Keeping Athletic Kids Healthy & Fit

In today's age of health and fitness, more and more kids are involved in sporting activities. Although being part of a football, soccer or Little League team is an important rite of passage for many kids, parents and their children could be overlooking the importance of proper nutrition and body conditioning needed for preventing injuries on and off the playing field.
"The majority, if not all, sports are good, provided that the child prepares appropriately," says Dr. Carl Heigl, president of the American Chiropractic Association's Council on Sports Injuries and Physical Fitness. "Without proper preparation, playing any sport can turn into a bad experience. There are structural and physical developmental issues that need to be taken into consideration before children undertake certain sports."
Highly competitive sports such as football, gymnastics and wrestling follow rigorous training schedules that can be potentially dangerous to an adolescent or teenager.
The best advice for parents who have young athletes in the family is to help them prepare their bodies and to learn to protect themselves from sports-related injuries before they happen.
"Proper warm up, stretching and weight-lifting exercises are essential for kids involved in sports, but many kids learn improper stretching or weight-lifting techniques, making them more susceptible to injury," says Dr. Steve Horwitz. "Parents need to work with their kids and make sure they receive the proper sports training."
"Young athletes should begin with a slow jog to warm up the legs and arms and stretch all the major muscle groups," says Dr. Horwitz. "Kids involved in football, baseball, gymnastics and swimming should develop a routine that includes strengthening exercises for the abdomen, the low-back muscles, arms and shoulders."
Proper nutrition and hydration are also extremely vital. "A student athlete may need to drink eight to ten 8-ounce glasses of water for proper absorption. Breakfast should be the most important meal of the day. Also, eating a healthy meal before and after practice or a game allows for proper replenishment and refuels the body," adds Dr. Horwitz.
Young athletes today often think they are invincible. The following tips can help ensure your child does not miss a step when it comes to proper fitness, stretching, training and rest that the body needs to engage in sporting activities.

Encourage your child to:

• Wear the proper equipment. Certain contact sports, such as football and hockey, can be dangerous if the equipment is not properly fitted. Make sure all items of equipment— including helmets, pads, and shoes— fit your child or adolescent. Talk to your child's coach or trainer if the equipment is damaged.
• Eat healthy meals. Make sure your young athlete is eating a well-balanced diet and does not skip meals. Avoid high-fat foods, such as candy bars and fast food. At home, provide fruit rather than cookies, and vegetables rather than potato chips.
• Maintain a healthy weight. Certain sports, such as gymnastics, wrestling and figure skating, require your young athlete to follow strict dietary rules. Be sure your child does not feel pressured into being too thin and that he/she understands proper nutrition and caloric intake is needed for optimal performance and endurance.
• Drink water. Hydration is a key element to optimal fitness. Teenage athletes should drink at least eight 8-ounce glasses of water a day. Younger athletes should drink five to eight 8-ounce glasses of water.
• Drink milk. Make sure your child has enough calcium included in his/her diet. ACA recommends 1 percent or skim milk for children over 2 years old rather than whole milk because of its high fat content. The calcium in milk is essential for healthy bones and reduces the risk of joint-and muscle- related injuries.
• Avoid sugar-loaded, caffeinated and carbonated drinks. Sports drinks are a good source of replenishment for those kids engaged in long-duration sports, such as track and field.
• Follow a warm-up routine. Be sure your child or his/her coach includes a warm-up and stretching session before every practice, game or meet. A slow jog, jumping rope and/or lifting small weights reduces the risk of torn or ripped muscles. Flexibility becomes a preventive key when pushing to score that extra goal or make that critical play.
• Take vitamins daily. A multi-vitamin and Vitamin C are good choices for the young athlete. Vitamin B and amino acids may help reduce the pain from contact sports. Thiamine can help promote healing. Also consider Vitamin A to strengthen scar tissue.
• Avoid trendy supplements. Kids under the age of 18 should avoid the use of performance-enhanced supplements, such as creatine. Instead, they should ask their coach or trainer to include weekly weight-training and body-conditioning sessions in their workout.
• Get plenty of rest. Eight hours of sleep is ideal for the young athlete. Lack of sleep and rest can catch up with the athlete and decrease performance. Sluggishness, irritability and loss of interest could indicate that your child is fatigued. 

