Energy Drinks!!

Performance. It’s what we expect out of our children (and ourselves). In every area of life:  Academics, athletics, you name it- we have an insatiable desire to achieve.This inaugural column is dedicated to the topic of energy drinks and their safety.  Are they all they’re touted to be?  Do they truly enhance performance?  Bring mental clarity and acuity?  Give us that “edge” over the competition? 

Believe it or not, the food industry outspends the pharmaceutical industry on advertising their products.  Nearly $40 billion per year.  The beverage industry is part of that.  This year, sales are expected to exceed $9 billion in energy drinks alone.  That’s billion…with a B

So What’s the Big Deal?

For starters, energy drinks like Red Bull, Monster, No Fear, and others may contain as much as 4 times the caffeine than most sugar-laden drinks. 

Caffeine is a diuretic.  It causes you to lose much needed water necessary to keep our soccer kiddos playing back to back games in the heat only an Okie could love!

These drinks have a side-effects list a mile long.  The potential dangers of energy drink consumption is so serious, the American Association of Poison Control Centers began tracking nationwide overdose and side-effects last year.  Most 2011 cases involved children and teens, 25 percent (of the 300 reported thus far) involved children under 6 years old!  Seizures, hallucinations, rapid heart rate, chest pain, high blood pressure, irritability, and insomnia have been reported in the medical literature.  Parents, these drinks mixed with alcohol have resulted in death!  France and Denmark have recently banned the sale of Red Bull.  That’s a huge caution flag, let’s take notice.

So What about Gatorade, Powerade, Make-Me-the-Strongest-Fastest-Longest Lasting-ade?

Research points to less than 1 percent of those who use sports drinks actually need them.  Intense cardiovascular aerobic activity lasting a minimum of 45 minutes, with profuse sweating constitutes their use.  Anything less corrodes your teeth, causes weight gain, and dramatically reduces muscular strength. Seriously.

Rules To Live By

  •  If the label has ingredients you can’t pronounce, don’t drink it.
  •  If it’s the same color as a highlighter, don’t drink it.
  •  If it was not here 10,000 years ago, don’t drink it.
  •  If it starts with “wa” and ends in “ter”, drink it!  Lots of it!  Athletes should consume at least half their body weight in ounces of pure, ionized water per day.

 Everything Has a Price

Our kids encounter so much more than we ever dreamed.  The pressures they live with are at times more than they can cope with.  The emergence of fad “energy” drinks driven by media’s superhuman claims of greatness, have put our children at risk.  It’s up to us to be aware of such dangers…personally, I’m not willing to take these risks anymore.  Are you?

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Orthotics: A Difference Maker!

As parents with athletic children, we are always searching for that competitive edge that may allow them to train harder, reduce injury, and ultimately acquire that next level. Just as Callaway marketed the Big, Bigger, Biggest Bertha as the answer to the golfer’s distance dilemma, athletes of all types are seeking solutions. The unfortunate mistake most athletes make is spending their hard-earned dollars on equipment…rather than THE greatest equipment ever created–your body! You see, it’s not the $300 Predators that make you a great player, it’s the structure that determines the function. Restoring and/or optimizing your body’s structural alignment by simply addressing the feet can be inexpensive, preventive, and a game changer.

Pop quiz…

What has three arches, 20 muscles, 26 bones, and can support six times your body weight? Your feet! They are amazing in their working. They are the foundation of your body. They protect your spine, bones in your lower extremities, as well as the muscles and soft tissues from the damaging compressive forces dealt to your body on a daily basis. During our children’s first 12-18 months of life, the foot is comprised of mainly cartilage. As they progress into standing, the cartilage rapidly transforms into bone. From 2-6 years of age, the legs and feet go through a “bowing”, and “toe-in” foot configuration. At three, they exhibit a “knock-kneed”and “toe-in” stance, and typically straighten out by age six. By this time, the young foot closely resembles the adult foot. So, if early signs of pronation are present-they are not likely to disappear. As the adage goes: An ounce of prevention is worth a pound of cure.

