advice and tips for preventing sports injuries october 17...

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Advice and Tips For Preventing Sports Injuries Webcast October 17, 2010 Betsy O'Kane, M.D. Sarah Kramer, M.D. Cindy and Hannah Remington Please remember the opinions expressed on Patient Power are not necessarily the views of UW Medicine, their staff, or Patient Power sponsors, Patient Power partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. Please have this discussion you’re your own doctor, that’s how you’ll get care that’s most appropriate for you. Introduction Andrew Schorr: As school starts, so do sports, sometimes for some children more than one sport at the same time. How can you protect your child from injury? Coming up, two experts from the UW Health System and the Neighborhood Clinics will provide advice and tips for staying healthy and preventing injury. It's all next on Patient Power. Hello and welcome to Patient Power. I'm Andrew Schorr. This program is sponsored by the UW Medicine Health System. Well, here we go. If you have children you want them to be active, of course, and we know we have an epidemic of obesity in this country so having your kids be active is so important. And a great way to do it is have them participate in sports. And there are so many children who just love it, and here in the northwest it's a busy time certainly all year around, but I know now as we talk about it in the fall there's football and there's cross country and there's soccer, of course, and some kids compete even at the premier or select level. They may even be on more than one team. How do you prevent injuries for your children? How do you help them have a long, healthy life where sports and an active life can be part of their lifelong activities? We have with us two experts from the UW Medicine Health System. One who is a family physician at the Woodinville clinic and one who is at the Shoreline clinic, and they both have children, and they have a lot of advice for us. So we're going to talk about it. We're also going to mention that we have other programs that we hope you'll take a listen to particularly about concussion because that is an extensive discussion in and of itself. Let's meet our guests. One is Dr. Sarah Kramer. She is a family physician at the UW Medicine Clinic in Woodinville. Sarah, you have two girls. They are swimmers, I understand? Dr. Kramer: They are swimmers. They are not aggressive athletes, but they certainly enjoy burning off some extra energy in the water.


Andrew Schorr: Right. And the key is of course how to help them enjoy that for years. And then our other guest is Dr. Betsy O'Kane. She is at the UW Medicine Neighborhood Clinic in Shoreline, and she hears a lot about sports, not just from her children, an eight-year-old daughter and then she has a ten-year-old son, and she's active, but her husband is a physician as well and actually happens to be the head team doctor for the University of Washington. Dr. O'Kane, I understand your daughter competes in premier soccer so you have to think a lot about keeping her avoiding injury and sort of in top shape. Dr. O'Kane: She does. We've been very active as a family, and she has decided that she wants to be what she calls a super star athlete so has been working very hard on her soccer career. She's playing premier soccer, and as an eight-year-old we need to be very involved in her care to make sure that she's not overusing anything and that she's getting proper care and nutrition as she goes through her sports. Andrew Schorr: Yeah. Well, you brought up a word I want to ask you about first, and that is "overuse." So for instance your daughter, premier, but there's some kids, maybe they're on a recreational team and then they're on a select team. You know, my son, even at the end he's playing basketball and he's finishing his football season, busy boy. Overuse, tell us about that and how we guard against that and how we really don't limit our kids' ability to enjoy activities for the rest of their life, Dr. O'Kane. Dr. O'Kane: That's actually a really important point, and it's one of the things that as parents we need to be particularly vigilant about. A lot of kids will be participating on two different teams. I know my daughter is playing premier soccer with Northwest Nationals, but she also plays on our community soccer team, so we need to be watching out carefully for how many practices a week she's doing as well as the amount of time and the intensity of each of those practices. And in addition to that we need to, you know, watch to make sure she's getting enough sleep every night, that she's eating well during the week as well as after each of her games so that she's able to recover and keep her muscles as strong as possible. A Young Cross-Country Runner Andrew Schorr: We always like to include folks who are dealing with these issues in our programs, and we have with us 15-year-old Hannah Remington from Bothell and mom, Cindy. And actually Hannah is a patient now of Dr. Kramer's. Hannah, I understand you're a cross-country runner in 9th grade, and lately you've had some knee pain, right? Hannah: Right.