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The Core is the Core

Regular Chiropractic Care and Long-Term Health

Just as long-term core strength starts with training the transversus abdominis, long-term health and well-being start with regular chiropractic care. In order for us to manifest ongoing good health, it's very important that all our physiological systems are working in harmony. Such seamless integration of activity is managed and maintained by the nerve system, our body's master system. The nerve system, that is, the brain, spinal cord, and peripheral nerves, transmit information to and receive information from the rest of the body. But nerve interference and nerve irritation can delay and distort the information stream, resulting in errors in cell function. Such errors may expand and cause errors in the functioning of organs and organ systems, resulting in symptoms and disease. Regular chiropractic care detects, analyzes, and corrects spinal misalignments, the cause of nerve interference and irritation. By restoring spinal biomechanical function, regular chiropractic care helps ensure a free flow of information between the nerve system and the body's other systems, including the cardiorespiratory, digestive, and endocrine systems. In this way, regular chiropractic care helps ensure long-term health and well-being for your family members and you.

Whether the topic is education or exercise, core content and core activities tie everything together. In education, core content includes the specific information upon which the course is based. Students are expected, at the very least, to demonstrate mastery of the core content. In exercise, core activities establish the musculoskeletal foundation that supports and enables all other components of physical fitness, including strength training, cardiorespiratory exercise, and sports readiness.

The term "core" in core exercise is relatively new, but athletes and other persons participating in physical fitness activities have been doing core routines since at least the time of the ancient Greeks, more than 2500 years ago. For example, wrestling, the ancient Greeks' most popular organized sport, is grounded in core stability and strength. More recently, in the 1930s, 1940s, and 1950s, high school "phys ed" classes emphasized squat thrusts, jumping jacks, pushups, pullups, and abdominal strengthening. Thus, before the advent of today's ubiquitous fitness centers and the plethora of personal trainers teaching members how to do an abdominal curl-up on a physioball, core exercises were part of the regular curriculum of all public school students in ninth grade and beyond. Core exercise is not new, but the need for core training became lost in the 1980s fitness boom that focused on "aerobics" and "cardio", and secondarily on strength training.

The importance of core training and the need to learn core exercises has undergone a resurgence recently, as the quantity and frequency of exercise-related injuries has skyrocketed. People eager to make healthier lifestyle choices, including those anxious to lose weight, have thronged their local fitness centers. But although it seems simple and straightforward to pedal an exercise bike, lope up and down on an elliptical stair-stepper, lift a dumbbell, or press down or pull up on a machine-assisted exercise bar, if the exerciser's core muscles are deconditioned, injury is the likely result, sooner or later.^1,2

The most important core muscle is the transversus abdominis, a sheet of horizontally oriented muscle fibers that lies beneath the more familiar abdominal muscles, that is, the rectus abdominis, internal obliques, and external obliques.³ Core muscles include the mutifidi and rotatores, small, deep spinal muscles that connect and help move pairs and groups of spinal vertebras, and other back muscles such as the erector spinae and longissimus thoracis. Everyone needs to train the core as a primary component of an ongoing program of regular, vigorous exercise. There are innumerable highly effective core exercises and most do not require any equipment. A physioball provides the opportunity for variety and increasing levels of difficulty. Such accessories are low cost and usually available in local fitness centers. As with all forms of exercise, start slow and build strength and endurance gradually. It doesn't take long to notice the benefits of a regular core routine, including enhanced spinal flexibility, improved balance, and a flatter abdominal region.
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1Chang WD, et al: Core strength training for patients with chronic low back pain. J Phys Ther Sci 27(3):619-22, 2015
2Southwell DJ1, et al: The acute effects of targeted abdominal muscle activation training on spine stability and neuromuscular control. J Neuroeng Rehabil 13(1):19, 2016
3Leonard JH, et al: Changes in Transversus Abdominis Muscle Thickness after Lumbo-Pelvic Core Stabilization Training among Chronic Low Back Pain Individuals. Clin Ther 2015;166(5):e312-6. doi: 10.7417/T.2015.1884

