Friday, November 30, 2012

Lack of ZZZs May Increase Injury in Teen Athletes

Teens always seem tired, except maybe on Saturday night. As parents of adolescents, we’ve all been there. We encourage them to get sleep to be at their best: to get good grades, be sharp in school and at work, to stay awake and alert playing in goal and even to act polite at the dinner table.

But there may be something more important that comes from enough sleep. That’s an immunization against injury.  A recent study from Connecticut shows that athletes who slept “at least 8 hours per night were 68% less likely to be injured, compared with athletes who slept less. Interestingly, the level of sports participation, commitment in terms of hours of training and practice, number of sports, private coaching or an attitude of “having fun in sports” did NOT correlate with increased injuries. The study was reported in the November 2012 issue of Infectious Diseases in Children. (

No mention was made of types of injuries but we can be sure that head injury and concussion figure in this data. It’s startling to me when I review ImPACT tests on athletes at school, whether baseline tests or post-injury tests, how often students report 4-5 hours of sleep the night before. So in addition to making them prone to bad moods, inattention and trouble learning, we now can point out that lack of sleep may well have contributed to the injury itself.

All this seems logical to parents who are perennially concerned about teens’ lack of sleep. But this might not be so evident to coaches, certified athletic trainers and athletic directors. Of course, “policing” or encouraging good sleep habits starts at home. But sometimes a student will hear the advice with a more open mind from a mentor on the team.

Image from

Thursday, November 15, 2012

Cheerleading Hurts!

The days of innocent pompoms, splits and clapping are long gone.  And with the increasingly athletic and fast-paced routines and stunts that we see cheerleaders doing from elementary school on through professional sports, it is not surprising that the number and severity of injuries has increased.  In fact between 1980 and 2007, the number of hospital emergency room visits for cheerleading injuries increased by over 400%.

Responding to this data, the American Academy of Pediatrics just issued a policy statement about cheerleading injuries.  One of the problems they point out is that cheerleading is not widely recognized as a sport.  Even competitive cheerleading is not included on the NCAA roster.  This leads to the following consequences according to the AAP:

  • ·      Data collection about injuries is not uniform or monitored
  • ·      Valuable safety resources and regulations are not available to teams
  • ·      Coaches may not be qualified
  • ·      Access to certified athletic trainers and physicians is not certain
  • ·      Pre-participation sports physicals are not mandatory, so many participants are not well conditioned.

Stunting which involves “maneuvers in which 1 or more bases supports 1 or more flyers off the ground” accounts for nearly 2/3 of all cheerleading injuries and 96% of all concussions.  Although the overall injury rates for girls in cheerleading are lower than many other sports,  almost 70% of “catastrophic” injuries--resulting in permanent brain injury, paralysis, or death--among high school and college female athletes were among cheerleaders. 

The Academy issued a twelve point set of recommendations which ranges from instructions on safer surfaces to improved training for coaches and the presence of certified athletic trainers to asking for the NCAA to designate cheerleading a sport. These recommendations and the entire article can be seen here.

image from the via google images

Thursday, November 8, 2012

Pediatricians Should be Checking for STDs in Teens

Did you know?

Nearly 50% of all STDs occur in 15-24 year olds?

Four out of five US 18 year olds have "engaged in vaginal intercourse, oral-genital sexual activity, and/or anal intercourse."


The proportion of office visits made by 11-17 year olds to pediatricians (as opposed to other health care providers) has climbed to beyond 50%.  

These data do not overlap exactly due to age differences in the three different studies.  However, experts are inferring from this mix of data that more than ever pediatricians are in a position to be responsible for the sexual health of their teenage patients.  I would also bet that with more young adults under 26 being covered by their parents' insurance through the Affordable Care Act, these folks are also returning to their pediatricians at least up to age 21 or whenever they "graduate" and move on to internists, gynecologists, emergency rooms, free standing clinics or more often, no one.

What many parents and young people should recognize from this data is that a whole lot of sex is happening before intercourse these days.  No problem.  We told them to wait, didn't we?  We told them that they could get pregnant or HIV or other STd's, didn't we?  But what we didn't count on, maybe, or want to deny is that teenagers are crafty, inventive and sexy.  They have found new ways of being sexual and STD's are definitely transmitted this way.

What many parents and young people do not realize is that NO PELVIC EXAM is necessary to check for chlamydia and gonorrhea, the two most common STD's that we check for. The most widely used test is  a simple urine test that gets sent off to a lab.  Often providers and teens are reluctant to risk insurance companies or billers revealing that such a test was done.  Time to face reality.  Be glad if your pediatrician is screening for STDs. It probably also means that your teen has had a chat with the doctor about sex and sexuality.  And that's a good thing, for sure.

This new recommendation was published in the October issue of Pediatric News.

image from via Google images