In the heat of the moment, keep your kids safe

It may be late August or early September, but that doesn’t necessarily mean the intense heat is gone. And as football kicks off into high gear, there’s not just the heat to keep an eye on. There is the risk of injuries, including concussions.

Those are just a couple of points Dr. Chris Carter makes. Carter, a Vestavia Hills resident who specializes in sports medicine at the newly opened Brookwood Grand River Clinic, believes the Alabama High School Athletic Association has instituted some good rules to help combat heat-related illnesses and concussions.

“The Alabama High School Athletic Association came out this year with new guidelines,” Carter said. “The first two days of practice are helmet only, helps kids get used to the heat and acclimatize. The next two days they can have their shoulder pads. So Day 3, they’re limited to 90 minutes, Day 4 goes up to 120 minutes. After that they can go full gear. … So that’s good for preventing heat injury and stroke.”

Week 2 allows alternating days of full-speed contact practice, not to exceed a combined total of 120 minutes of full-speed contact is allowed. In addition, one intra-squad scrimmage is allowed.

During Week 3, alternating days of full-speed practice, not to exceed 120 minutes of full contact is allowed. One interscholastic scrimmage or contest is allowed in Week 3.

During Week 4 through the end of the season, a total of 90 minutes of full-speed contact practice per week is allowed.

Besides serving the Brookwood Grand River facility, which is owned by Lemak Orthopedics, Carter is team physician for Miles College, Briarwood Soccer Club and Leeds High School.

“Hydration is also something I talk a lot about,” Carter said. “You’ve got to prehydrate, hydrate during the activity and then hydrate afterward. About prehydration, I tell people drink enough to where your urine is a pale yellowish to clear color. While you’re doing that activity, during that first hour, water is good, but after you hit over an hour of activity that’s when you need to use your sports drinks, Gatorade, PowerAde, to get your electrolytes.

“After the activity, same thing about restoring your electrolytes. One thing some people use the guideline of drinking a pint for every pound that you’ve lost. So weigh before and after to get an idea what their fluid detriment is and rehydrate based on that.”

The AHSAA guideline of no consecutive days of full-speed contact is designed to prevent the cumulative effect of slight concussions. Coaches and trainers and medical staff members who are on the field during games, like Carter, are much more attuned to concussions than ever before.  All coaches now are required to go through concussion training.

But parents should still watch out for things that might see in their concussed child, Carter said.

“Headaches, of course, but changes in emotions, changes in sleep patterns, difficulty concentrating, blurry vision, having a tough time in school … these are some of the things parents need to watch for.”

But Carter points out that there are even more common injuries that athletes and their parents sometimes overlook.

“The most common stuff in kids is overuse injuries,” Carter said. “We recommend for parents to have their children take one day off per week to prevent overuse and then three months per year. Like for baseball pitchers, we recommend not doing year round pitching. Cross train, pick another sport. Football here, soccer there. That way you give different parts of your body enough time to rest.”

Specialization has been the order of the day. Players quit other sports because they feel like their best bet at a scholarship or pro ball is to focus year round.

“The problem is you focus on it year round, now you’re getting fatigued, now your mechanics are off,” Carter said. “You’re more likely to get an injury if you’re compensating for a week shoulder now you’re putting more stress on your elbow, you could get a UCL tear, got to have Tommy John surgery. 

“Whether they take a rest completely, use that time to train or pick up some other sport, that’s what we’re really trying to impress on kids.”

Cheerleaders and gymnasts aren’t immune either, especially to potentially serious growth-plate injuries. “Constant overhead flips can result in ‘gymnast wrist.’ Premature closure of growth plates then the other bone in the wrist might grow at a longer pace.”

Coaches are trained to watch for this stuff, but parents need to also be aware. 

“Pain is a real good indicator that you need to get it checked out,” Carter said.