Terra Blatnik, MD: Hi, my name is Terra Blatnik and I'm a Physician specializing in Sports Medicine and Orthopedics at St. Louis Children's Hospital and I am a MomDoc.

Melanie Cole, MS (Host): HIgh school football season is here, and as parents and young athletes are really ramping up for another season, it's crucial to prioritize injury prevention. And we're here to share valuable insights and practical tips to help keep your young athletes safe on the field. Welcome to MomDocs, the podcast from St. Louis Children's Hospital. I'm Melanie Cole. Dr. Blatnik, I'm so glad to have you join us again. So what are, as we get into this season, and you and I have talked about injuries and things before. What are the most common injuries that you see in young football players?

Terra Blatnik, MD: So we definitely see a very wide variety of injuries in football players. So certainly knees and ankles tend to be kind of the highest level of injury that we see. But we see things like concussions, wrist breaks, finger breaks, injuries, so it's pretty wide range in football just because of all the contact.

Host: So then, as we're talking about factors that are contributing to this higher risk of injury in high school football, let's start with the equipment. Obviously we know what the sport is and, and whether it's touch or tackle, it's a contact sport, right? So there is equipment that goes with that, helmets, pads.

Do we trust these things? We've talked about concussion. We hear about this a lot. Do we trust the equipment? Does it have to be fitted a certain way? Can you speak about whether or not the equipment helps to protect our children?

Terra Blatnik, MD: Yeah, so certainly well fitting equipment is super important in football. So we need to make sure particularly the helmet is fit properly and so making sure that you have a coach or an athletic trainer or someone that can make sure that helmet is fitting appropriately is very important. So it needs to be fit well on the head. There needs to be a little space for some movement, but it needs to be pumped up well, and there needs to be no cracks or other things. So I'd say it's also important to look at the integrity and the quality of the equipment as your athlete goes into football. And also making sure that the pads are at least newer, that there's nothing missing, the pads are not cracking and are well fitted. All of these things are going to help them when they're hitting and getting tackled to prevent some of these injuries that we'll talk about.

Host: So we're thinking about the injuries you mentioned, a few places, and you mentioned concussion, as we're talking about these injuries and the fact that it is a contact sport, there are injuries with a lot of youth sports that are involved in chronic overuse. Training, the same thing for the same sport. Would cross training and other types of strength training be good for football players, or is this one of those sports where you really want to build up that stability, some of the flexibility? Tell us a little bit about if this is different than other sports where you see chronic overuse.

Terra Blatnik, MD: So certainly I would say that football tends to be one of those sports that's not necessarily played all year round. Things like baseball, soccer, definitely see a lot more overuse with those athletes because they do tend to be in a year round sport. Now that doesn't mean that they don't, that football players don't need to cross train or do other things because I do recommend cross training for athletes of all different types of sports along with strength and conditioning training and flexibility training.

So even though they're not necessarily as high a risk for overuse because of their shorter seasons, they definitely should do these other things that we encourage with other athletes as well.

Host: What about rest and recovery in preventing injuries of all sorts, but certainly if they've been injured, and then we're going to talk a little more about return to play, but rest and recovery, how can parents support a child in that resting and recovering process? Cause kids want to really work at it. They don't want to stop.

Terra Blatnik, MD: Yeah, it's always very difficult to get kids to understand that they do need a rest because they love their sport and they want to keep going and they want to play at a higher level. So I think really encouraging kids to get that one full day of rest each week. So make sure there's one day where they're not doing any sports, where they're just resting and letting their bodies recover.

And then also just making sure we're encouraging nutrition, sleep, other things, and that's all going to help their bodies recover as well.

Host: Is there a way to prevent some of the injuries we're talking about here today, whether it's a turned ankle or you mentioned hands and fingers, is there a way to prevent these things?

Terra Blatnik, MD: Unfortunately with football, there's not a lot of things we can do to prevent some of these injuries. A lot of them are just incidental in tackles and things like that, that are difficult to prevent. But I would say, you know, I would go back and say equipment is probably very important. So making sure that that equipment fits well and that you have all the proper equipment because that's really the best thing that we can do to make sure that the athletes are safe.

Host: Yeah, so let's talk about concussion a little bit. This is a problem with many sports and certainly with contact sports. And we want to get our athletes, especially our younger athletes, involved in concussion prevention, identifying things they may see out on the field that we may miss from the stands or even coaches.

Can you give us your best concussion advice? You've already talked about equipment, helmet, but can you give us any other advice about concussion, identifying it and whether it's an emergent situation?

Terra Blatnik, MD: I would say education is probably the most important thing when it comes to concussion. Both education of the athletes as well as of the coaches, and even the parents as well too. So kids need to know that if they have any signs of concussion and just reviewing that with them. So, headaches, dizziness, anything that happens out on the field or after a play that they should let their coaches know or let someone like an athletic trainer know on the sideline. So pulling themselves out and getting evaluated is very important so that we don't miss anything. And they have to understand that there's no penalty. There's no, no problems with doing this because it's very important to identify concussions early.

