Athletic Training guidelines

I have blogged on this subject previously so please forgive any redundancy.  However, the National Athletic Trainers Association (NATA) recently published guidelines for healthy sports training and participation and I wanted to share them with you.  They are:

  1. Delay specialization as long as possible
  2. Train 1 sport max 8 mo/year
  3. Only 1 competitive team per season
  4. 2 days off from training each week
  5. Age (years) = hours/week training maximum
  6. Time away from sport (min 2-4 weeks) in between competitive seasons

I cannot overemphasize how important I think the above is.  Sports participation is great–I think it is an essential element in the upbringing of almost all healthy children. However, we must ALWAYS focus on the real reasons: fitness, socialization and fun, cultivate positive personality traits like dedication, team work, fair play.

Remember that world class athleticism is so unique.  Those in possession of that rare attribute do need to work hard if they hope to realize it’s potential.  But if your child is not one of those singularly gifted individuals (few are) then you cannot create it in them by making them work more and harder, you are far more likely to cause injury, anxiety, and/or hard feelings between you and your child in that stubborn effort.  And if you are the only one who seems to recognize your child’s great potential then it’s probably time for a reality check, Mom and Dad.

Also, as I’ve pointed out, it’s a fool’s errand to chase college scholarships earlier than high school years, and at any rate the only sports that offer full scholarships are football and men’s/women’s basketball–the “revenue generating sports” in college. All others mostly offer partial scholarships as best. So if one’s goal is to finance your child’s college education it’s much better to invest in stocks/mutual funds/529 plans as opposed to extra sports training.  I’m not at all saying that paid training camps and private coaching is worthless, but rather that it’s purpose must be to improve your child’s performance to increase their enjoyment of the sport experience as opposed to being an investment in a scholarship to help pay for college. A good rule of thumb is if you have to talk your child into the extra training, if its your idea and not their’s, then it’s probably not such a good idea after all.

Please keep the above NATA guidelines in mind and call me with any questions regarding your child’s sports participation.  Thanks for following.


Cold Medicines

I have previously discussed appropriate non-medicine treatments for common cold symptoms.  The data–or lack thereof– regarding so called cough and cold preparations (“C/C”) continues to grow.  Let’s review it here.

In a recent edition of the journal Infectious Diseases in Children, Edward Bell, PharmD offered an excellent summary of the subject. His most important summary is direct–“evidence supporting the efficacy of commonly available orally administered C/C product ingredients (e.g. cough suppressants, mucolytics, anti-histamines, decongestants) in children does not exist.” This statement is based on research from 2002-15 involving > 3 BILLION pediatric visits and 95 million C/C prescriptions.  Randomized, controlled trials conducted in 1991 and 1997 compared drugs like diphenhydramine (benadryl) and dextromethorphan (the “DM” in most cough medicine) to placebo for treatment of nocturnal cough and found no difference between the 2 treatments (“fake” medicine did just as much).  A 2015 comprehensive review of > 4000 subjects(212 kids) evaluated anti-histamines for common cold symptoms demonstrated similar results–no difference, and Congressional testimony from respected university educators and researchers concurred that there is no scientific evidence  for efficacy of anti-histamines for treatment of common cold symptoms.

It is also important to note the evidence of no benefit with the well documented list of common and sometimes serious side effects of these drugs.  Besides sedation, they can cause dry mouth, urinary retention, increased heart rate and appetite.  Please note that these occurrences are NOT rare.  Perhaps of even greater concern are the secondary effects from the well known problem with drowsiness–cognitive impairment with adverse effects on learning(school) and DRIVING (teens!), even hallucinations.

In 2017 the Food and Drug Administration labelled codeine as of no use for cough suppression in children under age 12 and then followed that up with warnings against its use up through age 18 as well.  Side effects here also include even more serious problems with drowsiness along with constipation, abdominal pain, agitation, sometimes even respiratory compromise and /or drug dependency.

Claims regarding so called “second generation” antihistamines, like loratidine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) being “non-sedating” are at least somewhat disputed by considerable published literature.  Those studies suggest that mostly the above problems still occur with these more recently developed products, only to a lesser degree than the older stuff.

So, please, parents, I urge you to stay away from this CRAP and concentrate on what works–fluids, vaporizer, nasal saline, OTC analgesics. And try and be patient: George Harrison of the Beatles sang “All Things Must Pass” (couldn’t resist the reference) and mostly nature will run its course and in a bit of time all will be well again.  Too often, trying to rush things along like with the above does little of benefit and can cause harm. (A lesson in life, perhaps?)

Certainly for more severe episodes with significant fever, pain, sleep or activity disruption, or prolonged disruptive symptoms more thorough evaluation and often treatments may be indicated.  Give me a call to discuss it, and thanks for following.