McKnight Pediatrics

Stay In Touch

Soccer Injuries and Prevention Techniques

August 4, 2020

From the American Academy of Pediatrics:

Soccer injury rates differ by age and gender, but players can lower the risks of landing in the emergency department with knowledge of common injuries.

Youth soccer is a tremendously popular year-round sport with many physical fitness benefits, but, as with any contact sport, it carries a risk of injury to players that should be discussed with the family pediatrician.

The American Academy of Pediatrics (AAP), in a comprehensive review of the most recent research, will publish the clinical report, "Soccer Injuries in Children and Adolescents," in the November 2019 Pediatrics.

"Families, soccer players and coaches should be aware of the most common types of injuries -- from sprains and fractures to concussions - so that we can work together to prevent them," said Andrew Watson, MD, MS, FAAP, a lead author of the report, generated by the AAP Council on Sports Medicine and Fitness.

"We know that there are circumstances when players are more likely to get hurt. Our report describes the research behind ways to improve safety on the field, such as specific neuromuscular training programs and adherence to the rules, that can potentially improve the safety of our young athletes."

As the rate of soccer participation soared from 1990 through 2014 -- rising by an estimated 90% -- the number of injuries reported rose dramatically, as well. One retrospective study of 25 years of emergency department visits showed the annual number of soccer-related injuries among 7 to 17-year-olds per 10,000 soccer participants increased by 111 % from 1990 to 2014.

The majority of youth soccer injuries result from player-to-player contact, with a significantly higher proportion of injuries occurring during competition rather than practice, according to one study. More athletes are suffering concussions and anterior cruciate ligament (ACL) injuries, particularly female players.
The AAP recommends:

- Neuromuscular training programs that teach proper landing and stopping techniques and develop balance.- An emphasis on fair play, rule enforcement and proper, age-appropriate heading techniques to reduce risk of concussion.

- Injury reduction strategies including the completion of a preparticipation examination prior to the start of the season; proper hydration and rest; modification of activities in hot, humid weather; use of appropriately sized shin guards and mouth guards; and use of protective eyewear.

- Basic Life Support training of coaches and placement of automated external defibrillators at practice and competition sites.

The clinical report also examines research concerning other safety gear, footwear, playing field turf or grass, and environmental conditions.

"We encourage kids to participate in athletic activities, especially team sports, in order to develop skills, as well as build fitness and confidence while having fun. Playing soccer is a great way to achieve these goals," said Jeffrey M. Mjaanes, MD, FAAP, a lead author of the report. "We just want to be sure they play safely and leave the field with a smile, not a limp."

How Solitude Can Help You Regulate Your Mood

July 27, 2020

From NPR:

This year has given many of us a whole new understanding of solitude -- whether we wanted it or not.

That's been one of the odd side effects of the coronavirus: Between the shelter-in-place orders and social distancing guidelines issued across the world, many of us have spent weeks at a time seeing no one in person but our local grocery store clerk. Or perhaps cramped among family or working at a busy hospital or grocery store -- just dreaming of a lot more alone time.

Either way, being alone has been on our minds -- and on the minds of experimental psychologists, too. Over the past few years, researchers have devoted significant study to the concept of solitude -- its potential benefits, its role in our lives, even its basic definition.

So, here are a few takeaways from their recent work -- with an eye toward how you can make solitude a healthy practice in your own life.

1. Solitude is in the mind of the beholder.

Let's get one crucial idea out of the way first.

"There isn't even a really agreed-upon definition about what solitude means," says Robert Coplan of Carleton University in Canada.

And he should know. Beyond his role as director of the Pickering Centre for Human Development, he and colleague Julie Bowker edited The Handbook of Solitude, a collection of some of the latest scholarly research on solitude.

It makes sense that there should be some confusion. After all, are you experiencing solitude if you are stranded on a desert island ... with a good WiFi connection and updates to peruse on Instagram? What about when you're on a crowded subway platform, but with earbuds in and everyone else ignoring you? Where is the line between "together" and "alone"?

