With college basketball tournaments recently taking the national stage, we want to highlight the medical teams, particularly the sports medicine physicians, behind the scenes that work to prevent injuries and provide a healthy environment for all athletes.
In this episode, we will discuss what a safe sports environment for children and young adults looks like and how sports medicine can prevent and manage injuries.
Gina Melton: You know, I really love that both my boys are totally into sports. I was such a girly girl, and I played sports, too. I love watching my son, Parker, play football and my youngest, Grant, does wrestling.
I think it’s super important for kids to be involved in these activities because it helps them in so many different ways. It helps them stay healthy and fit. And it’s a great way to learn about good sportsmanship and they’ve met some of their best friends that way as well but — you know, there are injuries that come along with that.
That’s just one of the things that comes along with sports sometimes and, in fact, my son, Parker, is doing a little bit of PT right now on his knee. But how do we, as parents, know if it’s something minor or if it’s something more serious? And maybe the bigger question is — when do we seek medical attention for our kids?
Well, luckily, we have an expert here today to talk to us about this. I’m Gina Melton, with the Just Kids Health Podcast from Children’s Nebraska. Join me as I talk with the region’s pediatric experts about everything related to our kids. We’re talking everything from health, medical issues, mental health — all to keep our kids super healthy, and safe, and strong.
And today, we welcome Dr. Natalie Ronshaugen to talk to us about youth sports medicine. Good to see you.
Dr. Natalie Ronshaugen: Thank you so much for having me, Gina.
Gina: Well, of course. Now, I know — because talking before this — you did some sports when you were in school, right?
Dr. Ronshaugen: I played all of the sports. I think most good sports medicine doctors have had most good sports medicine injuries, and so we recognize the importance of needing a good doc in your back pocket to call if you’ve got an injury that you don’t really know what to do with.
Gina: Sure. Now, what made you get in, specifically to this arena, I guess?
Dr. Ronshaugen: There’s a great pun there. I got into this arena for a lot of reasons. I played three sports in high-school. I, then, played tennis in college — and I’ve been very active ever since — running marathons and I just love the sports environment.
I went into medical school, thinking I was gonna do primary care, but about halfway through residency — was talking with a friend of my mine who was going into sports medicine. She had an extra ticket to a hockey game she was covering, and by the end of that, I was just hooked. I was like, ‘You get paid to sit and watch hockey?’ How great is this! All the slamming up against the window.
Dr. Ronshaugen: Right. And getting to take care of like-minded people. People who wanna get back into sport as quickly as possible, and as safely as possible. I mean, that’s the whole point of what I do and the reason that I love this.
Most Common Sports Injuries
Gina: I love that. Well my boys both do sports and sometimes, I look at that and I think, oh like, don’t hurt my baby, you know. And usually it’s just fine but — what are some of the most common injuries that you see — sports injuries?
Dr. Ronshaugen: So, the cool thing about taking care of kids is — the sports injuries really vary based on, not only the sport that you are playing, but also the level at which you’re playing and the age of the kid. So, our younger kids, our Pee Wee Soccer players, tend to fracture things.
Our high-level gymnasts often have back injuries, and ankle injuries. Football and wrestling, is full of concussions, and basketball — we get lots of knee sprains. So, I get a big variety, even though they’re all athletes — but we’re seeing lots of different things, based on age, based on sport, based on how hard that kid dives for the ball in the corner.
Dr. Ronshaugen: So, there’s all sorts of stuff. Overuse injuries are really common in young athletes and common all the way through high-school and collegiate sports as well. So, we see a lot of overuse injuries in our clinic, but — we’re seeing fractures, we’re seeing muscle strains, we’re seeing ankle sprains and ACL tears and concussions — all of that, it gets housed in our clinic.
Sports with the Highest Concussion Rate
Gina: Now, speaking of concussions — because I know one of my sons has had a concussion — what sport has the highest rate of concussions?
Dr. Ronshaugen: So, that’s a good question. The rates of concussions — we see probably the most concussions out of football, but part of that has to do with the fact that there’s 90 guys on a time. So, there’s going to just — based on raw numbers be large numbers of concussions coming out of football. But we also see high numbers of concussions coming out of wrestling and slightly higher rates, though our raw numbers are lower because the wrestling team is smaller. And then for girls — soccer. Soccer is the number 2, most likely sport to get a concussion in — girl’s soccer, specifically.