Children & Good Computer Ergonomics

At least 70 percent of America's 30 million elementary school students use computers, according to a recent New York Times article. As a result of this increased usage, doctors of chiropractic are treating more young patients suffering from the effects of working at computer stations that are either designed for adults or poorly designed for children. Many children are already suffering from repetitive motion injuries (RMI) such as carpal tunnel syndrome and chronic pain in the hands, back, neck and shoulders.
A recently published study conducted by a team of researchers from Cornell University found that 40 percent of the elementary school children they studied used computer workstations that put them at postural risk. The remaining 60 percent scored in a range indicating "some concern."
"Emphasis needs to be placed on teaching children how to properly use computer workstations," stated Dr. Scott Bautch, past president of the American Chiropractic Association's Council on Occupational Health. "Poor work habits and computer workstations that don't fit a child's body during the developing years can have harmful physical effects that can last a lifetime. Parents need to be just as concerned about their children's interaction with their computer workstations as they are with any activities that may affect their children's long-term health," added Dr. Bautch.

What can you do?

To reduce the possibility of your child suffering painful and possibly disabling injuries, the American Chiropractic Association (ACA) and its Council on Occupational Health offer the following tips:

• If children and adults in your home share the same computer workstation, make certain that the workstation can be modified for each child's use.
• Position the computer monitor so the top of the screen is at or below the child's eye level. This can be accomplished by taking the computer off its base or stand, or having the child sit on firm pillows or phone books to reach the desired height.
• Make sure the chair at the workstation fits the child correctly. An ergonomic back cushion, pillow or a rolled-up towel can be placed in the small of the child's back for added back support. There should be two inches between the front edge of the seat and the back of the knees. The chair should have arm supports so that elbows are resting within a 70- to 135-degree angle to the computer keyboard.
• Wrists should be held in a neutral position while typing - not angled up or down. The mousing surface should be close to the keyboard so your child doesn't have to reach or hold the arm away from the body.
• The child's knees should be positioned at an approximate 90- to 120-degree angle. To accomplish this angle, feet can be placed on a foot rest, box, stool or similar object.
• Reduce eyestrain by making sure there is adequate lighting and that there is no glare on the monitor screen. Use an anti-glare screen if necessary.
• Limit your child's time at the computer and make sure he or she takes periodic stretch breaks during computing time. Stretches can include: clenching hands into fists and moving them in 10 circles inward and 10 circles outward; placing hands in a praying position and squeezing them together for 10 seconds and then pointing them downward and squeezing them together for 10 seconds; spreading fingers apart and then closing them one by one; standing and wrapping arms around the body and turning all the way to the left and then all the way to the right.
• Your child's muscles need adequate hydration to work properly and avoid injury. Encourage your child to drink four 8-ounce glasses of water a day. Carbonated beverages, juices and other sweet drinks are not a substitute.
• Urge your child's school or PTA officials to provide education on correct computer ergonomics and to install ergonomically correct workstations.

"If your child continues to complain of pain and strain from sitting at a computer, see a doctor of chiropractic," urges Dr. Bautch. "A chiropractor can help alleviate your child's pain and help prevent further injury."
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Are You Protecting Your Children?

The growing awareness of safe driving and state safety laws have alerted the general public and parents to the importance of using car seats for their small children whenever and wherever they are driving. Most states require the use of car seats for children under the age of 4 and weighing less than 40 pounds. However, these safety rules aimed at protecting children may cause serious neck and spinal injuries and can even be deadly if the child car seats are used incorrectly.
The American Chiropractic Association (ACA), its Council on Occupational Health and ACA member Dr. Michael Freeman, trauma epidemiologist and clinical assistant professor of public health and preventive medicine at the Oregon Health Sciences University School of Medicine, have developed the following general guidelines and safety tips to ensure proper car seat safety.

