Transcription:
Keeping Kids Active and Preventing Burnout: Tips from Athletic Trainers

Melanie Cole (Host): Welcome to Bryan Health Podcast. I'm Melanie Cole. And joining me, we have a panel today with Cassie Metzner and Stacy Dahlkoetter. They're both athletic trainers with Bryan Health Nebraska Orthopaedic Center, and they're here to highlight athletic training in youth sports.

Cassie and Stacy, I'm so glad to have you join us today. This is such a great topic and it's a topic near and dear to my own heart, and so important as we see what's going on in youth sports today. So Cassie, I'd like to start with you. Can you quickly touch on the role of an athletic trainer in youth sports all the way into college and professional, if you would like? Because we don't think of athletic trainers as much as we think of just coaches. Tell us what your role is.

Cassie Metzner: Well, thank you for having me today. As an athletic trainer, we get to be at sporting events and be at practices. But with that comes preparing for emergencies within those events. As you could see at the professional level that we just had with Damar Hamlin, there were athletic trainers that helped with that situation.

So doing that, we're there at the high school level youth sports, helping with the emergency situation. We're also there if the injury does occur to evaluate and determine whether or not we can treat the injury ourselves in rehab or if we need to refer on to another specialist.

Melanie Cole (Host): Cassie, I'd like to stick with you for a second. Not everybody really knows what an athletic trainer is and what the difference between a physical therapist or an orthopod or a personal trainer for that matter. Can you please tell us a little bit about the field of athletic training? How long did it take you to get there? What is the difference between you and a physical therapist?

Cassie Metzner: An athletic trainer, schooling-wise, we are now going into a master's program. So, we have to do a five or six-year program. So, you do your undergraduate degree and then you do your graduate degree. The difference between an athletic trainer and a physical therapist is physical therapists, they can work with more of the elderly people, more specific types of diseases; athletic trainers are only allowed to work with the population that we are trained to work with. So, we are seen more in the sporting activities in high school, colleges and professionals, but we can also be seen in military settings and law enforcement, in the industrial setting as well.

Melanie Cole (Host): I think it's such a cool profession that you have. Really such a cool profession. And Stacy, I'd like you to tell us about the amazing impact sports involvement can have on children. Why is participating in organized sports so important for kids? And especially right now, we've seen this epidemic of mental health issues, we've seen an obesity epidemic, we've seen all of these things and, with the advent of COVID, such a sedentary lifestyle. Speak about what you have seen in your career that the impact that sports has had. And I told you both about my own son before we got on, because the impact that it had on him was remarkable and gave him a whole career.

Stacy Dahlkoetter: Yeah. So, there are, you know, lots of proven articles out there of what physical activity can do, as far as improving your bone health, helping with weight status, helping with heart health and muscle fitness. And sports, it tends to increase those physical activity levels. It improves cardiovascular fitness. So, it just kind of takes that physical activity cardio health to another level and then increases your quality of life because it releases a whole hormonal process that can give you some good mental health benefits, so that way you have lower anxiety and depression rates, lower amounts of stress, you have better confidence in maybe your balance or your skills. And that doesn't just translate in the sports world, it can then translate into your everyday life.

Melanie Cole (Host): Well, it certainly can. And, you know, I saw that with my own son who was a video-playing D student when he joined gymnastics, and now he is a coach of a men's gymnastics team, which is crazy to me. But it shows the full circle. And youth sports has such an impact on these kids. Stacy, when we think of youth sports and we've talked in the media so much about concussion, about ACL injuries in our girl soccer players, well, in anybody really, so can you tell us the most common athletic injuries that you see and specifically in youth sports?

Stacy Dahlkoetter: Well, specifically if I talk about this year in my high school, because injuries tend to ebb and flow, you might have more of one injury one year, and then it's a different injury the next year. But the most common one that I see within the high school that I work at is ankle sprains and then also concussions. Ankle sprains tend to be pretty typical across all sports. And then, same thing with concussions. And they don't just happen in sports, they could happen in the hallways. I've had a couple of students run into each other in the hallway and get a concussion that way.

Melanie Cole (Host): So, I myself as a parent know that I was always worried about concussion. I was worried about injuries. My son was rings, so I was always worried about rotator cuff. And I can see as a parent that this is one of our hesitations, is the injury rate. But another thing that happens besides the injuries, which you guys are so amazing at helping these kids to prevent, is burnout. And we see chronic overuse injuries happening in some sports because, you know, kids start these club teams so early, they play all year, they're pretty intense and some of them, I know tennis is a pretty intense sport; baseball can get pretty intense, all of them really; soccer, any of them. Speak to me, Stacy, about burnout and chronic overuse injuries and how you've seen that, because when they start too young and hit it too hard, and we know that the secret is really cross-training and giving them a little time off too.

Stacy Dahlkoetter: That's absolutely correct. Burnout tends to happen when you have a lot of high levels of stress, whether that's emotional stress or psychological. But then, your body gets fatigued when you are involved in a lot of different events all at the same time. Sometimes you can have an immune system failure where you're sick all the time. And so, what I tend to see is more of an increase in some of those overuse injuries, so shin splints, patellar tendonitis or any sort of inflammatory response within a tendon or a ligament. And so, we get those chronic muscle and joint pain. And sometimes you can have a personality or mood change just because the body's fatigued, they don't have the rest that they need. Their sleeping patterns might change. And so, with the increase in injuries, that's when it becomes more of a risk for injuries when you have those chronic inflammation, chronic lack of sleep patterns, that sets the body up for failure.