Those questions aren't easy to answer, and to date, psychologists haven't settled on a single definition of solitude or the nature of its "active ingredient," in Coplan's words.

But many agree, at least when conducting their studies, that the key rests with whether participants feel alone. One's subjective perspective matters more than whether their objective circumstances would bear that out on closer inspection. In other words, if you feel alone, you probably are -- at least for the purposes of your mental state.

2. We may crave time alone the way we crave time with others.

When we feel lonely, it's because our desire for company exceeds our ability to find it. And Coplan posits that this process can work in reverse, as well: If our desire for solitude exceeds our ability to find it, we can also struggle with feelings of discomfort.

"All the evolutionary psychologists talk about the need to affiliate with others, that we evolved with this need to be around others. And that's 100% true. I also think there is a need for solitude, which has been less well defined and less well discussed," he explains.

"If we're not satisfying that need, there might also be a cost, just like there's a cost of being lonely if you don't satisfy your need to belong."

What constitutes the right amount of solitude varies person to person, Coplan says, but when you aren't getting enough time on your own, you may begin to feel more irritable, anxious or put out.

3. Don't expect an epiphany.

Easy there, Thoreau. Don't get solitude mixed up with the promise of insight or revelation. While the concepts are often paired in books and films, real life is obviously a lot more complicated. Sometimes solitude is calming, sometimes meaningful, but for a lot of us, it's often downright uncomfortable.

Just look at a 2014 study, in which a majority of participants preferred giving themselves an electric shock(!) to simply sitting alone with their thoughts for up to 15 minutes. Perhaps you, too, will find yourself wishing for a simple electric shock while waiting impatiently for that lightning bolt of inspiration.

But that bolt from the blue need not arrive for solitude to show some psychological benefits. And you don't need to emulate a medieval hermit to get the kind of time and space needed to feel those effects either.

Paul Salmon, a psychology professor at the University of Louisville, recommends looking at your quest for solitude more along the lines of a high-intensity interval workout -- as a variety of exercise that can be brief and scattered throughout the day but no less effective for it.

Be opportunistic, Salmon says.

"Maybe even go into a room if you have a space that you can go to where you can be alone for a little bit," he says. "And also, to be clear, this is not isolating yourself but simply giving yourself a time to kind of recharge the batteries."

Thuy-vy Nguyen has found that just 15 minutes in solitude can have an effect. A professor at the University of Durham in the U.K., Nguyen was tracking something she calls a person's arousal level: High arousal could mean something good (excitement) or bad (anger), just as low arousal moods could be good (contentment) or bad (boredom).

And in just that brief window of time, Nguyen says she has found that solitude correlates with a drop in those high-arousal moods. That means, effectively, that time alone may simply help even us out.

4. Solitude can be a communal exercise.

Funny as it may sound, pursuing your solitude may help develop your sense of community. By asking others for the time to yourself, and explaining why this is no reflection on their company, Salmon says you are bringing others into your trust, which they may appreciate.

"Explain that it's not like you're isolating yourself and setting yourself apart, but that what you're doing is something of personal value," he recommends. "By doing so, you're inviting other people to at least acknowledge and accept that and possibly even engage in it themselves."

And if even this does not help you obtain a separate space of your own, even for a little bit, remember that in many ways, solitude is what you make it. According to Salmon and his wife, Susan Matarese, a political scientist also at Louisville, one doesn't need to be physically alone to experience solitude.

Just close your eyes, turn inward for a bit and pay attention to what's going on in your body and what thoughts are going through your brain.

Choosing Organic is Even More Critical Now

July 21, 2020

The world is slowly reopening, but the COVID-19 crisis isn't over, and everyone still has concerns. While in many areas, the number of cases is decreasing, our health will remain in danger until we make a major change and paradigm shift.

That change is closer than you might think. It's in your kitchen, your backyard garden, and at your local farmers market.

The solution is our soil and in our food. What we eat is critical to protecting our health, and our broken food system needs an overhaul.

