teens may experience excessive sweating which can lead to heat rash, a type of skin irritation. Heat rash causes clusters of small, red blisters or pimples. Typically, the rash appears in the elbow creases, groin area, neck, upper chest or under the breasts.
When the body loses electrolytes and water faster than it replenishes them, heat-related muscle cramps may occur. In addition to cramping, symptoms include pain or spasms in the abdominal, arm or leg muscles. Heat cramps can be a sign of heat exhaustion.
Heat exhaustion is the most common symptom due to heat-related illness and happens when the body loses a significant amount of electrolytes and water through sweat. While mental functioning remains intact, it is important to recognize and respond quickly to symptoms or signs of heat illness which may include:

  • Clammy, cold or pale skin
  • Dizziness or light-headedness
  • Elevated body temperature
  • Headache
  • Heat cramps
  • Nausea or vomiting
  • Tiredness or weakness

Heat exhaustion may lead to heat stroke if not treated. Heat stroke happens when the body temperature rises too high and the body cannot cool itself down. This type of heat illness is a medical emergency. Without immediate cooling and other treatment, heat stroke is life-threatening. Signs and symptoms of heat stroke include:

  • Confusion
  • Extremely high core body temperature
  • Fast, strong pulse
  • Loss of consciousness
  • Seizures
  • Skin that feels excessively sweaty or hot and dry
  • Slurred speech

6. Know How to Respond Early to Heat Illness

Even minor symptoms of a heat injury or illness need your attention. However, the appropriate response depends on the type of heat illness or injury. When a child or teen has signs of any heat-related illness, he or she needs to cool off. Have your child move to a cool place, loosen any tight clothing, wipe down with cool towels and sip water. If symptoms continue or worsen, seek medical attention. If the condition progresses to heat stroke, dial 911 and look for ways to safely, but rapidly, cool the athlete with total body cooling.

To learn more ways to keep young athletes safe, sign up for our sports medicine newsletter to learn the latest news from our experts.

Does my child need surgery to fix an ACL tear?

Does my child need surgery to fix an ACL tear?

by | Jul 30, 2024 | Sports Medicine

Anterior cruciate ligament (ACL) injuries, continue to challenge young athletes, many calling it an epidemic. Because of the high cost of care and loss of playing time, Scottish Rite for Children’s Sports Medicine team is actively looking for answers to prevent these injuries. As we study the conditions that may contribute to the risk with programs like the Sports-specific Assessment and Functional Evaluation (SAFE) program, we also continue to evaluate and contribute to the available evidence for caring for ACL injuries in young athletes.

Medical director of clinical research and pediatric orthopedic surgeon Henry B. Ellis, M.D., led a multicenter team including others from the Scottish Rite Sports Medicine team just published a critical analysis of the literature pertaining to the management of pediatric ACL injuries. The article is available on the Journal of Bone and Joint Surgeries (JBJS) Reviews site.

Here are some key messages you should know when considering surgery for an ACL tear:

» Even though these are happening at a high rate, there is very little published evidence for managing ACL injury in a pediatric or skeletally immature case.

Studies suggest that as many as 3 out of 4 athletes return to play after completing a nonoperative plan of care after ACL injury, but there are times that surgery is necessary. A physical therapist or athletic trainer can guide rehabilitation with a comprehensive exercise program to prepare an athlete to return to competitive sports with an ACL tear.

» This review suggests that surgery for an ACL reconstruction is recommended when another condition is present. These include:

  • Repairable injury to the cartilage, soft tissue that covers the surface of the bone.
  • Repairable injury to the meniscus, a disc between the two major bones in the knee joint.
  • Symptoms of instability even after high quality rehabilitation.

Since both paths for care can be successful and come with some risk, a decision for surgical or nonsurgical approaches to care for a pediatric ACL reconstruction should include a broad team considering many aspects of the circumstances.

Learn more about individualized care for ACL injuries at Scottish Rite for Children.
 

Ellis, H. B., Jr, Zak, T. K., Jamnik, A., Lind, D. R. G., Dabis, J., Losito, M., Wilson, P., & Moatshe, G. (2023). Management of Pediatric Anterior Cruciate Ligament Injuries: A Critical Analysis. JBJS reviews, 11(8), 10.2106/JBJS.RVW.22.00223. https://doi.org/10.2106/JBJS.RVW.22.00223

Movement Science + Olympic Sprinter = FAST

Movement Science + Olympic Sprinter = FAST

by | Jul 3, 2024 | Sports Medicine

Previously published in Rite Up, 2024 – Issue 2.

New and novel research that focuses on adolescent sprinters is coming off the blocks at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. FAST, short for Functional Analysis and Speed Training, is a series of data collection clinics led by Sophia Ulman, Ph.D., director of the Movement Science Laboratory. She and her team are partnering with Mechelle Lewis Freeman, USA Track and Field Olympian, Olympic coach and CEO/ Founder of TrackGirlz, a Frisco nonprofit that gives girls access to mentorship and sport through track and field empowerment programs. 

The goal of FAST is to reduce the risk of injury in the adolescent sprinting population. To achieve this, Ulman’s team collects data that measures a sprinter’s mobility, stability, strength and power. “A lot of sprinting data in the research community is in collegiate or Olympic athletes,” Ulman says. “No one has really tapped into sprinting at the adolescent level.” Analyzing this data helps determine the mechanical weaknesses or deficiencies that young sprinters have, which could lead to injuries. Athletes receive their data on report cards that include recommended exercises, or correctives, which sprinters can do to improve their specific areas of weakness. By participating in FAST clinics, young sprinters learn how to move correctly so that they can improve their speed and reduce their risk of injuries. 

On the inaugural day of FAST, Freeman brought middle and high school sprinters from TrackGirlz to participate in a variety of functional tests on the track and in the lab at Scottish Rite. A month prior, she completed the tests herself, providing Olympic-level counsel to help identify the appropriate sprinting metrics. “When watching the girls move, it was interesting to see how the data we measured correlated to what I observed with my eye,” Freeman says. “The data gives you confirmation on weaknesses that need to be addressed, removing the guesswork from their athletic development.” 

Beyond movement, researchers surveyed participants on their nutrition habits, sleep routines and training hours. “We can relate mechanical issues and movement deficiencies to these factors as well, which provides a more holistic message,” Ulman says. 

Once a large dataset is collected, the team aims to answer questions that will determine prevalence. “For example, 98% of sprinters have this mechanical deficiency or have a weakness in power that leads to this injury,” Ulman says. “These overarching data points are extremely helpful and will allow us to better target our interventions for these young athletes.” 

Freeman punctuates the importance of TrackGirlz’ collaboration with Scottish Rite. “Through the expertise of the Movement Science team, we are giving these girls world-class information, education and motivation to perform their best.”

Read the full issue.