Um, the sooner we get them off the field, that can definitely help with their symptoms and potentially, hopefully keep them off the field for a lesser period of time. So that's really, I would say education, and then I would say for parents too, just seeing their kids out on the field, if they have concerns, making sure they let coaches know, and then coaches, if they see a big hit, make sure they check in with that athlete, make sure, hey, are you feeling okay?

Do you have any headache? Should we check in with the trainer? So I'd say just having a very low threshold for any type of symptom to just identify themselves and pull them out for at least a little bit. And they may be able to go back in, but if the trainer or the coach sees something they don't, that they're worried about, then they need to come off for the rest of the game and then be evaluated.

Host: That's great advice. What types specifically of strength training, flexibility do you recommend for young football players to help them get the strength and stability that they need?

Terra Blatnik, MD: So I would say, you know, athletes even starting as young as age eight can start to do sort of lightweight and high repetition strength training. And I think it's important for, you know, athletes of all ages to do this. And I would say, especially for football players, making sure we're emphasizing all parts of the body.

So make sure we're doing upper body, core, lower body, and not just emphasizing one versus the other. And then I would say flexibility is important as well. You know, flexibility is often not something that's emphasized as much in sports, particularly football. So I would say making sure they're doing a good warmup before, really good stretching afterward, because improved flexibility is certainly going to decrease their risk of injury on the field.

Host: Yes, that's really good information. So important. What about nutrition? Is there any specific nutritional guidelines? Do they need more protein? Do they make sure to get hydrated? Tell parents what you want them to know because it does help to prevent injuries if the kids are well hydrated and fed the proper nutrition.

Terra Blatnik, MD: Yeah, so nutrition is super important for both sort of performance and for recovery. So we really want kids to have a very wide varied diet, so not just emphasizing just protein, but certainly getting good carbohydrates, protein, fats, and all of those sort of micronutrients. So we want them to make sure that they're really fueled before workouts, so not forgetting to eat something.

We usually recommend a pre workout meal a couple of hours before that's got some easy to digest carbs so that they have that energy that they need in order to participate in that practice or in that game. Hydration, as you mentioned, super important. So making sure they're drinking enough water throughout the workout and then post workout as well.

If they're working out more than an hour, we would like for them to add sort of a sports drink. So something with electrolytes because they'll be losing a lot of those things in sweat. And then post-workout recovery is important too. So getting some carbs, some fats, some protein in after the workout as well, so that can help their muscles recover, um, afterwards.

Host: Chocolate milk is a great recovery beverage and one that kids really do like. We've heard about sudden cardiac death. And with athletes specifically in high school, mostly I'm guessing in college, but are there any specific pre season or in season assessments that you recommend that can help identify potential injury risks and or other risks we may not know about?

Terra Blatnik, MD: So I would say a really thorough preseason physical is really the most important thing for this. So I really recommend kids going to their primary care physician rather than an urgent care or somewhere else, someone that knows them and can do a very thorough exam. And so they need to work through all of the questions related to things that could put them at risk for sudden cardiac death.

So things about family history, things they may have experienced like fast heart rate on the field or something like passing out when they're exercising. So we need to really go through all of those cardiac risk factors and do a very thorough cardiac exam, listening to their heart, checking their pulses, things to make sure that they're not at risk.

And if we do identify something, following through on that and making sure they get the appropriate cardiac workup before they go out on the field.

Host: What a great discussion we're having, Dr. Blatnik. As we wrap up, can you speak to parents about the psychological effects of injuries on high school athletes, how important that is, and how they can best provide emotional support during the recovery process, what you'd like them to know from a specialist in pediatric sports medicine?

Terra Blatnik, MD: Yeah, so it's very hard on an athlete to have an injury, especially in season. They're not doing what they want to do. They feel disappointed about it. And so I always recommend that athletes try to stay as involved as they can with their team. So even if they're not able to be out on the field or the court, making sure that they spend time on the sideline, you know, maybe they can help with water.

Maybe they can kind of be a manager, but just something to keep them with their pool of friends on the sideline and keep them involved in their sport until they're able to get back. And I would say for the parents, just making sure that they allow the kids the time and space to heal, not to rush them back, to make sure that they get better before they're back out on the field and kind of getting them to these games and encouraging them to be with their friends and their teammates.

Host: Thank you so much Dr. Blatnik, for joining us today and sharing your expertise with us once again. And for more advice and articles, check out the MomDocs website at ChildrensMD.org. And that concludes another episode of MomDocs with St. Louis Children's Hospital. Please always remember to subscribe, rate, and review MomDocs on Apple Podcasts, iHeart, Spotify, and Pandora. Until next time, I'm Melanie Cole.