The human body has five parallel planes. I teach my patients the first plane begins at the feet or subtalar joints. The next plane is at the knees, then hips, shoulders, and terminates at the base of the skull. This is referred to as the kinetic chain. If one leg is short, or pronation exists due to loss of height in the arch, knee pain, hip pain, and even headaches can ensue. By restoring balance within the body, proper pull can then be restored by the attached muscles and subsequent strength gains can be attained-dramatically reducing the risk of injury.
In my 20 years of dealing with student athletes of all ages, the most common conditions warranting  and a custom orthotic are pronated (flat) feet and short leg syndrome. Pronation results from a weakness in the muscle of the foot. This weakness then creates instability within the bones of the arch of the foot. If left untreated, over time, another condition common  to athletes can develop called plantar fasciitis. If you’ve never had it, count your lucky stars! It burns. It’s extremely painful to walk. It aches. Its life-altering for an athlete.

A recent study in Foot Ankle International found a significant correlation between pronation and overuse athletic injuries. The greater the pronation, the greater the chance for injury.
*Low back pain
*IT band syndrome
*hip bursitis
*hip joint capsulitis
*Piriformis strain/syndrome
*pelvis strain
*plantar fasciitis
*knee pain/non–contact ACL injury

A Simple Pronation Test

Have your child stand barefoot on a hard surface, like wood or tile, with their feet shoulder width apart. Parents, kneel down and slide your fingers under the right arch, then left arch. A good arch has enough room for the forefinger to slide under it at least to the first crease in your finger. If not, your athlete may be exhibiting signs of pronation and corrective action should be considered.

Overuse injuries and recurrent “nagging” injuries like ankle sprains, chronic knee pain, and plantar fasciitis can prevent our young athletes from performing at their best. Properly attending to early warning signs and implementing supportive correction are imperative for their growth and development as a person and athlete.

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Use Your Noggin Wisely

If a shot to the head, neck or upper body of your athlete has caused a headache, dizziness, nausea, or loss of consciousness- they’ve likely suffered a concussion! The concussion is a unique clinical enigma. It is invisible.  It typically heals within a relatively short period of time. If monitored properly, your athlete can safely return to play.

It is my intent to provide our families and coaches with a general overview of the signs, symptoms, management, and treatment of sports-related concussion.

Up to 3.8 million concussions occur among participants in sports and recreational activities each year.  Published reports indicate increased incidence of concussion in contact sports such as football, ice hockey, soccer, and lacrosse.  Recent research suggests the reported incidence rate of concussion is higher in female athletes, especially in sports with the same rules, like basketball and soccer. Probably because the ladies play harder! (Sorry boys, I couldn’t resist-jk!)

What is a Concussion?

When an athlete’s skull comes in contact with another object such as an opponent, the ball, the ground- or comes to an abrupt halt (like whiplash), the soft brain rebounds off the hard inside of the skull. Swelling of the blood vessels and abnormal communication of the bruised neurons within the brain result in a myriad of symptoms and cognitive difficulties.

What are the Signs and Symptoms of a Concussion?

Numerous symptoms can manifest in the concussed athlete, with one very  common misconception– that loss of consciousness must be present in order for a concussion diagnosis to be assigned.  Several studies suggest different.  Less than 10 percent of athletes who sustain a concussion actually experience loss of consciousness. 

Parents, coaches and the players themselves must be armed with the basic knowledge of the symptomatic picture of concussion. Sports medicine professionals often rely too heavily on the athlete’s understanding to tell them if they are experiencing such symptoms. Herein lies the problem: Lack of knowledge leads to a lack of a proper diagnosis  Should your athlete continue to play while concussed, a far greater risk for more catastrophic injury exists.  Second impact syndrome (sustaining another concussion before recovering from the first one) can lead to symptoms lasting for months, and even death in rare instances. Let’s NEVER underestimate the seriousness of concussion!

