Posts filed under ‘Dr. Brooke Pengel’

7 Tips to Keep Kids Healthy Playing Sports

By Olivia DeLong

Sports can help kids burn off extra energy and stay healthy, but unfortunately injuries among young athletes are very common. More than one million people ages 19 and younger went to emergency rooms for sports injuries in 2013 alone. Concussions, broken bones, sprains, bruises and overuse injuries are some of the most common. Still, injuries vary depending on sport and the type of movement being performed.

“In a runner, we often see shin splints or overuse knee pain, in a swimmer we might see shoulder pain and in a baseball player, elbow or shoulder pain,” says pediatric sports medicine specialist Brooke Pengel, MD. We talked with Dr. Pengel to learn how parents and coaches can help prevent these kid injuries.

Tip #1: Invest in the right gear
Protective gear like helmets and mouth guards won’t work properly if they don’t fit right. And while it may be tempting to recycle hand-me-down cleats and pads, make sure they fit properly and are in good shape before sending your child onto the field.

“A lot of times, the equipment is very expensive. I think recycling can save money if kids are playing multiple sports,” says Dr. Pengel. But, that’s not always the best idea. “You can get into trouble if the equipment is older or if it’s not well maintained. It won’t do its job,” she adds.

Seasoned coaches who know the rules and regulations can help you select the right protective gear. For information about the safest athletic equipment, parents can also visit the National Operating Committee on Standards for Athletic Equipment’s website.

Tip #2: Emphasize technique and using equipment properly
Kids are asked to execute highly athletic strength training maneuvers without knowing the proper form, says Pengel. Practicing such complicated moves incorrectly can cause injuries in young athletes.

Parents should make sure that coaches properly train kids before sending them out to play a game. Stretching and warming up can also help prevent muscle tears, sprains and reduce muscle tension.

Tip #3: Supervise
“Supervision is so important. It can mean the difference between healthy participation and an injury that can actually remove that child from play,” says Pengel.

Your child’s coach should have first aid training, know the signs of a concussion and enforce the safety rules. “As they’re growing and getting stronger, children are not even aware of how their strength can hurt another child,” says Pengel. In any sport where there’s rough contact, the zero tolerance policy should be in place for unsafe play. Children’s skill level should help determine the group or team they’re on. This helps ensure that kids are competing fairly and safely.

Tip #4: Be supportive
There might be specific sports you wish your kindergartener would get involved in, but your kid needs to enjoy the sport, too. “Loss of interest and burnout are very common in children, especially with the athletes who are participating in one sport at the exclusion of another,” says Pengel. If your child seems tired, anxious or reluctant to participate, then it’s time to talk about finding a new sport or activity.

“When kids are young, they don’t really know what they like and if they’re not exposed to a variety of sports, they can get pigeonholed into one sport,” says Pengel.

Talk to your kids about their interests, listen to their thoughts and let them know it’s okay if they want to try another sport. Encouraging athletic activity outside of organized sports can also promote a lifelong enjoyment of fitness.

Tip #5: Practice healthy eating habits
It’s no secret that a healthy diet will help your child power through their games, but what does a healthy diet entail? Kids need enough fuel to participate in sports and they need enough of what’s called energy availability, says Pengel.

A proper balance of carbohydrates, proteins and fats is the most important part of a healthy diet because it allows young athletes to perform and recover. And when it comes to encouraging a healthy diet — planning is key.

“Kids are busy and at school most of the day, so planning for nutrition and breaks where they can fuel their body is really important.” Pack lunches and snacks for days when they’re eating on the go so they’re more likely to make better eating decisions. is a great resource for healthy eating tips.

Tip #6: Make sure they’re staying hydrated
Hydration is important any time your child gets a lot of physical activity. “During the school year, if kids aren’t bringing a water bottle and drinking throughout the day, it’s very hard for them to catch up after school and in the evening,” says Pengel.

A good rule of thumb: have your child drink every 15 to 20 minutes while being physically active. For high intensity sporting events that last more than one hour, have your kid consume sports drinks with electrolytes. These sports drinks replace sodium and potassium depleted through sweating.

Tip #7: Notify coaches of respiratory issues or allergies
Pengel says that up to one in five children have exercise-induced asthma . “Parents and coaches of athletes need to be aware of the signs and symptoms of asthma attacks and allergic reactions and what to do if they come up on the sports field or in childhood play,” says Pengel.