The coronavirus pandemic has focused the spotlight on the importance of health, immunity, and disease prevention. We watched as our medical systems became inundated with patients, while feeling helpless to support our own health in the face of an invisible threat.

As we return to a new normal, it is imperative that we stay vigilant about maintaining our health. Sales of organic food rose 22 percent in March, 18 percent in April, and 16 percent in May as consumers looked for ways to boost their immune systems. We cannot return to our industrial, chemical food system as the crisis recedes -- a food system that is harming both people and the planet -- and expect positive impacts on our personal health. We need resilient agriculture for the future.

What we eat is directly related to how we feel and how we protect our health. So why have we allowed an agricultural system that sprays our food with chemicals, disproportionately harms vulnerable communities, and poisons our environment be the main source of food for our families? Why is our medical system so out of touch with the role that food plays in our physical health, prescribing pharmaceuticals for lifestyle diseases that create even more side effects and problems?

For too long, farmers and doctors have been siloed while pursuing the same goal -- keeping people healthy. Remember the grade school adage "an apple a day keeps the doctor away?" It's far past time that we bring these individuals and professions back together.

The path towards change can be found in regenerative healthcare. Regenerative organic food is free of the threat of chemicals like glyphosate, a probable carcinogen. At Rodale Institute, our research has shown not only that organic can feed the world, but that it can feed the world's families more nutrient-dense food, full of natural antioxidants and phytonutrients that can prevent, suspend, and even reverse the most wide-spread of lifestyle diseases.

And yet, the standard American diet gets only 11 percent of its calories from whole plant foods, and more than 50 percent from highly processed products. Today, more than 70 percent of global deaths are due to lifestyle-related diseases such as cancer, cardiovascular disease, diabetes, and chronic immune disorders.

When facing a threat as strong as COVID-19, we need to avail ourselves of every support system we have. Our diet is one of the simplest ways to improve our health and take control over our lives. And yet, nutrition is roundly downplayed in the medical community. Many medical students receive less than 25 hours of training in nutrition.

We need to deploy a health care system in which farmers and physicians work together to inform a prevention-based approach to human and environmental health. Regenerative healthcare is the only path forward.

We must combine what we know about the power of food with our knowledge of nutrition and our bodies, working to prevent disease through an organic, whole-foods, plant-forward diet that begins on farms that work in harmony with nature.

For more than 70 years, Rodale Institute has been researching the benefits of regenerative organic agriculture. From the beginning, our mission has been to support healthy soil that grows healthy food, feeding healthy people.

Results from Rodale Institute's Farming Systems Trial, a 40-year side-by-side comparison of organic and conventional grain cropping systems, has shown conclusively that organic systems are not only comparable to conventional systems in terms of yields, but can yield up to 40 percent higher in years of inclement weather like drought. Organic systems also use 45 percent less energy, reducing carbon emissions. Consumers clearly understand that organic food is healthier, as organic grocery sales and CSA memberships have skyrocketed since the pandemic took hold.

A shift in our medical system away from pharmaceutical-based disease management towards an integrative system founded on lifestyle medicine -- supported by organic, nutrient-dense whole foods -- could dramatically alter the trajectory of chronic disease and create a healthier future.

Let us agree, we cannot forget the critical role our food plays in protecting our health. Though the everyday threat of COVID-19 will eventually be a memory, the decisions we make about our food will always affect us. Take the first steps to protect your health now. You won't regret it.

Interested in more solutions? Rodale Institute, with our partners at The Plantrician Project, have released a new scientifically documented white paper that brings together, for the first time, doctors, scientists, and farmers to analyze the ways our food system has failed us, and, more importantly, solutions for a new path. "The Power of the Plate: The Case for Regenerative Organic Agriculture in Improving Human Health" is available for download at RodaleInstitute.org/poweroftheplate.

