Halloween Safety

With Halloween coming up tomorrow, we thought it pertinent to discuss some safety issues around the holiday.

Trick or Treating Safety

1. Make costumes out of bright visible colors or use reflective tape to help make children visible.
2. If children are going out without you, make sure you agree upon a route and to stay in well lit areas.
3. Have the children take a flashlight.
4. Remind the children not to eat any candy prior to you sorting through it.  

Sport and Halloween

If your child is allowed to wear their costume to their sporting event, it is important to keep in mind if it will restrict participation.  As when planning their trick or treating costume masks can restrict vision or breathing. How tight or loose fitting the clothing is will greatly effect your young athletes ability to participate fully.  Both baggy and tight fitting costumes pose safety hazards, the may restrict movement or become a tripping hazard.  Accessories such as wings, tails and head gear can throw off balance of the athlete as well as pose a risk to the other participants.  Depending upon the costume it may be wise to have two costumes, one for school and trick or treating, the other for sport related activities.  

Keeping up with Nutrition

Prior to heading out trick tor treating or to the local Halloween party, it is important to feed your young athlete a healthy supper.  This will help fuel them for the fun and excitement that they are about to participate in as well as decrease the urge to over indulge in their loot.  By no means do we think that young athletes are immune to wanting to consume the goodies they will gain from their evening of going door to door, but if they have had a filling meal before hand they will not use the candy as their meal.  Post trick or treating, moderation is key.  Having some candy each day will benefit them in the short and long term.  In regards to sport if they only have a small amount of candy each day will keep their energy on a more even level.  Long term advantage is their candy stash will last longer.  

Have a safe Halloween both at sport, school and play.  

Antioxidants and Sport

Why is it important for all of us to eat fruits and vegetables and other plant based whole food.  Well quite simply it is the nutrients that they provide.  The nutrients from these foods are special, they are called antioxidants and they help protect your body and cells from the damages that occur on a daily basis.

Antioxidants are found naturally in food and come in the forms of vitamins, plant chemicals such as flavonoids and carotenoids, and minerals.  The role that antioxidants play in the body is to protect cells from damage.  The damage that occurs to the cells is from free radicals.  Free radicals are produced during metabolism.  Free radicals can also be caused from environmental factors such as pollution, smoking and chemicals.  So with every breath we take, stress inducing moment, and exercise we complete we are producing free radicals in our body.  For athletes who are engaging in strenuous training their levels of free radical damage is huge.  The best way to counteract this damage is through diet.  

By consuming antioxidant rich foods they counter balance the free radicals in the body.  Antioxidants can be found in fruits and vegetables, whole grains, lentils, beans, nuts, seeds, vegetable based oils, garlic and green tea.  By in large fruits and vegetables are great sources of antioxidants.  The Canada Food Guide recommends 4-6 servings of fruits and vegetables for children, 7-8 for teens and between 7-10 for adults.  The Food Pyramid recommends 2-4 servings of fruits and 3-5 servings of vegetables.  These recommendations are per day not per week, or for some people per month.  Typically raw is better than cooked when dealing with fruits and vegetables but in some cases cooked is better.  Spinach, kale and chard is better cooked as the cooking process releases more beta-carotene and lutein.

Of fruits and vegetables berries, broccoli, tomatoes, red grapes, spinach and artichokes are considered high in antioxidants.  As each food is created differently it is important to eat a wide variety of fruits and vegetables to get all the nutrients and minerals available.  A good rule of thumb is fill your plate with the colors of the rainbow.  For many people, especially athletes finding time to eat the variety and amount of is hard.  If you are having difficulty achieving this level of consumption, you can consume a whole food based supplement made of a variety of fruits and vegetables.

Providing your body with the proper nutrition it needs to grow and perform is essential.  Knowing what you put in your body is key.

MRSA in Sport

It used to be said that cleanliness is next to godliness.  In the case of athletes and the locker room that holds true.  Methicillin resistant staphylococcus aureus (MRSA) comes in two forms HA-MRSA which is health facility based and CA-MRSA which is community based.  In the world of sport we need to pay attention to the community based MRSA.

The main cause of all MRSA is the over prescribing of antibiotics.  Even the proper use of antibiotics has lead to the increased resistance of bacteria.  In sport settings there are five C's of risk.  Contamination, lack of cleanliness, compromised skin, crowding and contact.  30% of all individuals are carriers of CA-MRSA which is why dealing with the 5C's is so important in the prevention of MRSA.  Cleanliness of both the athletes, their equipment and the facility is pivotal in the early stages of prevention.  Athletes should shower immediately after participation, soap and towels should never be shared.  Paying attention to any type of open wound is imperative.  All wounds must be cleaned properly and covered to avoid the chance of infection entering the body.  Crowded locker rooms or dormitories increases the chance of infection spreading. If you are in charge of the locker room, use a cleaning solution of 1:100 bleach to water. The use of antimicrobial cleaners can also reduce the amount of bacteria on surfaces.  Main areas that you need to be concerned with are the locker room, shower facilities, weight room, and any adjoining areas to the locker room.   Contact of an infected person onto either training surfaces or other athletes either by direct or indirect contact start the transmission process.  By having your athletes maintain proper levels of hygiene, cleaning their gear, and maintaining clean facilities will help decrease the chance of CA-MRSA being transmitted.

