Ask the Experts

Written by Various

Our Experts on Breech Babies, Making Healthy Snack Choices & Preventing Sports Injuries

Avoiding Athletic Injury

 

Dr. Jack R. Giangiulio, D.C., is chiropractor in Newport Beach who treats both amateur and professional athletes, dancers and entertainers. www.danceinjurydoctor.com. 

Q (For Child Athlete): My 13-year-old son is a competitive athlete in several sports.  He is constantly training and practicing.  Will all of this activity at such an early age hurt him or cause future problems?

A: These years are when competitive athletics become more intense. It’s the time when coaches expect more out of their athletes and the athletes expect more out of themselves.  Many athletic children are on multiple-school sports teams as well as participating in personal training and private sports training.  Their activity levels are insanely high, but that’s all part of being a teenager.  To prevent injuries and future problems, it is essential to spot the early warning signs of overtraining.  Early symptoms of overtraining such as decreased mental focus, mild body aches and fatigue often go unnoticed.

So why is it that some athletic teens develop symptoms of overtraining and others do not?

It’s because the problem is not so much the amount of activity as it is the teenager’s individual body type, growth spurts and technique flaws.

The early teenage years are when growth spurts occur and children’s body types become more evident.  It’s important for parents and coaches to know the three basic body types and to notice when teens are going through growth spurts.  The three basic body types are Endomorph, Mesomorph and Ectomorph.

Children with Endomorphic body types will appear stockier with more prominent midsections, due to their affinities to gaining fat weight.  This increased weight will adversely affect both their ability to jump and their cardiovascular capabilities.  In their early teens, they should be eased into increased activity levels and gradually introduced to higher jumps.

Children with Mesomorph body types are muscular with shorter tendons; they quickly bulk up with muscle.  In their early teens, their muscles have more tendencies to tighten; therefore, they have higher chances of straining their muscles. Coaches should educate these athletes in advance stretching techniques to offset the effects of hard training.

Children with Ectomorph body types are thin and usually tall, with long tendons.  In their early teens, they are susceptible to rapid bone growth; however, their ligaments, tendons and muscular growths lag behind.  This changes their center and the leverage of their muscles.  Their muscles will fatigue quicker and ache more. Ectomorph athletes have higher incidences of joint sprains, Osgood Schlatter’s disease and stress fractures (rapidly growing bone is soft bone). Coaches should decrease the number of jumps and allow these athletes to sit-out of practice if the athletes experience severe aches.  Note that the quality of their athletic performance may slightly diminish after their growth spurs, but within less than a year, their muscular development will return as well as the quality of their athletic performance.

In general, with all body types, growth spurts will exaggerate the flaws in your child’s athletic techniques.  These exaggerated flaws will bring about injuries especially as their sports activities become more intense and more frequent.

As every coach will say, “practice the basics.” The basics are foundational techniques that promote proper biomechanics to produce the best possible outcomes. These foundational techniques not only increase teens’ skills and abilities, they prevent injuries. The better biomechanically aligned the body, the more efficient the movement and the less stress placed on the body. Since these foundational techniques are continually put to the test during practice and competition, any flaw in the technique may lead to over-use injuries or even traumatic injuries.  As stated previously, technique flaws accompanied with growth spurs will lead to a greater risk of injury in children.

It is also important for parents to match their child’s body type and genetic potential to the chosen sport.  For example, if a teen is built like an offense lineman then it is probably not a good idea to train him as a jockey; and vice-versa.  Picking a sport that makes sense is not only important for a child’s future athletic endeavors, but also for the athlete’s physical health.  Matching the sport to the child’s body type will make training for the sport easier and less physically demanding.

Assuming that your teenager avoids injuries, properly trains for his body type and is participating in a sport that makes sense, he is actually doing his body well.  He is building a strong body, heart and mind.—Dr. Jack Giangiulio

Junking the Junk Food

Melanie R. Silverman MS, RD, IBCLC, is a pediatric registered dietitian and board certified lactation consultant in Laguna Beach. www.feedingphilosophies.com. 

Q (For School-Age Children): My 9-year-old daughter is on a soccer team and after every game and practice, parents bring unhealthy snacks like chips, gummy fruits and artificially colored sport drinks for all the kids. I have a hard time denying my daughter the snacks when all of her friends eat them, but I feel they are inappropriate. Can you offer any suggestions on how to handle this situation?

A: This can be a real dilemma.  On one hand, you do not want to embarrass your daughter in front of other parents and kids, but on the other hand, you are concerned with the nutritional quality of these snacks and drinks.  In my opinion, your concern is warranted.  Let me explain why.

1. Chips:  The reality is that most chips are full of fat, especially saturated fat.  They are also high in sodium and low in fiber.  If you can find a snack chip that meets my nutritional guidelines, then I approve of it as an occasional post-game snack.  I would look for a brand that does not have artificial flavors, colors or preservatives.  Saturated fat should be very low (less than 1 gram to zero grams) and fiber should be more than two to three grams per serving. Some brands of blue chips may qualify as an acceptable snack. 

