Due to the high demand on sports performance these days, it is possible to see a young athlete struggle with an eating disorder. Young people often work hard to keep their struggles with food secret, so it’s hard to know just how many people suffer from eating disorders. Between 1 to 13 percent of American high school and college-age women are estimated to suffer from these illnesses.
How it begins
Eating disorders often begin with dissatisfaction in appearance and efforts to “eat healthier” or exercise more. But for some people, these behaviors can lead to changes in thought patterns and behaviors that develop into an eating disorder. The thoughts and behaviors become difficult to resist, and emotional and physical health begin to deteriorate.
The problem often begins with active efforts to lose weight, such as a weight-loss diet, or increasing exercise, but then something goes wrong. Once 5 pounds have been lost, the weight goal is lowered another 5 or 10 pounds. Or perhaps the original goal is never quite reached, and instead the teenager’s weight goes up and down in a seesaw pattern. Eventually, the pursuit of thinness becomes an obsession that assumes more importance than anything else in the person’s life.
How to recognize an eating disorder in your child
Young people go to great lengths to deny and conceal their painful struggles with food. Here are some signs that may help you recognize an eating disorder in your child:
Excessive weight loss. Anorexia nervosa is diagnosed when someone is 15 percent below expected weight (whether because of loss of weight or failure to gain with growth).
Use of laxatives or diet pills.
Weight fluctuations. Although people with bulimia nervosa usually maintain near-normal body weight, their roller coaster dieting may show up in erratic weight gains and losses.
Food disappearing on a regular basis.
Unusual eating habits. This includes taking tiny bites to stretch out eating time or compulsively arranging food on the plate.
Dull hair and hair loss, splitting or softening nails.
An absence of menstrual periods for females related to malnutrition.
Secretive behavior, especially with respect to eating and bathroom use. A teenager who habitually runs water, plays the radio or flushes the toilet repeatedly while using the bathroom may be masking the sounds of vomiting.
Dental cavities and gum disease, caused by malnutrition and vomiting.
Drug or alcohol abuse. Sometimes, teenagers with eating disorders will turn to substance abuse to relieve feelings of fear, shame and depression.
Extreme sensitivity to cold, caused by loss of fat and muscle.
Fine body hair on arms and legs. This is the body’s attempt to keep warm.
Low self-esteem.
Distorted body image. No matter how thin they get, people with anorexia still believe they are too fat.
The person stops eating meals with the family. They might make excuses that they are too busy or eating elsewhere.
Remember that no one is to blame when a child develops an eating disorder. Discuss your concerns openly, and then seek professional help. The pediatrician or primary care provider is where most families start when they become concerned.
For more information on how you can help someone who has an eating disorder, watch these helpful tips:
Written by: Jennifer Hagman, M.D., Medical Director of the Eating Disorders Program, Children’s Hospital Colorado. To learn more about Children’s Colorado’s Eating Disorder Program, the Rocky Mountain region’s most comprehensive center for evaluation and treatment of eating disorders in children, adolescents and young adults through age 21, please visit our Eating Disorder Program website.
Many parents wonder if it is safe for their child to continue playing football, soccer or other sports after suffering a head injury/concussion. A common question we get in the Concussion Program clinic is, “How many concussions are too many before we decide that this may not be the best sport for my child?”
Parents should be aware of the potential for second impact syndrome, which is a rare catastrophic event that can occur in young athletes. Second impact syndrome occurs after one has suffered a concussion and while still symptomatic from that injury suffers a second blow to the head, neck, or body. This second injury can potentially cause significant swelling around the brain and lead to severe neurological deficits or even death. Currently, there are only 21 cases of second impact syndrome documented in the literature. It is also thought to only affect young athletes in whose brains are still maturing and vulnerable to this rapid swelling.
After a significant head injury, young athletes should always be evaluated to determine if they have suffered a concussion, as it is important to monitor for signs of a more serious head injury. If a concussion has been diagnosed, the athlete should take it easy and avoid activities that may exacerbate common symptoms. Watch our Sports Medicine expert, Dr. Rachel Coel, discuss the importance of early concussion detection:
Most concussion symptoms will resolve within a 7-14 day period in a majority of children and adolescents. In some athletes, however, symptoms may last several weeks or even months. To determine if the athlete is completely symptom free after their first concussion diagnosis, they should seek medical advice to determine a return to sports protocol.
