Transcription:
Keeping Your Kids Safe, What You Need to Know About Sports Injuries and Prevention

Deborah Howell (Host): Hello and welcome to the show. You're listening to Weekly Dose of Wellness brought to you by MemorialCare Health System. I'm Deborah Howell, and today's guest is Dr. Kenneth Huh, a pediatric orthopedic surgeon and sports medicine specialist at Miller Children's Hospital Long Beach with a focus in sports medicine, trauma, hip reconstruction, and foot deformities. He received his medical degree from Northwestern University, Feinberg School of Medicine. Dr. Huh completed his orthopedic surgery residency at the University of Southern California. Additionally, he completed two fellowships, one in pediatric orthopedics and the other in sports medicine. His clinical interest is primarily in pediatric sports medicine and he currently is the head physician for three local high school sports teams. Welcome and good morning to you, Dr. Huh.

Dr. Kenneth Huh (Guest): Thank you. Thank you for having me.

Deborah: Our pleasure. Today we'll be talking about sports injuries and how to help prevent them. What are the most common types of sports injuries?

Dr. Huh: The most common things that, I guess, we see in kids are sprains and strains. Obviously, the ankle is probably the most commonly sprained joint. Other things that I typically see in kids that is different than adults would be injuries to the growth plate, which is near the end of the bone. This is the area where kids grow, and this tends to be a little bit weaker. In kids, the bone and growth plate is weaker than the ligament.

Deborah: Right.

Dr. Huh: So that's why the injury is here. In addition, we see a lot of repetitive motion injuries, stress fractures and tendinitis, overuse syndrome. The other couple of things we see are concussions and heat related illnesses.

Deborah: Sure, none of them pleasant. What's the difference between a strain and a sprain?

Dr. Huh: A sprain actually occurs to a ligament—a ligament is the tissue that connects bone to bone—whereas a strain happens to muscles or tendons. The muscle turns into a tendon, which then goes into the bone that it actually moves.

Deborah: I've always wondered that, and now I know. Thank you so much. All right. Let's focus on the two types of injuries, acute injuries and overuse injuries. What's the difference between those two?

Dr. Huh: Acute injuries, by definition, is something that usually occurs from a specific event. For example, like in ACL, someone's playing soccer, they plant, the knee gives out, and they get an actual episode that someone can pinpoint when their pain or the symptoms occurred, versus overuse, which usually there's no specific event, just a pain that kind of comes on over time and worsens over time due to this repetitive motion.

Deborah: Okay. All right. I can directly relate to the ACL as I'm sporting a new one in left knee. And I have to say, if you go to your PT, you just never know the difference because it's fully 100 percent again. So it's a wonderful thing you're doing.

Dr. Huh: Yes. The therapies, I always tell my patients, at least 80 percent of the work is having a good therapist.

Deborah: That is so true. And a good surgeon, too. So what factors contribute to overuse injuries?

Dr. Huh: I think the most important thing would be improper technique, mechanics. We see this in a lot in kids, people who are pitchers because they got a lot repetitive, these things that they try to overthrow the ball, they kind of lose the technique by trying to throw the ball as hard as they can. Also, when you're starting, whether it would be practice or a game, it's good to warm up, because if you're doing sudden, forceful movements rather than gradually increasing the stress and intensity, it can cause these overuse injuries as well. And then trying to "play through the pain."

Deborah: Sure.

Dr. Huh: That's another thing that contributes to this. You got to listen to your body. And along those lines, I think you need to make sure that you rest. You got to take at least one to two days off a week from your sport in order to let your body heal. It's especially important in the kids because they're growing. And like I said before, their physiology is a little different than an adult. They need time to rest and grow.

Deborah: It's got to be kind of tough for kids on sports team when the coach is saying, Down. Do some more burpees, and you know you got a little twinge in your knee and you don't know that burpees can take it to the next level.

Dr. Huh: Yes. I agree, especially if the dad is the coach too, which commonly happens.

Deborah: Yes. That's so true. All right. Can you share some helpful tips for athletes and parents on some things they can do to help prevent injuries?

Dr. Huh: First and foremost, definitely, is wearing protective gear. And protective gear that fits. Putting on a helmet that's three sizes big isn't helpful. You have to make sure it's protective gear that's been checked and is up to date and is well fitting. Then, like I said before, making sure you warm up and cool down is important. I know kids probably don't think that they need to. But as you get older, you realize the importance of it.

Deborah: Yes. Exactly.

Dr. Huh: Yes. That's very important. Hydration is important. You want to make sure you drink plenty of fluids at least 30 minutes before a game, and then at least every 15 to 20 minutes during the game, you want to be drinking fluid.