Andrew Schorr: And this knee pain, some of it you've run with, and what happened just at the most recent meet? Hannah: This recent meet I sprained my hamstring while running through gravel. Andrew Schorr: So this pain has been such that I understand you got some crutches from a friend. Hannah: Yes, I borrowed crutches because I could not put pressure on my knee. Andrew Schorr: And you go to Dr. Kramer and she says rest, and then you went back because it's still been hurting, right? Hannah: Yes. Andrew Schorr: And the answer, Cindy, the prescription is? Cindy: The prescription is let it rest until you're able--she's able to put weight on it and walk normally, and then she needs to work on some stretching and strengthening of the knee again. Andrew Schorr: Now, I understand that track and cross-country is new for Hannah and maybe new for you, so what do you think about overuse? Is this something you're more attentive to now? Cindy: It is something you have to be careful of, especially as she has grown so much in the last year or two, so there's a lot of, you know, things happening in her body, and then she's really working it hard. So I know the coach is very intentional about stretching and icing after and trying to help prevent some of these things, but that's such as sports, I guess. Andrew Schorr: Well, it happened, but, Hannah, I imagine that as you go on in your athletic career, whether it's this season or beyond, you're going to really be paying attention to stretching now. Hannah: Yeah, I have to be very careful in doing all the right stretches.


Andrew Schorr: Okay. Well, I know you're on the road to recovery. You've got a great doctor. How about eating right? Are you giving yourself good nutrition? Hannah: Yes, I'm trying to. Andrew Schorr: Okay. That's important too. Cindy, you're going to pay attention to nutrition as well. Cindy: That's what we aim for. Nutrition Andrew Schorr: Dr. Kramer, let's talk about nutrition. Let's start with that as a baseline. So first you have to have a healthy body, so what about that? What kind of nutrition should we be ensuring for our kids, and maybe where do certainly supplements come in, if they don't have this in their diet, they don't have that in their diet, we give them a bunch of pills? Dr. Kramer: Sure. Well, I think most parents, we break our kids down into being kids that are pretty good eaters or then you have to deal with the picky eaters. So let's just sort of assume first of all that your kid is generally pretty good about eating, you know, what's on their plate. Maybe they're not big on Brussels sprouts, although actually one of my daughters just loves Brussels sprouts, so go figure, but you if you've got a kid who is a pretty good eater the emphasis should really be on food. I think that a lot of the interest in supplements dates back many decades to a time when we couldn't rely on fresh fruits and vegetables being at the grocery store all year around, but at this point where you can walk into the grocery store any time of year and pick up those apples, get shows grapes, you know, you can get dried fruit, you can have--of course milk is packaged and these nice, convenient cartons that are--can be heat stable at room temperature, and you can just throw those in your sports bag. The emphasis should really be on just making sure that your child athlete has ready access to a good balance of tasty, nutritious snack. I mean, other things that--of course if your child is not allergic and if there's no prohibitions on having nuts being shared among their teammates, a lot of things like almonds, cashews, you know, even regular old peanuts are also a great source of protein and fat as well as carbohydrates. And then for girls especially we really have to watch the calcium, and for bone health, both girls and boys we need to watch the vitamin D because vitamin D is something that is normally made by our skin in response to sunshine, and it's just not something we get enough of in this area. So most of the foods that have vitamin D, they're not necessarily kid-friendly foods. I don't know how many sardines your kids normally like, so calcium and vitamin D are often things you're going to have to look to supplement. Sometimes iron, especially if