2. Gummy Fruits:  Just because fruit is part of the name does not make gummy fruits nutritionally sound.  Read the labels.  The gummy may be made with fruit purees, but there is often a significant amount of some type of sugar listed several times in the ingredient list.  In addition, many gummies have artificial flavors and colors.  Even from health conscience companies, gummy fruits are nowhere close to the nutritional benefits of real fruit.  So why not offer fresh fruit?  Bananas are as easy to grab at the store for kids as a box of gummy fruits. 

3. Artificial Colors:   In the United States, artificial colors or color additives are any dye, pigment or substance applied to a food, drug or cosmetic (FD&C) capable of imparting color.  There are several artificial colorings that are allowed in foods.  They are FD&C Blue Nos. 1 and 2, FD&C Green No. 3, FD&C Red Nos. 3 and 40, FD&C Yellow Nos. 5 and 6, Orange B, and Citrus Red No. 2.  The United States Department of Agriculture insists these colors are safe, but the Center for Science in the Public Interest wants them banned because of renewed concern that the colors may contribute to hyperactivity and learning difficulties in children.  In fact, many of the dyes are actively being phased out of Europe.  As a pediatric dietitian, my feeding philosophy is to promote and push real food on kids.  I advise families to avoid food dyes because this nudges them to choose healthier foods for their children.  Artificial colors are most commonly found in snack foods and drinks, which are not nutritionally adequate for children.

I have a few suggestions for you on how to deal with the parents on this issue. 

Contact the parents on the team and volunteer to be in charge of designing a snack rotation list.  Pitch that the menu will save time and energy because parents will not have to think about what to bring.  If you have other nutritionally like-minded parents on the team, ask for help with the snack list.

Do some research on sports nutrition for kids.  Once you present the snack list to the parents, support the snacks listed with the information you found. This way, the parents are less likely to claim you are trying to be preach your own nutritional beliefs. 

To get you started on your list, here are a few snack ideas:
 
•    Trail mix, bananas, 100 percent juice
•    Ready-to-eat cereals with >3 grams of fiber, pears and water
•    Peanut butter and crackers, apples and water.

Good luck!—Melanie R. Silverman

Turning a Breech Baby

Dr. Nona Djavid, DC, is a chiropractor with a private practice in Newport Beach and is the founder of the Wellness Choice Center and Women of Wellness. www.wellnesschoicecenter.com.

Q (For Expectant Moms): I am 35 weeks pregnant and my baby is in the breech presentation. I’m stressed about it, but I have heard there is hope. What can I do to help turn my baby?

A: As you know, in the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation. Fetal presentations are considered to be unstable until 35 to 36 weeks. It is normal for the fetus to present breech in the second trimester and spontaneously invert sometime in the third trimester.

I would highly recommend a variety of techniques to help you with turning your baby—and it involves some exercises and techniques you can do at home, as well as a few visits to a chiropractic physician licensed in the Webster Technique.

The Webster Technique is a chiropractic analysis and adjustment which relieves nerve system stress and improves pelvic muscle and ligament function, reducing torsion to the uterus and potential intrauterine constraint. This allows the baby to get into the best possible position for birth. Once the tension and structural strain are reduced, in a case of a breech baby, it provides more support for the correct positioning of the baby, and the baby is more likely to turn. The purpose of the Webster Technique is not to ‘turn breech babies’ but it’s been known to do to so, due to the reduction in tension of the ligaments in the pelvic area as well as opening up the space for the baby. Make sure to ask your doctor about the process before you go to a certified Webster chiropractor who specializes in pregnant women and children.

As a certified Webster chiropractic physician myself, I have my patients perform the following exercises in conjunction with their chiropractic treatments:

Visualizing: Closing your eyes and seeing your baby move around with the head down in your pelvis a few times a day with or without meditation.

Breech Tilt Position: This is most useful when the baby is active.  Using pillows raise your hips above your shoulders by about 18 inches and lay down on a flat surface. Stay in this position and practice deep breathing in conjunction with visualization.

Massage: Using both hands, massage your belly clockwise around your abdomen. Also massaging or stimulating the lateral portion (outer part) of your little toes has been known to stimulate the baby to turn. 

Hands and Knees: Stay on all fours, kneeling over a birthing ball and stretch your pelvis. You can also do this exercise without a ball; it’s a yoga stretch called cat or camel stretch. While on all fours, you lift up your buttocks and your belly and round your back up towards the ceiling. Then you slowly bring your back and belly down towards the floor.

Flashlight: With the flashlight, you can get the attention of your baby toward the light.  Grab a flashlight and put it where you think the baby’s head is, and then move it towards your pubic bone. Quick movements can get the baby’s attention better.

Music: The same concept done with the flashlight applies here and you can use an ipod with classical or calming music. Do this when the baby is most active. Continue pulling the music down to your pubic bone until you get some motion. Don’t give up and continue visualizing your baby’s head moving down.

Ice: The baby will move away from the ice, so place a bag of frozen pea’s on your belly close to the head. The purpose of this is to get the baby to move away from it and toward your pubic bone.

There is hope in turning a breech baby and having a natural pregnancy, however, it is important to be patient and stay positive.—Dr. Nona Djavid

 

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