So, here’s what you look for…

Diagnosis is based on how the injury occurred and the presence of specific symptoms, confusion being a primary concern. I use the TAG principal of confusion:

     Thought: Can the athlete maintain a coherent stream of thought?

     Awareness: Is the athlete easily distracted? Can’t focus on the “now.” 

     Goal-directed movements:  Can sequential  movements be carried out?

 The following are CONCUSSION symptoms:


Prolonged headache

Visual disturbances


Nausea or vomiting

Impaired balance

Memory loss

Ringing ears

Difficulty concentrating

Sensitivity to light

Loss of smell or taste

** If any of these occur after a blow to the head, a health-care professional should be consulted ASAP.

How do we  Prevent a Concussion?

No helmet can prevent it. No amount of conditioning can dissuade it. With competition comes contact…so, let’s implement steps to reduce the chances of sustaining such an injury.  Soft protective headgear can reduce the shock and impact force(s) the skull encounters.  Proper fitting and instruction on its use is crucial.  In the July issue of the British Journal of Sports Medicine, an innovative study of 268 adolescents from 12 to 17 years of age revealed only 52 of them wore headgear during this period.  The risk of concussion was 2.65 times higher for players who were not protected! In fact, 52.8% of the adolescents who DID NOT wear headgear reported being injured compared to only 26.9% of those who did. These results are staggering- since approximately 80% of sports-related injuries are not recognized or reported! Prevention equals protection.  By the way, since 2002, the Fédération Internationale de Football Association (FIFA) has authorized soft headgear during official matches but has not made it mandatory.

Soccer players should make sure they use proper technical form to head the ball. Failure to do so may increase the chances of sustaining a concussion.  Not to worry, our coaches are all over this!

How do we Clinically  Manage a Concussion?

The initial management of a concussion begins with basic ABC’s of life support protocol. Airway. Breathing. Circulation. If the athlete is unconscious, we must assume a neck or spinal injury until proven otherwise. Once a spinal injury has been ruled out, the above symptoms list can then be reviewed. If in fact concussion is even suspected, the player SHOULD NOT return to play and must seek medical attention for an extensive evaluation. “When in doubt- sit out!” There’s always another game. 

How do we Treat a Concussion?

Concussed athletes should be regularly monitored for any signs of deterioration and receive a full medical evaluation following injury. The recommended return-to-play process includes:

1. No activity. Complete rest.

2. Light aerobic exercise: Walking or stationary cycling.  No resistance training.

3. Sport-specific exercise and progressive addition of resistance training (bands, etc.) 4. Non-contact training drills.

5. Full-contact training after medical clearance.

6. Game play.

If concussion symptoms reappear, the athlete should revert back to the above plan and resume the progression after 24 hours. These guidelines allow for a more individualized approach when returning an athlete back to competition. 

Same-Day Return-To-Play (RTP):  It is essential to understand there is no same-day RTP for the concussed athlete!

Post–Same-Day RTP:  Before returning to exercise, the athlete must be asymptomatic or returned to baseline symptoms at rest, and have no symptoms with cognitive effort.  Amnesia surrounding the event may be permanent, but the athlete should no longer be taking medications that may mask or modify the  symptoms of concussion.  The athlete’s clinical neurological examination (cognitive, cranial nerve, and balance testing) must have returned to baseline before resuming exercise.

Progressive aerobic and resistance exercise should be utilized before full RTP is authorized. This process may take days, weeks, or months. Remember: Recurrence of symptoms and/or signs warrants additional rest and monitoring.

Although our athletes may often feel pressured to return to play prematurely because of their competitive nature, let’s use prudence when dealing with such critical issues as those involved in sport-related concussion. I always tell my patients “I’d rather over-call it than miss it.” Translation: Careful, step-by-step evaluation ensures we treat the problem correctly.

Hope this helps! May our young athletes enjoy great success in every area of their lives. 

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