your kid is not a big eater of either meat or other iron-rich foods. But other than that we should not be looking at multivitamins or protein powders as being a substitute for things you buy in the grocery store. Andrew Schorr: Let me talk about iron for just a minute because I know cross-country and track in the spring, those are popular sports, too. I know where I live on Mercer Island there are like over a hundred kids in the cross-country program. It's a no-cut sport, and it's wonderful activity. Dr. O'Kane, what about iron because I know particularly in some girls they get really thin and they're very active and they're running and their iron can get really low, sometimes into trouble. Dr. O'Kane: Right. Iron is a really important component of creating red blood cells, and people who are not eating adequately or who are exercising to the very highest levels, the ferritin, which is kind of our marker for iron stores, can be pretty low. We test that in a lot of athletes, and we're looking to have a level at above 70. Some athletes will just need some supplements to get it that high. There will be some athletes that have a ferritin that's over that, but, as you mentioned, the cross-country runners and gymnasts and other people who are really focused on a very lean physique and low body mass sometimes will have trouble keeping their ferritin at a high enough level. They'll require supplements, and if they're not getting enough actually may find that their performance is not what they'd like it to be, that they're not performing up to their full potential. Andrew Schorr: Dr. O'Kane, let's talk about weight for a second. So if you have that kid, let's say I think of wrestling and maybe running as well, they think, boy, I either have to make weight--or gymnastics as well--got to be really lean and I will compete better or wrestling, I'll make a better weight class where I can be more competitive. Do you want to make a comment about weight, because I know some kids, that can push them into eating disorders. Dr. O'Kane: Right. Weight is really challenging, and also with weight it's just what your body looks like. And there are certain sports, gymnastics, ice skating, where your appearance is really, really important. However, as you mentioned, that can lead to significant eating disorders so that people are not get enough nutrition, they're actually, for girls and young women they are not getting their periods or they're getting their periods at a very late age. This can lead to improper growth. It can also increase their risk for particularly bone injuries or stress fractures, and those are very common injuries particularly in cross country runners. There's a line. You can't be overweight to participate successfully in these sports, but it's also really important to be maintaining enough nutrition so that your body can function at its highest level and that your bones and your muscles are strong enough to compete and work out on a regular basis.


Andrew Schorr: I've heard that when it comes to running that being thinner is not necessarily making you faster. Dr. O'Kane: That's right. There have been some studies that have come out recently that have shown that for appropriate weight athletes, those that have just a little bit higher body mass index will actually be stronger and able to compete more successful fully. Asthma Andrew Schorr: Wow, that's good information. Dr. Kramer, so let's talk about asthma for a second. So there are a lot of kids with asthma, or some compete in sports and they develop what seems to be asthma. Tell us about that. So, first of all, can a kid with asthma compete? And, second of all, what is sports-induced asthma? Dr. Kramer: Sure. Well, I don't think things have ever been better than right now in terms of having children with asthma participate in sports. There's such a good number of very convenient medications that can be used for controlling asthma, so the child is not necessarily stuck with having to use an inhaler multiple times during the day. There's nice 12-hour medications that can be used. Also kids a lot of kids with asthma have underlying allergies or other conditions that if you control those underlying conditions can really get that asthma under control. And quite frankly sports is oftentimes how we first run into asthmatics. It's oftentimes someone who has extremely mild asthma. They will only notice it during the time they're competing, and it may show up as either a tendency to get more easily winded compared to other kids that they're competing with. It may be the child who after they're 20 minutes into a practice they start to get a real hacking cough, or perhaps even when they get home from practice that night they develop a bad cough that prevents them from sleeping. So a child who is just coughing for no reason, where there's no cold, no runny nose, no good explanation, we really have to think about sports-induced asthma. And we often see asthma becoming worse during the change of seasons, so fall is oftentimes the first time that we get a child diagnosed with it. Andrew Schorr: So what do you do? Dr. Kramer: Well, the first thing is to make an accurate diagnosis. And purely sports-related asthma can be difficult to diagnose because the child may have a totally normal lung exam when they're there in the office. You may even do lung function studies when they're sitting in a nice, warm room and they're fine, so some pulmonary experts will take the child, actually run them in the cold fall air and then repeat the lung function studies and see a