• Make sure the child safety seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
• Car seats for infants should always be rear facing as the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
• Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with air bags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
• Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.
• The lap harness should be fastened low, as close to the hips as possible; the harness should never be fastened around the waist.
• Make certain the shoulder harness is fastened securely and the straps lay flat against the body. Twisted straps can cause additional injury that might prevent the seat from working properly.
• Use a retention clip (if provided by the manufacturer) when securing a child safety seat with the shoulder harness. The retention or shoulder harness clip is an added safety feature and must be fastened close to the armpit of the infant or child.
• Borrowing or purchasing a used car seat can be dangerous; there is the possibility of unknown or undetected damage. Car seats that have been in a serious accident should never be used again.
• Be sure the seat meets federal motor vehicle safety seat standards. Consult the owner's manual or contact the manufacturer for that information. All car seats should have an owner's manual and instruction booklet.
• Be sure the clip between the legs of the child is fastened snugly.

While car accidents can be dangerous for all passengers, small children are especially at risk, according to Dr. Scott Bautch, past president of ACA's Council on Occupational Health. "The weight of the head of a child makes the cervical spine much more vulnerable to injury," Dr. Bautch explained. "The infant has little control in the muscles of the neck, and the head can bounce from side to side and fall forward, which can cause serious spine and neck injuries. Children have more flexible upper bodies and shoulders. Make sure the harness comes up, way up, over the shoulders."
Underscoring the importance of proper car seat use, a recent article in Nation's Health reported the findings of a study conducted in Kentucky by the Centers for Disease Control and Prevention. The study found a 37 percent drop in infant fatalities since the 1982 enactment of the state law mandating the use of child car seats. "To continue this decline, prevention efforts now must focus on the proper use of the seats to maximize their life-saving potential," the researchers said.
The key when traveling with small children is to be aware of and follow these rules and tips to ensure proper car seat safety. And remember everyone: Buckle up!
If you or one of your children have been involved in a serious automobile accident and have experienced neck and back discomfort, you should consider a visit to a chiropractor.
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Today's Fashion Can Be Tomorrow's Pain

Looking your best might not always be the best thing for you. Today's society is extremely fashion and style conscious. Unfortunately, clothing designers and stylists aim to please by creating unique looks that might not always be practical or even comfortable.
The look of the season shows runway models in high platform heels and tight skirts or pants. Models have perfected the runway "walk," but the popular looks and accessories are frequently impractical and could create leg, back, and spine or neck problems. "Sometimes I see a woman walking down the street with high heels and a two-ton bag, and I want to stop her and make her aware of what she is doing to her body," said ACA national spokesperson, Dr. Jerome McAndrews.
Women generally wear high heels to complement an outfit, not for comfort, but some might not realize that these shoes can cause serious discomfort in the feet and can also exacerbate back pain. High heels alter the balanced position of a person's body. When a woman wears high heels, a new dynamic equilibrium occurs. Dr. McAndrews compared the musculoskeletal system to a mobile, hanging in dynamic equilibrium, each part balancing the other. If one part becomes 'fixed,' the whole system will compensate with a movement or restriction. Essentially, wearing high heels for any length of time increases the normal forward curve of the back and causes the pelvis to tip forward. This alters the normal configuration of the pelvis and spine necessary for the body to maintain a center of gravity.
"The legs are the foundation of the musculoskeletal system, and a person standing flat-footed or bare-footed would be completely balanced," said Dr. McAndrews. "While standing, the hamstrings are taut and both parts of the pelvis are stabilized so that the support is normal. By bringing the heel up, you encourage the shortness of the hamstring muscles."
Women and men alike fall into the fashion trap. However, women, more than men, tend to wear clothes that are too tight. Stylish tight tube skirts and tight pants can be attractive, but are often too restrictive. Clothes that are too tight throw a person off-balance, and simple everyday tasks such as bending, sitting and walking become difficult. "Tight clothes restrict a person from moving comfortably, resulting in poor posture and misalignment of the spine," said Dr. McAndrews.
Another unhealthy fashion statement is the use of heavy purses, backpacks and handbags. Women and men tend to carry too many items in one bag, or briefcase, and are often not aware of the potential health risks associated with toting an excessive amount of "stuff." Carrying a bag with detectable weight-more than 10 percent of your body weight-can cause improper balance. When hiked over one shoulder, it interferes with the natural movement of the upper and lower body. "The person carrying the bag will hike one shoulder to subconsciously guard against the weight, holding the other shoulder immobile," said Dr. McAndrews. "This results in the unnatural counterbalance movement of one shoulder and little control over the movements of the arms and legs. Even worse, the spine curves toward the shoulder."
More and more people carry their credit cards, ATM cards and personal identification in the back pocket of their pants. This might be a convenient way of carrying the necessary items with you each day, but carrying your wallet in the back pocket of your pants can cause discomfort. Dr. McAndrews suggested men and women remove their wallets or other items before sitting for long periods of time. "Sitting on your wallet or card holder for the entire day will create a pocket in the muscle lying underneath the wallet, and whether your pants are tight or loose-fitting, this can result in discomfort or pain."
In today's society, it might be important to you to look fashionable, but it is more important to choose clothes, shoes and bags that are comfortable and that suit your style. By following and remembering these simple steps, it is possible to look and feel your best.

