This document provides guidance for parents on keeping their children hydrated, preventing heat-related illness, injury prevention, and overall health and wellness for young athletes. The key points covered include drinking plenty of water before, during and after practices and games; using sports drinks for prolonged or vigorous activity in hot weather; avoiding energy drinks; stretching and strength training; treating injuries properly; and making sure children have fun playing sports.

2. THANKS FOR THE INVITE!
Pamela Trout MD, FAAP, CEDS
Lake Nona Pediatrics in Association with Nemours
9145 Narcoossee Rd, Suite 103
407-243-2043
Pamela.Trout@Nemours.org

3. CONGRATULATIONS!
By participating in sports, your child will gain many rewards for
both the SHORT and the LONG term:
• Increased Physical Activity
• Better Social Skills
• Positive Self Esteem
• Improved Academic Success
• Better Lifelong Health

4. 1. DO: HYDRATE, HYDRATE, HYDRATE!
Start with getting enough FLUIDS during the day:
Ounces needed per day = ½ your child’s weight in pounds
Minimum = 50 ounces per day
Then focus on hydrating for sports:
Water should be available before, during and after practice and games
30-60 minutes before sports: 8-16 ounces
During sports: 4-8 ounces every 15-20 minutes of activity
How do you know your child is getting enough fluid?
He/she does not have a dry mouth, or feel thirsty
His/her urine is light yellow

5. WHAT ABOUT “SPORTS” DRINKS FOR SPORTS?
Sport Drinks DO have a place in hydration for young athletes:
• Practice and sporting events when it is HOT (especially >90’F)
• Prolonged and vigorous sports activities (more than 45-60 minutes)
• Recovery phase (within 30 minutes of sporting event/ practice)
Sport Drinks replace Carbohydrates and Electrolytes, and should
be used for hydration when appropriate. They may help prevent
heat-related illness, fatigue, and cramping.
Low-calorie and flavored-water alternatives are NOT “sport drinks.”
These should only be used for the child who participates in
sports but does not like plain water for basic hydration

6. DO NOT: DRINK “ENERGY” DRINKS
“Energy” Drinks and “Sports Enhancing” drinks have NO
place in the Young Athlete’s regimen for nutrition or
hydration
• Most have not been studied in children and teens
• Caffeine, a common ingredient, has been shown to have
adverse effects in kids
• Many ingredients can ADD to the risk of children overheating

7. 2. DO NOT: GET OVERHEATED
Heat Stress can lead to HEAT STROKE
Heat related illness is most common:
• In August
• With strenuous and prolonged exercise
• In high risk environmental conditions (HOT & HUMID)
To avoid heat-related illness:
• Pre-hydrate, and hydrate during activity
• Wear light-colored, absorbent, loose-fitting clothing
• Have close supervision
• Take adequate breaks in between activities (2 hours)
• Watch the Heat Index!

8. DO: ADJUST ACCORDING TO HEAT INDEX:

9. DO WORRY: HEAT STRESS CAN BE DANGEROUS
When Heat stress leads to HEAT Exhaustion & Cramping:
• Stop activity and have athlete lie down in cool/ shaded area
• Give hydration (sport drink), place cool compresses, use fans if
available
• Passive stretching for cramps
When to worry, and SEEK MEDICAL ATTENTION IMMEDIATELY:
1) Signs of heat exhaustion not improving after 15-20 minutes
2) Any signs of HEAT STROKE: Flushed skin with NO SWEATING,
severe dehydration, body temp >104’F, confused, slurred
speech, or passed out.

10. 3. DO: STRETCH!
• In growing athletes, muscles are often tight to begin with
because their muscle length is trying to keep up with the bones
growing longer.
• Flexibility is not just about being able to do the “splits”
• Flexibility helps to avoid injury by putting less tension on the
tendons and bones
• Stretching should be incorporated into every practice and
athletic event
• Muscles should be WARM before starting to stretch
• For “warm-up,” take a few laps jogging or do some
jumping jacks first
• Always stretch AFTER practice or a sporting event
• NO BOUNCING or forcing a stretch!

11. 4. DO: STRENGTH TRAIN!
Young athletes DO need strong muscles!
Muscles help support the joints, which decreases
their risk of both acute and over-use injuries
Strength-training should include:
• Exercises that use their own body weight for
resistance
• Lighter weights with higher repetitions (heavy
weights can STRESS the joints instead of helping
their muscles)

12. 5. DON’T: “PLAY THROUGH THE PAIN”
ALWAYS let your coach know if you have been hurt, or have a nagging pain.
The GOAL is to avoid:
• Damage (possibly permanent) to your body from ignoring an injury
• New injury because your old injury was not ready for play.
Follow your doctor’s and trainer’s orders:
• Don’t skip the ICE, and REST it takes to let your injury heal
• Don’t cheat on the stretching and strengthening exercises it will take to
get your body ready to return to the sport
You should not return to your sport until:
• Your injury does not distract you with pain
• You can complete all drills and activities with proper form

13. 6. DO: ICE!
ICE is your friend! Ice is an anti-inflammatory.
• For aches and pains after practice:
ICE the area for 10-20 minutes after activity
• For acute injuries:
ICE for 10-15 minutes up to every 1-2 hours
TOO much ice for too long can lead to frostbite and blistering
Heat may be warranted if recommended by your doctor or trainer.
Ibuprofen can help decrease inflammation after an injury, but
should not be taken consistently for long periods of time,
UNLESS recommended by your doctor.