On Mother’s Day, every mom deserves the moon, the stars and the…Colorado sunshine!
If you’re wondering what activities are awaiting your family this Sunday, look no further than your own backyard. Denver offers a wide variety of activities that will keep the whole family entertained, and the best part is…they’re just a quick bike ride, hike or drive away.
Here are five fun ways to help Mom enjoy her special day:
1. Take a stroll through City Park
Home to Denver’s largest green space, City Park offers paddle boats, which are available from May to October, on Ferrill Lake for your paddling pleasure. After your boating adventure, take the family for a round of golf at the Denver City Park Golf Course that provides 18 holes, beautiful views of the city and the Rocky Mountains. Oh and don’t forget the Denver Zoo—the African lions at Predator Ridge, Bear Mountain and Primate Panorama are all a must see!
2. Fly kites, play frisbee or ride bikes
Flying kites, playing frisbee or riding bikes are perfect outdoor activities for an inexpensive family outing on Mother’s Day. Size up your bright, colorful kite with other kite goers at Cranmer Park, or, visit Sloans Lake Park to play frisbee across the large, grassy fields.
If you would rather ride bikes, jump on the Platte River Trail off 15th and Platte downtown for an exciting and safe urban biking journey. (Note: A playful splash, before or after your biking venture in the Platte River is always encouraged on a hot day, and don’t be shy—you’ll see other families enjoying it, too)!
3. Visit Red Rocks for a hike
If you’re looking for a quick, yet delightful mountain getaway, head west for Red Rocks. As one of the nation’s most popular concert venues and public parks, Red Rocks Park and Amphitheatre sits at the base of the majestic Rocky Mountains, providing remarkable views, hiking trails and an outdoor experience like you’ve never experienced before.
As you enter the park and slowly wrap around the winding road, look out for deer, hawks, coyotes or foxes, which are sometimes spotted behind large crevices and rocks. After wildlife watching, it’s time to hit the trails. Hiking is free at the park and there are two trails available: The Red Rocks Trail (6 miles) and The Trading Post Trail (1.4 miles). Enjoy your hike and don’t forget to stay hydrated!
4. Plant a garden
According to Denver lore, Mother’s Day is the perfect time to plant a garden. With the last freeze likely behind us, it’s time to get out there and sow the seeds for what can be a great family-filled activity all summer long. Local green thumb experts suggest planting tomatoes, squash (butternut to be exact), jalapenos, cilantro, peas, carrots and cantaloupes in your garden, as these seeds typically flourish in the region.
If you’re not keen on digging or planting, Denver Botanic Gardens has a great botanical garden scene, boasting a wide variety of local and exotic plant species for your family to learn about and enjoy.
5. Bike Cherry Creek State Park
Hop on a bike and head to the lake! Cherry Creek State Park offers a plethora of family-oriented activities, including beach volleyball, boating, bird watching, shooting and more. To get there, consider jumping on the Cherry Creek Trail anywhere between downtown Denver and the park. The trail spans 20 miles from the city to the park, and there are a lot of places where you can literally ‘park and ride’. Once you’ve arrived, enjoy a nice picnic and relax.
Barefoot running has recently become an increasingly popular trend due to its minimalist nature and the idea that man was “Born to Run.” The idea that running without shoes is better for our bodies may have some historical basis, but in recent times can seem impractical and risky. There are certainly some obvious reasons for wearing shoes; the bare ground can pose hazards to the uncovered foot. Thorns, glass, rocks, road-kill, dog waste and phlegm from the previous runner can all be accumulated on the bottom of a bare foot.
Why run without shoes?
The purists would argue, however, that you should repeatedly expose the surface of your foot to the environment so that you can form protective calluses. Then blisters would be a thing of the past. The more moderate philosophy would state that you can gain the biomechanical benefits of barefoot running without the exposure of “biohazardous waste.”
As a result, we have seen an explosion of minimalist shoe wear such as the Nike Lunar Glide, Vibram’s Five Fingers and Merrell’s Sonic Glove. These shoes are certainly not less expensive but they do lack a significant amount of supportive material. I have run in many of these shoes and the lack of dragging, heavy shoes is liberating. They are very comfortable, but they do take some gradual adjustment.