But we see concussions in everything. I’ve seen concussions in swimmers. You’d think that should be safe for your head but kids find a way to bump their heads on everything, it seems like. So, even our swimmers, our gymnasts, cheerleaders sometimes get concussions — anybody can. So, it’s a good one to have in the back of your mind is — I don’t wanna miss that if my kid gets hit in the head.
Gina: Sure, and what are some of the signs, maybe — if, a child has a concussion?
Dr. Ronshaugen: The classic sign that I see with concussion is a kid who just gets up and looks totally dazed. Some kids get up and are so confused, they line up on the wrong side of the football field. They like, line up with the other team but a lot of them just get up, and you say to yourself, “He doesn’t look like he feels good or doesn’t look right.”
Some kids will stumble because they’ll have balance issues afterwards. But the biggest key with concussion is — we don’t want them to get hit again, if they have a concussion. So, our big phrase in sports medicine is, “when in doubt, send them out.”
And it’s not always the popular decision to make but if — the nice thing about being a parent is, you know your kid and you can say, “Yeah. That’s not right. You’re just not acting like you.” And pulling that kid early, and taking the wrath of your child early instead of having to deal with a kid who’s got long term issues with their brain because we thought it was an important state match, and we couldn’t miss it.
Gina: Right. That’s funny that you say that. I mean not funny — the topic is not funny but it’s funny that you say that because my son was really mad at me because he’s like, “Mom, I don’t wanna sit out.” I said, “You know what? We’re lucky we have a good pediatrician, who told us, you know. You need to sit out for a while because this is, you know, really important for you, and it’s really serious, and if you miss one game or something like that, you know, sorry buddy but that’s what we gotta do.”
Dr. Ronshaugen: And we’re also battling the mentality of the athlete that says, “It hurts but I am tougher than pain. I can push through something.” And they’ve been taught from the moment they hit the ball off the T in Pee Wee Baseball, that sometimes you gotta push through a little bit of pain.
Concussion is not one of those things you wanna push through pain on. We just have to let it heal — which is a total bummer, and really hard for an athlete to take and accept, and really hard to just mentally adjust — I guess, I can’t push through this one.
Gina: Right. Yeah, it doesn’t matter if you’re a boy or a girl. You know, they think they need to be super tough, and it’s probably our job as parents to say, “Hey, you know what? We gotta ease back here a little bit. Ease back.”
How to Prevent Sports Injuries
Gina: Now, how do we prevent sports injuries? As a mom, I am dying to talk to you about this because I want to try to keep my kids safe. I wish I could put bubble wrap around them. You know what I mean?
Dr. Ronshaugen: Yes, we have not invented the bubble wrap that works to prevent every sports injury, unfortunately.
Gina: Darn it.
Dr. Ronshaugen: But there are a few things that you can do to prevent some of the more significant sports injuries, for sure. Concussions, specifically — really just making sure, in football, we’re hitting properly — not leading with our head and having really good form with that. Making sure you’re watching where you’re going. Some of this is — seems like, kind of, common sense but — don’t rush into something with your head trying to blow through it with your head.
Wearing the equipment that is appropriate for your sport — a helmet in football, a helmet in baseball — those kinds of things, particularly, help prevent things like skull fractures, but are just good common sense to keep that head safe. Overuse injuries, we talked a little about earlier, and those are super common.
Good stretching is important but also — one thing we talk about is — it’s important to get in shape to practice, not practice to get in shape. So, we’ve got a lot of kids who start cross country season on August 17th or whatever that very first day of cross country practice is. And they’re like, “Well, I haven’t ran for a year but I can run four miles.” Like, “No! Don’t do that!”
Gina: No, right.
Dr. Ronshaugen: We gotta be working up our endurance, working up our stamina, and making those muscles strong before we ask that much of them, and try and race on those muscles. That can help prevent a lot of things like just sprains, strains but also, in track, for instance — our sprinters, they can literally, in youth track — they can literally run their butts off where they like pull a piece of bone off the back of their pelvis because they run so hard and we’re not stretching well enough.