Cassie Metzner: And I would just like to add on, so now like physicians and studies are starting to show it's good to avoid specializing before puberty, just to avoid putting too much stress on the body. They also encourage playing multiple sports, but just doing one sport at a time versus trying to do two or three at the same time.

Melanie Cole (Host): That's a great point. So then, Cassie, as we move into the preventive tips from the trainer, if you will, I'd like you to speak a little bit more about scheduling, injury prevention, even strength training. Because we've heard over the years, ossification, bones not done growing. Is strength training appropriate for young athletes as we learn to cross-train? Are we just doing body weight exercises? Give us some of the injury prevention things, the sports that, you know, maybe divers are going to do something else in the off season or vice versa. Just give us some of your best advice.

Cassie Metzner: At my school, my best advice is just sticking with the one sport at a time. We play one sport in the fall, one sport in the winter, one sport in the spring. Try not to do club sports on top of all of that. And then, trust your strength coach. Don't try to do additional strength training on your own. Trust your strength coach at the school or trust your coaches. And then the coaches, a tip for them is just to include warming up properly, stretching properly. Teach these kids how to do all of that so that way they can take it on with them as an adult as well.

Melanie Cole (Host): Yeah, that's great advice. And now, Stacy, this one's important here. Tips for the parents because as we've seen, and I tried real hard when my kids were in soccer not to be that parent screaming on the sidelines, but I'd like you to speak to the parents a second on also recognizing concussion. Their child might come home from a sport one day and they notice something is a little bit different. I'd like you to speak to the parents about what they can do to help their kids get ready to play, how they shouldn't really be over-involved or dreaming of their own vicarious dreams through those kids, because we've all seen that, right? And we've all seen that in the field where we all think our kids are going on to play college and professional, whatever, and it doesn't always work out that way. Speak to the parents for a minute.

Stacy Dahlkoetter: Yeah, that would be the number one piece of advice I would kind of suggest, is being involved in multiple sports is a great thing because it decreases your chance in those overuse injuries; however, you want to avoid playing too many sports at the same time. So if they're playing a high school basketball, they shouldn't be playing club volleyball and maybe club tennis or doing multiple things at the same time, because that can lead to those injuries, like stress fractures. But then also, don't just have them play one sport year round. They do need that time off. And then, a lot of our physicians that work with our sports medicine program really suggest having two to three months off per year. And so, just to encourage multi-sport participation, but trying to limit that to one sport at a time. Because having the lofty goals of wanting to be a college athlete or a professional athlete is a fantastic dream to have, you just don't want to have those dreams lead into bad habits of over-training.

And then to touch on the concussions a little bit and kind of how a parent maybe could recognize symptoms, not everyone has the same symptoms, so it's not kind of a one-size-fits-all. Your child, they might just have a headache, they might be complaining about some maybe sensitivity to light or noise; may have personality changes, they might not. Sleep can be affected, but it might not. But especially if they were there at the event, saw the incident happen, they can check in with their child to see how they're doing maybe right after the event, and then an hour or two later. And then if something is still not right, go with your gut. And if there is an athletic trainer at their school or associated with their youth sports league, have them see the child and kind of help determine if it's a concussion or not. If there's not an athletic trainer that's available, we usually suggest that they see their primary care physician just for that initial visit to help out with that.

Melanie Cole (Host): That's great advice. That's so important. And so, Cassie, I'd like you to have the last word here. Speak to parents. I'd like you to reiterate the amazing impact sports involvement can have on children. And even touch on how parents can be involved and that they and their children can do things that aren't necessarily only team sports, like playing frisbee, taking walks, things that they can do together to get the whole family up and active.

Cassie Metzner: No, that's going to be great advice is just, parents, teach your kids how to be active. Go out, like she said, go out on walks, go on bike rides. Spend time together. Don't just pressure your kid to play a sport. Because like we were talking about earlier, Melanie, your son didn't start doing gymnastics until he was a freshman in high school and then he was able to go on and compete at the collegiate level, that's incredible. You don't hear that very often because parents want to push their kid too early to specialize when they're three, four, or five years old, which can lead to burnout. I've even had a kid on the volleyball team, she played volleyball grade school through high school, got on a collegiate team and now just decided to let it go with the college level. She decided to take a different route and be with family more so instead. So, just encourage your kids to spend time with you. Teach them good habits, healthy habits of eating nutritionally correct, eating right, being active. It doesn't always have to be about sports.

Melanie Cole (Host): Well said. Thank you both so much and sharing your incredible expertise today. You've seen this, and, parents, I hope that you will share these shows with your friends and family on your social channels because we are learning from the experts at Bryan Health together and they're giving us great advice. As parents, we don't always want to hear it, but it's great advice in getting our kids involved in youth sports because it really can be life changing and help them so much. Thank you both for joining us. And I'd like to thank our Bryan Foundation partner, Medica. To listen to more podcasts from our experts, you can visit bryanhealth.org/podcasts. That concludes this episode of Bryan Health Podcast. I'm Melanie Cole. Thanks so much for joining us today.