• Choose comfortable shoes. If you must wear high heels, bring a pair of flat shoes along with you to change into should you become uncomfortable. If you walk to work, wear flat shoes and change into your more fashionable shoes when you arrive to alleviate any pain or discomfort.
• If the shoe is uncomfortable while standing, chances are it will not be any more comfortable while walking. The wrong shoe can affect the body's center of gravity.
• Choose supportive shoes. Designer spikes or non-supportive loafers may look nice but do not allow for easy, symmetrical walking.
• While sitting, whether or not you are wearing heels, it is important to take frequent stretch breaks to alleviate atrophy of the hamstring muscles.
• Avoid excessive wear of tight pants or clothing. If you prefer tighter clothes, choose styles that allow you to perform daily tasks with ease.
• Select a briefcase or purse with a wide adjustable strap. Ideally, the strap should be long enough to place over the head. This evenly distributes the bulk of the weight across the body.
• When carrying a bag, or briefcase, switch sides frequently to avoid placing the burden of the weight on one side of your body.
• Take the time to empty unnecessary items from your bag.
• Place all necessary items-such as wallets and cellular phones-in the front pockets of the bag. Stretching around to reach for your wallet can result in a pulled neck or back.
• If you are driving or sitting for long periods of time, remove your wallet or card holder from the back pocket of your pants.
• Think about your daily tasks. If your clothes affect your movements, consider outfits that fit your lifestyle.

Designers and stylists tend to be more concerned about the way something looks rather than the way it feels. Listen to your body. One of the most important aspects of being in style and looking your best is to maintain healthy judgement. By following simple suggestions, being fashionable can be comfortable.
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Travel Can Be a Pain In Your Back

Traveling can be rough on the body. Whether you are traveling alone on business or on your way to a sunny resort with your family, long hours in a car or an airplane can leave you stressed, tired, stiff and sore.

"Prolonged sitting can wreak havoc on your body," says Dr. Scott Bautch, immediate past president of the American Chiropractic Association's (ACA) Council on Occupational Health. "Even if you travel in the most comfortable carrier opt to fly first class, certain pressures and forces from awkward positions can result in restricted blood flow. One of the biggest insults to your system from prolonged sitting is the buildup of pressure in the blood vessels in your lower legs. Contracting and relaxing the muscles helps the blood flow properly."

Dr. Bautch and the ACA suggest the following tips and advice to fight the pains and strains of travel before they occur.

Warm Up, Cool Down

Treat travel as an athletic event. Warm up before settling into a car or plane, and cool down once you reach your destination. Take a brisk walk to stretch your hamstring and calf muscles.