decline in their lung function. Or there are some challenge tests that can be used where we have the child actually inhale a medication that sort of reproduces the irritation of exercise, and that will sometimes provoke a response. But the medications for asthma are so safe, from a practical standpoint a lot of times we just have the child use an inhaler, see if they respond and, if their cough magically goes away that pretty much nails the diagnosis. Andrew Schorr: That was my son Ari, same thing. He's a runner, and so in spring it was really bad for him, and he would use an inhaler, and he's done great. Dr. O'Kane, let's talk about strength training for a minute. So I remember the advice was don't have younger kids or kids, really, be lifting weights. Maybe high school ones, but none of this. What about strength training? Should kids be using any kind of weight or anything like that to train, or does that harm their growth plates, and, you know, we've done the terrible thing as parents if we let them do that? Dr. O'Kane: You're right. The traditional thinking from years ago was that strength training not only wasn't needed for the kids but also that it could be dangerous and that it could harm the growth plates of kids who are still trying to grow. We clearly know that that is not the case and that strength training done appropriately at appropriate ages can be really beneficial in improving the sports performance as well preventing injuries. There's been a lot of research recently. There was actually an article published in the Physician and Sports Medicine, which is a common sports medicine journal, back in the spring that went over preventing common soccer injuries. There's a big increase in knee injuries in girls as they start to go through puberty. Before puberty their knees are pretty safe. After puberty there seems to a lot of physiologic changes that increase the risk for knee injuries, particularly the catastrophic ACL injuries. And there have been some studies that have come out that show that a specific strength training program done appropriately that involves specifically strength, some plyometrics, proper jumping techniques, that those will significantly decrease the risk for these catastrophic knee injuries. Dr. Kramer: I'm going to just tag into that too that a lot of times it's very tempting for people to look at braces that you can buy over the counter and see those as being a substitute for strength. And it's very tempting to say, hey, if that joint feels a little unstable I'm just going to pick up an ankle brace or I'm going to use an ankle brace or a knee brace that was prescribed for an injury recovery and then put that on as a preventive basis, and that is really--not only is it not a substitute for strength training but it actually I think gives people a false sense of security and can actually increase the risk of injury.


Dr. O'Kane: Right. It's much more important to do the appropriate rehab and to do the prevention work so that if you have ankle sprain that you've gotten your proprioception back, you've gotten the strength back, and that's going to keep you much safer than wearing a brace. Deciding When to Sit Out Andrew Schorr: All right. So now we've sort of broached this topic of maybe that there's some injury. So, Dr. Kramer, you have kids and parents who come to you, and there's some soreness or maybe something more. How do you know, how do you get at whether they can continue to practice and compete or they need to sit out? Dr. Kramer: That's a great one, and I can illustrate with a couple scenarios. I saw a relatively young gentleman recently where he had had some recurring back pain, and people had repeatedly told him the advice, which is good advice, that most people who have back injuries or low back pain should kind of get in the gym, strengthen their back, work on their core stability, work on their abs. And he got absolutely perfect advice, but he said that every time he came home from the gym he felt like his pain was getting worse and worse instead of better and better. And he started to really doubt himself and think, am I working hard enough, am I doing this right. And by the time he came to see me we started talking about what other conditions he was having. It turns out he also suffers from a skin condition called psoriasis. That was obviously a red flag for me to say maybe he's got something else going on, and it became pretty apparent that he had an arthritis condition associated with the psoriasis, and the reason why he wasn't getting better was that he had joint inflammation that was not going to get managed with exercise and in fact is one of the few cases where we tell people to, you know, really back off. And he needed to see an arthritis specialist and get on appropriate treatment. On the other end, you know, you see, I sometimes will see somebody where they've--they come to me and say, oh, I can't do this running or I can't do this because I have weak ankles or I have, quote, bad knees, and that just is like nails on a chalkboard to me because in most cases that's because that's somebody who maybe had a minor injury, didn't really get the appropriate recovery exercises in place. Dr. O'Kane mentioned the word "proprioception," and we should probably revisit that word in a little bit, but people can get this sort of chronic instability of their joints that is really just because they've not retrained the joint and the muscles appropriately, and those are people that absolutely have to be just coached past those points of sort of fear and loathing of the exercise and get to the point where they are strong again. Andrew Schorr: Okay, Dr. O'Kane, so again if my kid is complaining of a pulled muscle or this or that does that mean they lay in bed, stay home from school, or do they begin some activity and