Dr. Ronshaugen: So, good stretching, good mechanics, good being really in shape before you start your season — all of those things are really important. There’s also great data about making sure that you’re doing lots of different kinds of sports. So, Patrick Mahomes — excellent football player, right?
Dr. Ronshaugen: Everybody knows about him because he can throw a football with pristine accuracy and win a Super Bowl. We don’t think about the fact that he played baseball and basketball in high-school. He was so diverse in his sports and now he attributes part of his success in football to being an overall athlete.
He knows how to look at a field because he was able to pass the ball where it needed to go in basketball. He had good hand-eye coordination because of catching a grounder in baseball. And oftentimes, we get so single-minded, like, ‘I’m gonna be a great baseball player.” But really, be an athlete. And you’re gonna avoid a lot of overuse injuries, and you’re going to be better at your sport because you’re gonna be able to look at it from different angles.
Gina: I never really even thought about that. That’s interesting. I guess, I thought, you know, well if you’re gonna be good in one sport, be good in sport or something but that makes total sense.
Dr. Ronshaugen: It is. Nationally, a lot of cities have been moving to be great at one sport and we’re finding that kids are dropping out of sports or at younger ages. And, you know, our obesity epidemic is partly because we’re not active. We forget — being a part of sports is being partly — like, contributing to your overall health as an adult and being active as an adult.
And, if we can teach our kids that you just need to be active. Do whatever is fun for you. Don’t focus on being a professional. Most of our kids don’t end up being professionals. Even the very best high-school athletes don’t end up being professionals. They end up being CPAs or physicians, right?
Dr. Ronshaugen: But if we can really make them love sports, we make them a better athlete all around anyway.
Gina: I really like that. I’m gonna tell my kids when I get home. I’m gonna say, “Look at Patrick Mahomes and look at all these different sports that he did.” You know, that’s really inspiring. I love that.
Dr. Ronshaugen: Right.
Myocarditis in Sports after COVID-19
Gina: I love that. Now, I wanna talk to you about something that’s specific to this time frame right now, the pandemic that we’re going through. I’ve seen some things on the news where some athletes are having, maybe, a little bit of trouble with their heart down the line. What can you tell me about that?
Dr. Ronshaugen: Yeah. So, we’re still gathering lots of data on myocarditis in sport after COVID-19. We know that adults have been having lots of cardiac problems, after they contract COVID-19. Most of those people who are having cardiac problems are hospitalized patients. But now, we are realizing that some people who have COVID-19 — even COVID-19 that doesn’t have any symptoms, you know, you have a positive test but you feel great — even those athletes are starting to have some cardiac problems.
Now, in general, it is going to be safe for athletes to go back to sport. But because we are finding that this myocarditis problem is more prevalent than we thought, we’re really encouraging people to check in with their pediatricians before they go back to sport. Now, if they were hospitalized with COVID, they’re probably gonna end up with — hooked in with cardiology at some point. Just to make sure that everything is safe as they move back into sport.
Dr. Ronshaugen: Again, most of these kids are not gonna have major heart problems — but we don’t wanna miss any because sometimes the first symptom is your heart stopping, and that would be completely devastating. So, check in with your doctor. Have your kid checked out. Make sure that they’re not having any potential concerns for cardiac problems, before they get back into sport.
Gina: That’s some great advice. And I know you’ve spent a lot of time on the sidelines over the years, with kids in sports. So, thank you for doing that because I feel better sometimes seeing that there’s, you know, physical therapists, and there’s like a, you know, a sports medicine doctor on site at some of those games. That’s very comforting.
Dr. Ronshaugen: Well, I’m glad you appreciate that because I really enjoy doing that.
Gina: It’s a great way to see something you love, and do something you love as well, right?
Dr. Ronshaugen: Yeah. Yeah, and if I can tape somebody up and get them back out on the field safely — that’s awesome. But, if I get to just watch some basketball, that’s okay too.
Gina: That is awesome. Well, thank you so much. This has been a great conversation. Really appreciate it.
Dr. Ronshaugen: Thank you for having me.
Gina: You bet. And, thanks so much for listening to the Just Kids Health podcast. Please remember to rate, review and subscribe. And for more information on how we can help your child, you can visit https://www.childrensnebraska.org for tons of different resources.