Ease into barefoot running
The biomechanical advantages of barefoot running make sense if you really think about it. Our feet are designed to take the impact of running and transfer that to forward motion. In traditional shoes the impact is transferred to the heel which has the largest weight-bearing surface area, but also has the least biomechanical advantage in forward propulsion.
The power in our calves comes from landing at the mid-foot, or just at the edge of the ball of the foot. Impact at that point is more efficiently transferred to forward motion, putting less stress on the heel, leg, knee, hip and back. But because we have run for so long in traditional shoes, our feet are not conditioned to take that amount of stress. We have to “ease” them into it.
Is barefoot running right for you?
I have run numerous marathons in a variety of shoes and I can’t get through a long endurance race in my “bare feet” but many people do successfully. For the rest of us, the safest way to enjoy our feet is to get to know them. Start with a minimal shoe on an easy surface, such as a treadmill or high school track. If you want to go truly bare, start on the grass. Run short distances and enjoy being “naked” in nature but keep your shoes close by.
After running without shoes for a while, you may notice fatigue setting in or notice a specific area where pain is concentrated. If that is the case, adjust your time in and out of the shoe. Train your feet the same way you train your body. Be patient and listen to what your feet are telling you. At the end of the journey you may have the strongest, most natural stride in the world or you might decide that you really like clean, neat running shoes.
Most of us can remember our first few jumps on a trampoline. The acceleration, gravitational forces, and the weightless feeling were all so pleasing it would put an instant grin on anyone’s face. I think most parents think back to their childhood enjoyment on a trampoline and want their children to experience the same excitement and fun.
What most people probably do not realize is truly how much risk is involved when purchasing a trampoline for their children. No one wants their children to suffer concussions, oral trauma, strains, or tibia (shin bone) fractures…do they?
92% of these injuries occurred between the ages of 4 and 24
4.3% of these injuries ended in hospitalization or death.
Most injuries with trampoline use are due to jumpers bumping into each other, trying to do stunts, rebound energy of the trampoline into the lower extremity, falling off the trampoline or falling onto the frame or springs of the trampoline.
At Children’s Hospital Colorado, we see many fractures from trampoline injuries every week. Most of these injuries include lower extremity fractures just below the knee. Even after these fractures have healed, there is a risk of further angulation of the leg months to years down the road.
Tibia (shinbone) fractures commonly occur when a larger child is rebounding upwards and a smaller child simultaneously is landing on the trampoline, causing a significant compression force to the lower extremity. If this compression force is large enough, a buckle (or compression) type fracture can be suffered in the top of the tibia.
The American Academy of Pediatrics (AAP) reports that boys and girls are injured at approximately the same rate. Home-use trampolines actually cause most of the overall trampoline-related injuries, and the AAP has gone so far as to recommend that parents never purchase trampolines for homes and never allow their children to jump on trampolines at someone else’s home. The AAP also warns parents and guardians to make sure their children’s schools do not have trampolines.
Does your insurance company cover trampoline-related injuries?
Another thing for parents to consider is whether or not their homeowners insurance covers injuries sustained from trampolines. Many insurance companies have exclusions for trampoline injuries in their policies.
Parents should know that if they own a trampoline, they could be responsible for medical bills/legal costs if children, other than their own, are injured while playing on their trampoline.
Steps to reduce the risk of trampoline injuries
The U.S. Consumer Product Safety Commission recommends several steps to reduce the risk of serious injuries:
Only one person at a time should jump on the trampoline
Do not allow jumpers to attempt somersaults
Always keep the trampoline springs covered with padding
Do not place the trampoline near trees or other structures
Only allow children 6 and older to jump on full-sized trampolines
Supervise all children on trampolines
Place an enclosure around the trampoline to prevent falls to the ground
Do not place a ladder near the trampoline because small children can potentially climb the ladder and jump unassisted
Written by: Aaron J. Provance, MD, Co-Director Pediatric Sports Medicine Program Children’s Hospital Colorado Department of Orthopedics. To learn more, read our archived injury prevention posts, or schedule an appointment at 720-777-6600. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado.
Over the years protective equipment has evolved with technology to help reduce the risk of injuries in various sports. In football, high tech helmets reduce the risk of serious head injuries, while mouthguards provide protection against oral and dental trauma in sports like soccer. Today, certain protective equipment are even required for different sports such as faceguards in hockey, chest, leg and arm pads in football, and batting helmets in baseball and softball.