rehabilitation? So how do we do that, because some kids will say, well, dad, I competed and now I just got to sit out, or others who say, yeah, I'm in pain, but I'm going to push through it. Dr. O'Kane: Right, and that's really difficult because kids are so different, but part of it is knowing your child, know whether they are the kind of child who is going to push through anything and it doesn't matter how much it hurts, or if you have the kind of child who is looking for any excuse not to participate. So that's a big step. And then talking to them a little bit about what happened and how that's impacting their day-to-day activities. So if there's a girl who is doing gymnastics, she fell off the balance beam and is complaining that her ankle is sore, but she's able to run around at school, she's able to do all of her normal activities, she's walking perfectly fine when she's doing everything except running around at gymnastics, then, you know, we may need to say, you know, this injury itself doesn't seem to be as much of a problem as it's appearing in the gym, let's look at some of the other things that are going on. But that person would probably be appropriate to continue, as opposed to the girl who sprains her ankle on the soccer field and continues to play through the whole game but is limping around for the next couple days, is not doing some of her favorite activities because her ankle is so sore. That says that that's a more significant injury that's really limiting activities outside the sports arena, so we need to pay attention to that. And then figuring out how you actually treat the particular injury kind of depends on what the injury is and what your comfort level in dealing with athletes is, and that's one of the things my husband and I, a sports medicine doctor, talk about. There are a lot of primary care doctors in the community who aren't necessarily as comfortable with some of the injuries as they could be, and sometimes they'll lean towards taking kids out of sports while they're waiting for that injury to heal, and that may or may not be the best approach. Sometimes that's very, very appropriate, and other times if they have a guided path back to recovery that can be done with a physical therapist or with a sports medicine specialist, then they can continue to play through their injury and recover just as quickly. Andrew Schorr: Right. I want to mention just a couple of things that you brought. First of all, red flag here, and I mentioned it at the beginning, there's a certain situation, a kid gets dinged on the football field, and we hate that word, but they're dazed, you know, there are some issues that need to be evaluated right away. So that is an alarm bell before they ever go back on the field or go back to practice, any of that. So listen to our programs on concussion. We have some great ones with Dr. Stan Herring, who is one of the team physicians for the Seattle Seahawks, and Dr. Rich Ellenbogen, also at the University of Washington, who is one of the leading experts for the whole NFL.


Also related to rehabilitation, one of the cool things about the university--UW Medicine Health System is you all deal with sports medicine, and then you have other people who can get involved if needed. I think of Brian Krabak, who is a rehabilitation specialist, and I think he's avid runner himself. Dr. O'Kane: Yeah, he's an athlete of extreme proportions. Recovery Andrew Schorr: Right. Right. And I've taken one of my kids there, so sometimes if needed there can be a referral like that to get further. But let's talk about sort of the more mundane. The kid competes on a Saturday in the big game and you want them to recover. So, Dr. O'Kane, what about tricks for a quick recovery, nutritionally? Dr. O'Kane: Right. There are a couple of things that can be really, really helpful. In the first two hours after exercise that's a really important time for refueling your body. Unfortunately, a lot of people don't feel like eating. They're tired, they're worn down, they want to play with their friends, but it's an important time to get some recovery food in. And that's a time when foods with a high glycemic index, actually a lot of sugar are going to be helpful. They stimulate the release of insulin, which then carries sugar into the muscles, which helps them to recover the fastest. So, interestingly, chocolate milk has actually been shown to be a wonderful recovery drink, and it's recommended as it's easy to drink, it comes--as Dr. Kramer mentioned earlier, it comes in little boxes that can be brought out in any temperature so it doesn't have to be refrigerated. And that has a great balance of carbohydrates with some protein and a little bit of fat. Andrew Schorr: So many people would say, oh, it's a sugary drink, bad thing, but you're saying the opposite. Dr. O'Kane: I am saying the opposite. In that first two hours after significant exertion of energy you need to replace that. You need to get the energy back into the muscles so that they can recover from basically the injury that occurred during the sport. They need to recover from that. After that immediate time, then we start to get back into getting the healthy food with a diet of 60 to 65 percent carbohydrate, maybe 20 to 25 percent fat, and some protein, with a little bit lower glycemic index so there's not as much of the simple sugar in there. Dr. Kramer: Can I say thing too about…