At the beginning of the season, notify athletic trainers and coaches of your child’s conditions and let them know how to handle any problems. “Thankfully, asthma and respiratory care is very advanced and the treatments to keep kids more comfortable while exercising are exceptional,” says Pengel.


June 27, 2016 at 3:42 pm Leave a comment

Commonly asked questions of sports medicine physicians

Should my child drink water or sports drink?
Water usually is the best choice for exercise unless your child is involved in work-outs longer than 60 minutes. At that point, the energy stored in muscle is becoming depleted and electrolytes in the body have been lost in the sweat. Therefore, for these longer bouts of exercise, have your child consume a sports drink that contains carbohydrates (for fuel) and salt/potassium (for electrolytes).

When can my child start to lift weights?
Research has shown that even young children can safely begin strength training. If your child is ready to participate in organized sports, they are probably ready to begin strength training (This typically corresponds to age 6-8 years). The key to making this activity safe is to provide supervised training that emphasizes safety precautions and proper technique/ use of equipment. The training regimen should involve lower weight, higher repetition lifting. Body resistance exercises are a great choice for young athletes. Maximal lifts or any type of Olympic-style lifting should be avoided.

Should my child compete wearing a brace?
If your child is recovering from an injury, it might be appropriate to wear a brace to compete. For example, if the athlete has had a significant ankle sprain, research has shown that an ankle brace may help prevent another ankle sprain. Not all braces have been shown to be as effective as the ankle brace, but there are other braces that may help athletes compete during the recovery phase. For athletes who have not had an injury, the use of bracing is controversial, as there is a lack of evidence that bracing is helpful to prevent an injury from happening in the first place. The most important concept for the athlete to understand is that regaining range of motion, strength, and balance after an injury is the best method of preventing future problems. Bracing cannot substitute for the hard work needed to rehabilitate an injury.

Should my child take performance-enhancing supplements?
Prior to considering a supplement, an athlete needs to determine what they are wishing to accomplish by using the supplement. Proper training, adequate rest, and optimized nutrition are the best ways to enhance performance. If an athlete is not maximizing these methods, supplementation will likely be unsuccessful and the athlete’s expectations will continue to prove unrealistic. In general, most supplements have not been studied in youth and using them should be discouraged because of this fact. There is no requirement for supplements to be proven safe by the Food and Drug Administration (FDA). The products often do not live up to claims and they may not contain what they list as ingredients. Additionally, because of the lack of regulation, the product may contain traces of illegal, potentially dangerous, substances.

How can my child stay active if he or she is injured?
Having an injury can sometimes be a blessing for an athlete! During the injured period, the athlete can focus on gaining strength of other muscle groups. For example, core muscle training is usually allowed and can be an effective method of enhancing sports performance in a multitude of sports. Additionally, time can be spent on stretching tight muscles, a common problem in children and teens that may have contributed to injury. During the injury recovery period, flexibility around the injured joint and other joints can often help the athlete once they are ready to return to participating.

Which is better for my child’s injury – ice or heat?
In the case of a sudden, acute injury, the best choice is to use ice. The swelling and inflammation associated with acute injury often results in significant pain. Ice applied directly to the injured area helps to reduce swelling, and therefore can be useful in controlling pain in the first 24-48 hours after a new injury. Ice can be applied with an ice pack. Applying ice directly to the skin should generally be avoided. Joints like the ankle respond well to submersion in a bucket of ice water. Heat tends to more useful in more chronic injuries as a method of increasing blood flow to the area in order to relax and loosen tight, painful tissues. Physical therapists may even alternate ice and heat during specialized treatments for the athlete.

May 6, 2014 at 1:11 pm Leave a comment

Common Knee Injuries: What You “Knee-d” to Know

It’s one of the most common reasons patients see their orthopedic physician—but how much do you know about knee injuries and how to protect the largest joint in your body from injury?

Your knees play a critical role in keeping you flexible and mobile, but unfortunately, they are often vulnerable to injuries. Fractures, dislocations and tears are all injuries your knees could sustain from sports and other physical activities.