Recently, batting vests were developed with the intent to protect batters from injuries that result from direct impacts to the chest by baseballs. Although not required, some athletes from hockey, lacrosse and especially baseball have chosen to wear these chest protectors with the assumption that it protects against adverse outcomes. Specifically, sudden cardiac death from blunt chest wall blows known as commotio cordis.
How chest protectors can prevent sudden cardiac death
Believe it or not, there have been scenarios on the playing field where athletes get struck in the chest by a baseball, hockey puck or lacrosse ball and then suddenly collapse and die. Typically, this occurs when an object strikes a specific area in the chest at a particular time in the cycle of a beating heart, causing the heart to beat irregularly. This event can sometimes lead to sudden cardiac death.
Like helmets, chest protectors are designed to absorb and distribute the force from a striking object so that the individual wearing the protective gear experiences less of an impact. In this regard, chest protectors can certainly reduce the risk of traumatic structural injuries to the chest, like rib fractures. Conversely, they have not been proven to be effective in preventing sudden cardiac death from commotio cordis.
Why chest protectors are not always the answer
As a matter of fact, studies have shown that about 30 percent of the athletes who died from commotio cordis during a sporting event were wearing some type of chest protector. Other studies using animal models have also found that commercially available chest wall protectors were not effective in preventing sudden death from chest wall impact. However, research efforts are taking place to improve the material composition and the design of chest protectors so that they may hopefully afford athletes the protection against cardiac related deaths from chest blows. Until then, I still recommend chest protectors to provide athletes defense against bone and soft tissue injuries.
Written by: Quynh Hoang, MD, FAAP, CAQSM, Pediatric Primary Care Sports Medicine Assistant Professor, Department of Orthopedics, Children’s Hospital Colorado. To find out more about sports safety, read our archived injury prevention posts, or schedule an appointment at 720-777-6600. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado.
In our lifetime we will have a total of 52 teeth. Twenty of these are what we call primary or “baby” teeth, which appear around the ages of 6 months to 1 year, and will be fully developed by age 3. We have these teeth until the ages of 6-7, when primary teeth begin to fall out and permanent teeth come in. By the time we have reached our early 20’s, the full set of 32 teeth should be well established.
It is estimated that over 3 million teeth are knocked out (avulsed) every year. As you can see from this statistic, the likelihood that your son or daughter will experience an injury to this area is quite high. Sports that have the highest incidences of tooth avulsion are basketball and baseball, mostly due to the poor facial protection of these sports. Other sports with high rates include hockey, rugby, and soccer, and seem to effect kids around the ages of 8-12 the most.
Again, we only get one set of permanent teeth. Taking the proper steps to ensure we do not lose these after avulsion occurs is crucial!
So, what do I do when the tooth comes out?
Never re-implant a primary tooth. Doing so can disrupt the bud of the permanent tooth behind it.
Keep the athlete calm. Many times the shock of the accident or seeing the tooth can cause the athlete to panic.
Always pick a tooth up by the crown (chewing side), never the root. Doing so can damage the nerve.
Attempt to rinse with water, milk, saliva, or saline (if the tooth is dirty)–again never touch the root.
Re-implantation of the tooth by a dentist. This is considered to be the most important factor in determining successful outcomes for tooth avulsions. Re-implantation involves putting the tooth back in the socket, if possible. Dentists also agree that 30 seconds to 5 minutes is the optimal time for this to occur. The longer this takes, the higher the risk of cell death. Once the tooth is implanted, get to the dentist ASAP for further evaluation.
Do not re-implant the tooth into its socket if it is dirty. This helps to prevent infection.
Control bleeding. Avulsions are usually accompanied with facial or mouth trauma that may also have severe bleeding. Use light pressure and cold compresses to stop before re-implanting the tooth. Do not disrupt clot if formed in socket.
Get to the dentist ASAP.
What do I do if I can’t re-implant the tooth?
Store it in their cheek.
Store it in milk, Hanks Balanced Salt Solution (Save a tooth Kit), saline or the last resort is water.
Go to the dentist ASAP for re-implantation and evaluation.
Additional things to consider
Sometimes, athletes may be unconscious or have a concussion.
Attempt to save the tooth in one of the above-mentioned means of transport, and get to hospital. Rule out any type of severe concussion or head injury before worrying about the tooth.
Do not place avulsed tooth in unconscious athlete for fear of aspiration or choking.