Andrew Schorr: Go ahead. Dr. Kramer: …about sports drinks, which, you know, I think that there's a lot of marketing of sports drinks, and a lot of people are going to say what about Gatorade, what about vitamin water, what about other these other things that are really marketed and have an implication that if you drink this drink you're going to be a better athlete and better at recovering from sports. And what I often share with people is just the story of where did the Gatorade come from. It was really developed by a biochemist at the University of Florida, and he was working with the Florida Gators, hence the word "Gatorade," and he just analyzed the sweat of these 18- to 22-year-old men that were perspiring in the Florida sun. Well, we have extremely different climatologic conditions in Puget Sound, and especially giving like an eight-year-old girl gymnast Gatorade is extremely inappropriate. It's got way too much salt in it, way too much sugar, not enough of the proteins, not enough of these other good nutritional elements. So I can't emphasize that I really warn parents that Gatorade is just not an appropriate recovery drink for most children, especially in our climatologic conditions. Andrew Schorr: So you're okay with chocolate milk? Dr. Kramer: Absolutely. When to Seek Care from a Physician Andrew Schorr: Okay. Endorsement there. I want to ask you another question, Dr. Kramer, and that is communication between the parent, the child and the clinic, and let's say you, as maybe the physician involved, when to call, when to call with concerns, when to come in? Dr. Kramer: That's a great question and I'm going to back it up even further about--because you touched on it. You know, where is the role of the family physician? Where is the role of the sports medicine physician? Where is the role of the rehab specialist? One of the--ideally, you have this great team like we have within UW Medicine where we have the network of people throughout that spectrum. One of the areas that an experienced primary care physician will focus is in really knowing the dynamics of that parent and child because just as we know our own kids, we know is that kid kind of a wuss or is that kid kind of somebody who is going to keep playing on a fracture, we need to get to know our families and their kids and know what's going on in that family's life. What are the motivators? Is this a family that is stressed because of other things that are going on and those stressors are going to make them perhaps less likely to tolerate