14. 7. DO: BE EDUCATED ABOUT CONCUSSIONS
Concussions can happen in ANY sport.
You do not need to get hit in the head to suffer a concussion
If anyone suspects a concussion, the athlete should stop practice or the
game immediately, and should not return to play that day.
Athletes: any hit or sudden movement to your head that causes pain,
abnormal hearing or vision, feeling confused, off balance, or like you
are moving in slow motion, or a sense that you can’t remember how it
happened
Parents and coaches: any event that causes the athlete to look like they
have “blacked-out,” paused for too long after a fall to get up, look
confused, can’t hear you calling for them, are stumbling or look off-
balance or have slowed reactions

15. HEAD INJURIES THAT REQUIRE IMMEDIATE ATTENTION:
IF associated with:
• Blurry or Double vision
• Drainage from nose or ears
• Severe or worsening headache
• Confusion or slurred speech
• Persistent vomiting
• Any numbness or weakness in arms or legs
• Extreme sleepiness or irritability
• Seizure
• More than 30 seconds unconscious

16. WHAT TO DO AFTER A CONCUSSION:
Do: go see your child’s Primary Care Doctor
Do: encourage fluids and REST (both from physical activity
and mental strain (TV, video games, texting)
Do: Keep a symptom checklist DAILY
Follow-up weekly with your PCP
Check in with the Trainer about your child’s progress
Communicate with your child’s school about any restrictions
FLORIDA LAW has strict “return to play” guidelines once your
child is no longer having symptoms. A licensed health care
provider must sign that it is OK for your child to start a graded
and scheduled return to activity.

17. For ImPACT baseline testing (age >11yrs),
or assistance with evaluation and management of concussions:
The Comprehensive Concussion Center at
Nemours Children’s Hospital
407-650-7250

18. 8. DON’T: “CUT WEIGHT” OR “BULK UP”
WITHOUT A DOCTOR’S ADVICE
Weight Loss during a child’s period of growth can be detrimental to their
health . Risks include heart muscle atrophy, electrolyte imbalances, low
bone density, and even brain atrophy.
Adding weight or “bulking-up” is not an appropriate goal for pre-pubescent
kids.
The focus on weight or size at any age can lead to unhealthy eating
patterns, obsession with body image, and ultimately eating disorders.
Any “supplements” to aid in these processes should be checked for safety
with your doctor.
Focus should always be on healthy habits: including exercise, nutrition ,
hydration, and good sleep.

19. 9. DO: TAKE A BREAK
Our goal for young athletes should be to prevent:
Over-use injuries, over-training, and “burnout.”
Take a break from your sport:
• At least 1-2 days per week
AND
• At least 2-3 months per year
Encourage participation on only ONE team at a time (or take into
account their TOTAL time participating, instead of time for each
team)
Multi-sport athletes do best when their different sports have
emphasis on different body parts
Brenner, “Overuse injuries, Overtraining, and Burnout in Child and Adolescent
Athletes,” Pediatrics, 2007

20. 10. DO: HAVE FUN!
FOR THE ATHLETES: Sports can be challenging, but you should
be having FUN at the end of the day!
• Enjoy the time you get to spend with your teammates.
• Appreciate the learning process and every little improvement you make.
• Be proud of all the hard work you have put in to this sport!
• Don’t be afraid to try a NEW SPORT when the season is over.

21. FOR PARENTS: IT IS NOT ALL ABOUT PERFORMANCE.
The Only SIX Words Parents Need to Say to Their Kids About Sports”:
“ I LOVE TO WATCH YOU PLAY!”
Before the Competition:
Have Fun.
Play Hard.
I love you.
After the Competition:
Did you have fun?
I’m proud of you.
I love you.
From: “What parents should say as their kid performs,” Tim Elmore

22. FOR COACHES & PARENTS:
Prior to adolescence, focus on:
1) Have fun
2) Learn Skills
3) Learn Teamwork
From the AAP Committee on Sports Medicine and Fitness

23. REFERENCES & RESOURCES

24. QUESTIONS?
Thank you! Have a fun & safe season!
Go Lions!