How do I prevent this from happening?
Unfortunately, this type of injury is very hard to prevent in any sport. The most important factor in limiting the incidence of this is proper facial protection and use of an approved mouth guard. It is highly advised, especially in sports that do not have facial protection (basketball, rugby, baseball, softball, wrestling, soccer), to use mouth guards at all times. Additionally, proper dental screenings can help identify at risk individuals for avulsions who may have poor dental habits, gum disease, orthodontics or loose teeth.
Taking these steps, along with the ones mentioned above, can greatly increase the chances you have a nice smile your whole life, even if you sustain a tooth avulsion at some point.
Written by: Matt Brewer, MS ATC/R, Certified Athletic Trainer, Sports Medicine for Young Athletes, Orthopedics Institute, Children’s Hospital Colorado. To find out more about tooth loss prevention, read our archived injury preventionposts, or schedule an appointment at720-777-6600. We are happy to consult with parents or referring providers before a patient is seen atChildren’s Colorado.
At Children’s Hospital Colorado, we’re focused on all aspects of youth sports, from helping heal injuries to offering tips on how to help competitors excel during play.
Participating in sports not only helps with improving cardiovascular strength, reducing stress and maintaining a healthy weight and body image. They also offer chances for kids to learn and master skills, work with their peers and coaches, and challenge themselves in a safe environment. And through sports, young athletes learn the value of practice and the challenge of competition.
Keeping your child’s sport activity positive
To ensure that your kids are able to enjoy all of the benefits of playing sports, it’s also important to keep things fun! Maintain a positive and encouraging environment and make sure kids take a break and avoid overtraining. By cross training and playing more than one sport young athletes can avoid injury while still getting a good workout and staying in shape.
KOSI 101 Young Athlete of the Month submissions
Because sports play such an influential role in developing youth, we’re partnering with KOSI 101 to highlight the next Children’s Hospital Colorado Athlete of the Month. If your child is a sports superstar who excels on and off the field, we invite you to visit KOSI 101 to nominate the next Children’s Hospital Colorado Athlete of the Month. Or, you can visit Highlands Heritage Park in Highlands Ranch (9651 South Quebec Street, Highlands Ranch, CO 80130) this Saturday, April 21, from 10 a.m. to 12 p.m., where we’ll be on-site with the KOSI 101 Street Team, taking live submissions for April’s contest.
And make sure to stay tuned…because next month, we’ll highlight one lucky athlete who will also receive a Sports Prize Package complete with the gear your young athlete needs to compete including water bottles and athletic attire.
New website provides Sports Medicine resources for athletes, parents and coaches
The Orthopedics Institute at Children’s Hospital Colorado has launched a new website, which helps users learn more about treatment for common orthopedic conditions and sports-related injuries. The website also introduces parents to the integrated Pediatric Orthopedics, Sports Medicine, Orthopedic Surgery and Rehabilitation Medicine programs at Children’s Colorado.
In addition to being able to search by body area and condition/injury, users can find information about our:
A special Sports Medicine section of the website features an interactive way to learn about sports-related injuries caused by sports like basketball, cheerleading, hockey and more. The site educates athletes, parents and coaches about nutrition and injury prevention, and provides treatment resources if injuries do happen.
Twelve-year-old Gabbie is very active. She is in her school’s gifted program, loves to read and write, plays violin, and excels in skiing and golf – but soccer is her true passion. A member of a highly competitive youth soccer league, Gabbie’s fierce spirit is admired by her teammates.
At a soccer game last fall, Gabbie fearlessly challenged an opponent to defend her team’s goal. The ball, kicked at close range, hit her in the head, knocking her off her feet and leaving the stitched Nike swoosh imprinted on the side of her face. Coaches rushed the field to tend to her and onlookers feared a broken nose.
Watch Gabbie’s road to recovery:
Concussion care at Children’s Hospital Colorado
Our experts see thousands of patients each year and educate families and young athletes on the signs, symptoms and ways to properly care for concussions.
Our Concussion Program services range from same-day or next-day medical consultation for concussions, to helping decide when athletes can return to play, to comprehensive evaluation and management after an injury.
To find out more about concussions and trauma, read our archived concussions and injury prevention posts, or schedule an appointment at (720) 777-2806. We are happy to consult with parents or referring providers before a patient is seen at Children’s Colorado.