physical activity? Is this a family where they have a significant financial incentive, like an important scholarship, where they're going to perhaps err on the side of pushing that child to really continue to compete, especially during the time that the colleges are going and making their selections and offering scholarships? So getting to know that family system and what they're motivators, what their philosophies are. And then you have to tailor the advice based on that. So if I know that it's a child who perhaps has some significant incentives to compete, I'm going to coach the advice based on the thought that by the time they even get to the point of explaining there's probably a serious issue. Conversely, there's other people that perhaps are looking for the slightest excuse to kind of give up exercise, and those are people you have to couch the advice as saying, okay, well, let's try exercising. If you feel like your joints are loosening up during exercise that's probably a good thing, and that means that you could actually work through this. Andrew Schorr: All great comments. I want to get the last comment from Dr. O'Kane. Dr. O'Kane, I mentioned along the way we have this obesity epidemic and more and more in children. And when I do interviews with cardiologists they worry about giving heart medicine or even intervention in teenagers before long, and with diabetes it's become so bad. So we talked about preventing injury, but if we do all the right things what is your statement as far as the importance of exercise, whether or not they're an elite athlete? Dr. O'Kane: Yeah, that's a really, really good point. Exercise is wonderful, for kids, for teenagers, for adults. And one of the things that I really focus on with my patients and people that I see, particularly who are not terribly athletic and who maybe don't even enjoy doing sports, is to find an activity that you like to do, something that you're not going to dread every time you have to do it. For some people that's going out for a walk in the evening after they get home from work or school. For other people, they like more structure, and they prefer to go to a spinning class or a basic aerobics class at the gym so they have an set time and a set place that they're going to go. But the real key in preventing the obesity, diabetes, hypertension down the road is being active, and that's one of the places where we've seen kids and families over the years becoming less and less active. As a result, a lot of the health conditions are coming up. One of the things that Dr. Kramer and I also focus on is cutting down on TV and screen time in kids and teenagers, that they're activity involved--if they're actively watching TV then their body is not very active. So if we can get the TV turned off, get the Nintendo turned off, and get them involved in some kind of sports or just going outside and shooting hoops with a friend, that gets their body moving, it cuts down on calories--or increases the calories that they're burning off and just make them more active in general. And kids and adults who start to be more active feel better about themselves. Their bodies feel better, they feel stronger, and they're more inclined to continue with activities.


Andrew Schorr: Right. I couldn't agree more. I'm just going to end on one story as a parent. Now, I have one kid in college, one is headed to college next year, and I have this number three who is still around, and when he says, hey, dad, will you throw the football with me, I drop everything. Not because I'm an avid football player, I'm not a football coach, but it allows me to be active, and he's active, and we have time together. So this whole sports thing, if you have good nutrition, work on preventing injuries, we've given a lot of advice here, give proper attention to injuries if they develop, but stay active. It is great for your relationships, it's great for your kid, it's great for you. Ladies, would you agree? Dr. Kramer: I think that's just perfect. Andrew Schorr: So, Cindy and Hannah, you've been listening to all of this. So, Cindy, any advice for other parents about, first of all, trying to prevent injuries, sports injuries with your kids, and then if it's persistent pain that you get the help you need with an understanding doctor like Dr. Kramer. Cindy: I would just suggest being attentive to what the child is saying and be sure to seek advice from the coach in how to handle it, and take good care of their body while they're in training. Andrew Schorr: Right. And, Hannah, you're going to work on trying to prevent injuries in the future. Hannah: Yes. I have to be very careful to watch how I'm running. Andrew Schorr: Right. Well, relatively new sports for you, and it's pretty demanding, I know. You told me you run 25 miles a week or so. We hope you get to running soon. All the best. Hannah: Thank you. Andrew Schorr: Well, thank you so much, both, for your time, two wonderful family physicians who are devoted to you and your kids and the appropriate role of sports, and that's Dr. Sarah Kramer, who is at the UW Medicine Neighborhood Clinic in Woodinville, and Dr. Betsy O'Kane, who is at the Neighborhood Clinic in Shoreline. Dr. O'Kane, thanks for being with us. Dr. O'Kane: Great. It's been my pleasure. Thank you.


Andrew Schorr: It's fun. And, Dr. Kramer, thank you so much. Dr. Kramer: Absolutely, thank you. Andrew Schorr: This is what we do on Patient Power. It's so much fun. Have a successful sports season, whatever season it is, whatever sport it is for your child and for you, whether you're a coach or you’re on the sideline just cheering them on. Remember, knowledge can be the best medicine of all. I'm Andrew Schorr. Thanks for joining us.

Please remember the opinions expressed on Patient Power are not necessarily the views of UW Medicine, their staff, or Patient Power sponsors, Patient Power partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. Please have this discussion you’re your own doctor, that’s how you’ll get care that’s most appropriate for you.

advice and tips for preventing sports injuries october 17...

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