As a coach, parent, trainer or athlete it is key to pay attention to skin condition.  If a wound is present it must be cleaned and covered before the athlete returns to participation in sport.  If a wound does go untreated look for the following signs of infection.  Hot, red and raised area around the wound is the standard signs for any infection.  CA-MRSA will start as small red bumps similar to pimples and will develop into painful abscesses.  Early intervention and treatment is essential to the athlete returning safely from CA-MRSA.  If any athlete does have CA-MRSA the whole locker room must be thoroughly sanitized, this includes all hard and soft surfaces and all clothing.

Prevention of all injuries is important however the prevention of MRSA is even more important due to the long term dangerous health effects.

References:
Rogers, Sharon. A Practical Approach to Preventing CA-MRSA Infections in the Athletic Setting, 2008 Human Kinetics - ATT 13(4), pp. 37-41
www.cdc.gov
http://www.phats-sphem.com/newsletter/Newsletter_spring13.pdf
www.mayoclinic.org/mrsa

Dynamic Stretching in Warm Up

This week Jasmine Eisenhaur, PT, MScPT is our guest blogger. This weeks focus is the importance of dynamic stretching during warm up.

As a physiotherapist who has been involved with sports for many years, whether as an athlete or a team therapist, it amazes me how many athletes still continue to statically stretch as part of a warm-up prior to competition. While this was previously the main way to stretch as part of a warm-up, it has long been known now that dynamic stretching is the more beneficial method. As Faigenbaum et al reported in their study, a brief period of static stretching negatively affected jumping and sprinting performance in children (2005). While static stretching can help to improve range of motion at a joint, in a muscle, and in the surrounding fascia, there is most definitely a more ideal time to do this than before a competition. McMillan et al found that the group who performed a dynamic warm-up had  improved performance on their measures of agility, functional leg power and total body power compared to groups that performed a warm-up with static stretches or no warm-up at all (2006). 

There are some basic guidelines you can use to ensure any athlete is getting a proper warm-up:

- Start with some light aerobic exercise ie. a jog, riding a stationary bike. Ideally this should be long enough that the athlete breaks a sweat. This is usually a few minutes in length and ensures that blood flow to the muscles has increased.

- Do dynamic stretching exercises for any muscles that will be used during the competition. Dymanic stretches should be controlled movement, meaning never too fast to lose control of the affected body part, and should be painfree.  The stretches should also move through as much of the muscle's or joint's range of motion as possible, ie. don't do a walking lunge and only go halfway down - get the most out of the stretch. 

- An effective stretching program will leave the athlete feeling limber and ready to participate without fear of injury during the competition.

While this may sound like a lot, there only needs to be one stretch for each muscle group. In many sports, ie. hockey, another more sport-specific warm-up is done before the competition, which emphasizes the importance of keeping the dynamic warm-up simple but effective while still preparing the athlete for the sport-specific warm-up. 

The one instance I will educate athletes on using static stretches as part of a warm-up is when they have been injured recently and they feel that they simply will not perform as well without statically stretching the affected muscle or joint. However, I will generally recommend to that athlete to follow the static stretch with a dynamic one when it is possible, to ensure the muscle is dynamically prepared for the competition ahead. 

Proper Concussion Management

Gone are the days of returning to the game the same day you suffered a concussion.  Well it is supposed to be.  Even with all the media attention and front line education on concussions; coaches, parents, officials, athletes and trainers are still missing the message.  After a concussion has been diagnosed it is extremely important to have the athlete rest.  Not only physical rest but cognitive as well.  No matter the age of the athlete it is important to offer them this rest.

I has amazed me over the years that parents, athletes and coaches have tried to circumvent the return to play protocols because the concussion occurred in another sport. It is the parents role to inform teachers and other coaches of their child's concussion.  Concussed athletes may need to take time off work or school, to give the brain the rest it needs.  Student athletes need to be given the chance to fully recover before returning to full mental and physical activities.  Having athletes refrain from attending school while still suffering symptoms will aid in their recovery.  It may be required for the student athlete to remain home from school until symptom free as the level of concentration at school is too much.  Gradually introduce them back into school and homework.  Consultation with their teachers is important, ask for extra time to complete assignments and tests.  The other major part of cognitive rest is to take away screen time.  Put down the phones, turn off the computer, TV and video games.  That scream you just heard was every young athlete having a minor heart attack due to this.  The bright lights, sound and concentration needed for these activities do not help the brain heal.

Right after injury it is imperative that you do not give the athlete any pain medication.  Advil, Tylenol, Aspirin and Ibuprofen will only mask the signs and symptoms of the concussion.

Your qualified health care provider will complete a concussion test and compare it to the athletes baseline evaluation.  Only when an athlete is sign and symptom free do they progress onto step two of the return to play process.  A minimum of 24 hours is required between each step where the athlete must remain symptom free.
Step 1 - Rest until 24 hour symptom free.
Step 2 - Light aerobic exercise such as biking or jogging for 20-30 minutes.
Step 3 - Sport specific exercises such as skating in hockey, running drills in soccer or football.
Step 4 - Non-contact training drills such as passing drills.
Step 5 - Full contact training drills upon medical clearance 
Step 6 - Return to normal game play.

An athlete should remain at step 5 until both the athlete, parent and coach feels that the athlete is able to keep up with the play both physically and mentally.

Key points to remember are:

• Return to learn before return to sport
• No difference in management between elite and non-elite athletes.
• Younger athletes may require longer to recover.  

Rushing any athlete back to sport to quickly can cause serious damage both to the brain and other areas of the body. Following proper concussion management may help to decrease the long term effects of concussions.