According to the American Academy of Orthopaedic Surgeons, here’s what you need to know regarding common knee injuries:

•Fractures: Fractures to the kneecap are the most common types of fractures around the knee. Patellar fractures account for nearly 1 percent of all fractures and most often occur in 20-50-year-old individuals as a result of falls and vehicle collisions. Men are almost twice as likely to fracture their kneecaps as women.
•Symptoms of patellar fractures include severe bruising and inabilities to walk or straighten the knee. If the patella has been displaced, surgery will be required. Your doctor will discuss this procedure and any possible complications. If the fracture does not require surgery, your knee will be placed in a cast or splint to allow the broken ends to remain firmly in place while they heal. Recovery can take between six and eight weeks, and your doctor may suggest avoiding activities requiring frequent bending or squatting to protect your knee from future injuries.
•Dislocations: When a bone in the knee slips out of place, this is referred to as a dislocation. Patellar dislocations are the most common type of dislocation, and they can either be complete or partial. When the knee bends, the patella slides up and down over the trochlear groove of the articular cartilage – a slippery substance cushioned between the ends of the femur and tibia. A patellar dislocation as a result of a direct blow or fall occurs when the patella slides out of the trochlear groove either partially or completely.
•While the patella can easily slide back into place with assistance or even by itself, a patellar dislocation still requires medical attention. Dislocations are painful and can result in a loss of function to the knee joint. Your orthopedic surgeon will need to x-ray your knee and may even order a Magnetic Resonance Imaging scan (MRI), if more detailed images are required to diagnose the injury. Dislocations to the knee can typically be treated with a brace to immobilize the knee during the healing process and physical therapy to help restore the knee joint to full motion.
•Tears: Tears can occur in the following areas in the knee: •Anterior Cruciate Ligament (ACL) tear: An ACL tear is a most common injury for athletes who play high-contact sports such as football, soccer and basketball. The ACL is a ligament found inside the knee that crosses over the PCL to aid in your knee’s ability to move back and forth. When athletes change direction quickly or land incorrectly, the ACL can sprain or tear. Unless the individual is elderly or has a low activity level, injuries to the ACL require surgery to reconstruct the ligament with a tissue graft. Recovery can take at least six months.
•Posterior Cruciate Ligament (PCL) tear: A PCL tear occurs when an individual receives a powerful blow to the knee when the knee is bent. As with other knee injuries, this type of tear typically happens as a result of vehicle collisions and contact during sports. PCL tears are typically partial tears and can often heal without surgery. Your orthopedic physician will most likely recommend a brace, physical therapy and the RICE treatment method: Rest, Ice, Compression and Elevation.
•Collateral Ligament tears: This type of tear occurs when the knee is pushed to the side from a direct blow to the outside of the knee. Your knee is comprised of two types of collateral ligaments found on the sides of your knee: the medial collateral ligament (MCL) is on the inside, and the lateral collateral ligament (LCL) is on the outside. Both work to manage the sideways movements of your knee. LCL and MCL tears are not as common as other types of tears, and they rarely require surgical treatment. Surgery is only required if your LCL or MCL injury affects other areas in your knee. Ice, bracing and physical therapy are the most effective treatments for collateral ligament tears.
•Meniscal tears: Meniscal tears often occur during sports or as a result of arthritis or aging. The menisci are two wedge-shaped pieces of cartilage between the femur and tibia that support and stabilize your knee joint. Sudden twisting or pivoting motions during contact sports can cause a meniscus to tear. Treatment is dependent on the size and location of the tear.
•Tendon tears: Tears to the quadriceps and patellar tendons are common in middle-aged individuals involved in sports requiring running or jumping. Tendon injuries can either be partial or complete, and they most often occur from falls or landing incorrectly from a jump. While partial tears typically can be healed with nonsurgical treatments, complete tears require immediate surgery to repair the tendon.

April 30, 2014 at 2:48 pm Leave a comment

The Debate: Does Throwing a Curveball Lead to Injuries in Youth Baseball Players

This well-designed study highlights the importance of proper rest for young baseball pitchers.  The study emphasizes pitch counts over specific pitch types as a means to prevent injury.  Among youth pitchers, there is a wide variation of size and ability.  I would agree that the focus should be on teaching proper mechanics and controlling for appropriate volume of throwing, while using an individualized approach to decide which pitchers are ready to progress to more advanced pitches.  The authors use the valuable data gathered from this study to create a solid summary of recommendations to protect young pitchers from overuse injury.

 Dr. Brooke Pengel

August 10, 2011 at 7:24 pm Leave a comment


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