In the Car

• Adjust the seat so you are as close to the steering wheel as comfortably as possible. Your knees should be slightly higher than your hips. Place four fingers behind the back of your thigh closest to your knee. If you cannot easily slide your fingers in and out of that space, you need tore-adjust your seat.
• Consider a back support. Using a support behind your back may reduce the risk of low-back strain, pain or injury. The widest part of the support should be between the bottom of your rib cage and your waistline.
• Exercise your legs while driving to reduce the risk of any swelling, fatigue or discomfort. Open your toes as wide as you can, and count to 10. Count to five while you tighten your calf muscles, then your thigh muscles,then your gluteal muscles. Roll your shoulders forward and back, making sure to keep your hands on the steering wheel and your eyes on the road.
• To minimize arm and hand tension while driving, hold the steering wheel at approximately 3 o'clock and 7 o'clock, periodically switching to 10o'clock and 5 o'clock.
• Do not grip the steering wheel. Instead, tighten and loosen your grip to improve hand circulation and decrease muscle fatigue in the arms,wrists and hands.
• While always being careful to keep your eyes on the road, vary your focal point while driving to reduce the risk of eye fatigue and tension headaches.
• Take rest breaks. Never underestimate the potential consequences of fatigue to yourself, your passengers and other drivers.

In an Airplane

• Stand up straight and feel the normal "S" curve of your spine. Then use rolled-up pillows or blankets to maintain that curve when you sit in your seat. Tuck a pillow behind your back and just above the belt line and lay another pillow across the gap between your neck and the headrest. If the seat is hollowed from wear, use folded blankets to raise your buttocks a little.
• Check all bags heavier than 5-10 percent of your body weight. Overhead lifting of any significant amount of weight should be avoided to reduce the risk of pain in the lower back or neck. While lifting your bags,stand right in front of the overhead compartment so the spine is not rotated. Do not lift your bags over your head, or turn or twist your head and neck in the process.
• When stowing belongings under the seat, do not force the object with an awkward motion using your legs, feet or arms. This may cause muscle strain or spasms in the upper thighs and lower back muscles. Instead,sit in your seat first, and using your hands and feet, gently guide your bags under the seat directly in front of you.
• While seated, vary your position occasionally to improve circulation and avoid leg cramps. Massage legs and calves. Bring your legs in, and move your knees up and down. Prop your legs up on a book or a bag under your seat.
• Do not sit directly under the air controls. The draft can increase tension in your neck and shoulder muscles.

Safe Travel For Children

• Always use a car seat in a car when traveling with children below the age of 4 and weighing less than 40 pounds.
• Ask the airline for their policy on child car seat safety. Car seats for infants and toddlers provide added resistance to turbulent skies, and are safer than the lap of a parent in the event of an unfortunate accident.
• Make sure the car seat is appropriate for the age and size of the child. A newborn infant requires a different seat than a 3-year-old toddler.
• Car seats for infants should always face the rear. In this position, the forces and impact of a crash will be spread more evenly along the back and shoulders, providing more protection for the neck.
• Car seats should always be placed in the back seat of the car-ideally in the center. This is especially important in cars equipped with airbags. If an air bag becomes deployed, the force could seriously injure or kill a child or infant placed in the front seat.
• Make sure the car seat is properly secured to the seat of the vehicle and is placed at a 45-degree angle to support the head of the infant or child.

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Choose the Right Shoes

Look around any crowded city street, and you'll see plenty of footwear— from stiletto heels to platform shoes— that is more than a little unkind to our feet. It's no wonder that foot pain is such a common complaint. But it's not just our feet that are hurting. Improper footwear places strain on the knees, hips and back. According to Karen Achtermann, DC, your feet serve three purposes: support, locomotion and shock absorption. So, support your body by following these guidelines for proper footwear.

Leave the High-Heels Behind

Women, listen up: The higher the heel on your shoe, the greater the amount of stress placed on your forefoot. High-heeled shoes can contribute to the collapse of one or more of the foot's three arches. These shoes also place undue stress on the ankle, which can lead to ankle instability and sprains. Plus, when you wear high-heels your calf muscles shorten, warns Achtermann. Then, if you alternate between high heels and flat shoes, your calf muscles go through a shorten/lengthen cycle that can lead to pelvic imbalances and low back pain.
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