Deborah: You're saying fluid, do you mean water, do you mean Gatorade, or a mix of both?

Dr. Huh: I think water is probably the best. These things are good to replenish your electrolytes and stuff, but you can't go wrong with water, good old-fashioned H2O. And then I think other things would be just, particularly to the kids, would be what sport they're playing. The parents should be cognizant of what are the common injuries, then they educate themselves and try to.. how to prevent those specific injuries because each sport has different things that are higher risk in terms of injury.

Deborah: One is common to pretty much every sport, and that's concussion. So could you tell us what it is, please?

Dr. Huh: Yes. It's basically a form of what they call a traumatic brain injury. TBI is what they call it. Basically, it's like a jarring or shaking of the brain inside the skull that can alter the way your brain works temporarily.

Deborah: What are the signs and symptoms?

Dr. Huh: For severe ones, you'd see a loss of consciousness. The other things, like in terms of thinking, remembering people will feel slow, they may have problems concentrating. You can have problems remembering new things. In terms of physical symptoms, they can have headaches, blurred vision, nausea, vomiting, dizziness, loss of balance, and then they could be sensitive to light or noise. In terms of emotional mood changes, you can see people getting irritable or depressed or anxious.

Deborah: Really?

Dr. Huh: Yes. You might not see that right away. These are things that manifest after a week.

Deborah:   That's interesting. If it goes untreated.

Dr. Huh:   Yes. These are the signs that may not always appear right away. That's the difficult thing with concussions. A lot of times, the things I typically see, like in football games, would be nausea, vomiting, or dizziness, the whole feeling slow and not being able to remember things. But the emotional stuff and the problems of sleep are things that manifest after a few days.

Deborah: Is this recent discovery? I hadn't heard this before.

Dr. Huh: Well, it has probably become clearer. I think a lot more research is being poured into concussion. With all the professional athletes, particularly NFL having the big concussion problem, there has been a lot more money poured into research. We've discovered that there are a lot more things that occur with a concussion rather than just what happens in the initial symptoms after the injury.

Deborah: Right.

Dr. Huh: There are things that can come out a few weeks later and not present themselves for a few days.

Deborah: Is there a treatment for concussion?

Dr. Huh: The most important thing for treating a concussion is to make sure that you stop playing right away.

Deborah: Right.

Dr. Huh: Because the big thing is there's a phenomenon called the second hit phenomenon, which is when if you sustain a concussion and you don't give your brain adequate time to rest and recover, if you have another injury or insult to the brain before it has fully recovered, it's not just adding up to concussion. The effects could be exponential because your brain is already at risk and then there's another shock to it that can cause it to have a much worse effect than it would have if it was individual concussion by itself.

Deborah: As you're talking, I'm imagining pro boxers.

Dr. Huh: Pro boxers or offensive linemen, defensive linemen in football, or just every player smashing heads with each other.

Deborah: Yes. Well, you do see some of these symptoms manifesting in older athletes?

Dr. Huh: I'm sorry.

Deborah: Who have may be sustained multiple concussions over the course of their, say, their boxing career.

Dr. Huh: Yeah. You hear about this. Even with the NFL players. I think there have been a few people. I think, most notably recently, there's Junior Seau, who's a linebacker. He ended up committing suicide. They think a lot of the stuff is due to the effects of multiple concussions. The behavioral problem occurred afterwards.

Deborah: Just a tragedy, such a superstar he was.

Dr. Huh: Yes, for sure.

Deborah: Well, we're getting to pretty much the end of our show. What are other injuries we should be on the alert for, maybe something unusual that we might not typically see in a sports program?

Dr. Huh: I think now that people are so well-versed in knowing what to watch out for in terms of a lot of the big injuries, so I don't think there's too much slips by. I think the biggest thing right now is having kids be upfront and honest, because a lot of kids just want to play, so they'll hide their injuries.

Deborah: Right.

Dr. Huh: By the time they come out, they've done a lot more damage.

Deborah: Right.

Dr. Huh: And then, like I said, the other thing also is the parent has to be aware too and be willing to step in, because I used to routinely see parents who think that their 7-year-old child is going to be the next Kobe Bryant, and so they're pushing their kids. They have to tell them that their 7-year-old can take a break and it's not going to affect their career.

Deborah: That's right. Well, thank you so much, Dr. Huh, for finding the time to talk to us today about keeping our kids safe from sports injuries. It's been a pleasure to have you on the show. I'm Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness brought to you by MemorialCare Health System. Bye-bye.