Coronavirus Face Masks & Protection FAQs

July 17, 2020

From Johns Hopkins Medicine:

ew information is emerging every day on how the new coronavirus spreads and the best ways to protect against COVID-19. The most effective protections include washing your hands frequently with soap and water and practicing physical distancing. However, wearing cloth face masks or coverings in public when physical distancing can't be observed does offer protection against spread of COVID-19.

Lisa Maragakis, M.D., M.P.H., an expert in infection prevention, provides guidance based on Johns Hopkins Medicine policy.

Should I wear a face mask or covering for coronavirus protection?

Yes, if you are in a public place where you will encounter other people, you should wear a mask.

How do you properly wear a face mask?

Your mask should cover your face from the bridge of your nose to under your chin. It should be loose fitting but still secure enough to stay in place. Make sure you can talk with your mask on and that it doesn't irritate you, so you are not tempted to touch it or pull it out of place, which could put you at risk from touching your face or limit its effectiveness.

Can a face mask prevent coronavirus from spreading?

Face masks help prevent the spread of COVID-19. Because it's possible to have coronavirus without showing symptoms, it is best to wear a face covering even if you think you are healthy. A mask helps contain small droplets that come out of your mouth and/or nose when you talk, sneeze or cough. If you have COVID-19 and are not showing symptoms, a face mask reduces your chance of spreading the infection to others. If you are healthy, a mask may protect you from larger droplets from people around you.

Different levels of masks are appropriate for different situations and needs. At Johns Hopkins Medicine, we currently require everyone entering our facilities to wear a mask, with the exception of children under 2.

Here is how masks help prevent spread of COVID-19.

Masks for the Public

According to the CDC, recent studies indicate a significant portion of people who have COVID-19 don't show symptoms, and the virus can spread before they realize they are sick. This research -- combined with the fact that the coronavirus can spread through close proximity to others, often by speaking, coughing or sneezing -- led to their recommendation for the general public to wear cloth masks in public, especially in situations where physical distancing may be difficult, such as grocery stores or on public transportation, and in areas where there is a significant amount of community transmission.

Some states now require face masks in retail stores and on public transportation. In Maryland, face masks or coverings have been required in retail stores and on public transportation since April 18.

People with risk factors for severe consequences of COVID-19: This would include people over age 65 and those living with heart disease, diabetes, obesity, chronic lung disease, immunity problems or cancer.

While physical distancing and frequent handwashing are the best ways to protect against COVID-19, you should check with your doctor about the best option for you. Johns Hopkins Medicine offers these directions for a homemade mask and child-size masks, intended for use in non-patient care settings.

Masks for COVID-19 Patients and Their Caregivers

In order to protect from the spread of droplets, a surgical or cloth mask should be worn in a home setting by those with COVID-19 when they are around others. If the person who is ill is unable to wear a mask, their caregiver should wear one. Patients being treated in hospital settings will follow hospital guidelines.

Many websites offer guidelines on how to make a cloth mask. Johns Hopkins Medicine offers these directions for a homemade mask and child size masks for non-patient care settings.

Masks and Other Protective Equipment for Health Care Workers

Health care workers testing and treating patients for COVID-19: Anyone interacting directly with people ill or suspected to be ill with COVID-19 need professional respirators, such as N95 respirators, which are designed for medical use. N95 respirators fit the face snugly and filter the air to stop respiratory droplets from getting through or around the device. In addition, our care teams treating patients with COVID-19 wear added protective gear, including face shields that protect the eyes, nose and mouth from contamination from respiratory droplets, along with masks or respirators.

Health care workers in patient areas, but not working directly with COVID-19 patients: Procedural, surgical and cloth face masks are being used to help guard against the possible spread of COVID-19. These masks don't have a tight seal and are made of different types of materials.

Similar to influenza and other respiratory viruses, the virus that causes COVID-19 appears to be transmitted primarily through large respiratory droplets. Surgical or procedural masks provide protection against respiratory droplet spread.

While cloth masks are not medical-grade, they may be helpful in non-patient settings to contain coughs and to remind people to not touch their face, but they are not suitable for providing medical care to patients.