Expert Tips from Just Ask Children's


Just Ask Children's May Sports and Exercise

Keep your kids healthy with valuable tips and information from experts at Children's Hospital Colorado. Different popular topics are highlighted each month. 

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This month's topic: Sports and exercise

Here are the top 10 questions from parents about sports and exercise and answers from our panel of experts from Children’s Colorado. 

What is the best physical activity for kids?

That’s simple – whatever they enjoy. Just get them active. There isn’t anything that's necessarily better than another. It can be dancing, soccer, running, swimming, football, jumping rope, bike riding – anything that keeps them moving and helps build an active lifestyle. 

Julie Wilson, M.D., Pediatric Sports Medicine Physician, Orthopedics Institute, Children’s Colorado

When should I switch my child from a strider bike to a pedal bike?

There is not a specific age when kids can move from a strider bike to a pedal bike. When your child has developed the motor skills and balance to glide on their strider bike for at least 10-15 seconds with their feet up off the ground, then they are ready to transition to a pedal bike. 

Lower the seat of the pedal bike so they can easily touch the ground and have them start by gliding. Once they are comfortably gliding, tell them to start pedaling while keeping their eyes up. As always, make sure your child has a properly fitted helmet whenever they are riding.

Julie Wilson, M.D., Pediatric Sports Medicine Physician, Orthopedics Institute, Children’s Colorado

Should high school athletes have an Echocardiogram or any other test to rule out any unknown heart problems (ie: hole in the heart, enlarged heart) when training for sports?

The current recommendation from the American Heart Association is that sports pre-participation physicals should not include widespread ECG screening but ECG screening by individual quality-controlled local, community, or student-related initiatives were supported if conducted properly and with quality control and adequate resources. It is a highly debated topic in the sports medicine community. If there is a significant family history of cardiac issues or if a young athlete has any symptoms of heart trouble, it would be advisable to speak to their primary care physician about the need for testing.

Aaron Provance, Medical Director, Sports Medicine for Young Athletes, Children's Hospital Colorado, Orthopedics Institute

Should I let my child play football?

This is a very common question we're asked as pediatric sports medicine physicians. As mentioned above, football has all the benefits of other sports including cardiovascular health, psychological benefits, improved school performance, social development and learning how to be a team member. These attributes will aid in life-long learning skills that will be used throughout their lives and careers. On the flip side of the coin, football carries the burden of the highest rates of concussions per 1,000 athlete exposures. 

The majority of young athletes suffering concussions from football will have a full recovery within two to three weeks. There is significant concern over more long-term cognitive complications from multiple concussions. At this point in time, no true cause and effect relationship has been proven with medical research between multiple concussions and long term cognitive conditions. In football, there is also a risk of catastrophic head and neck injuries resulting in long term or permanent neurological deficits. These more serious injuries usually involve three to four athletes per year in the U.S. 

Looking at the statistics, there is a higher chance of a football player being hit by lightning than suffering a catastrophic head or neck injury. Allowing your young athlete to play football should involve a discussion with the athlete and their parents/guardians about the risks/ benefits. The benefits of playing football seem to outweigh the risks at this time but future research may change our perception. Learn more about football injuries we treat.

Aaron Provance, Medical Director, Sports Medicine for Young Athletes, Children's Colorado, Orthopedics Institute

Are there any steps or measures we can take to ensure our child plays "smart" to avoid becoming a victim to concussions?

Concussions can be scary and must be taken seriously, but we must also remember that youth sports like football are associated with innumerable benefits including improved physical health, psychosocial well-being, and even better school performance. The most effective tools for minimizing the risk for concussion are concussion education, proper helmet fitting and proper tackling techniques.

Knowing the facts about concussions is important because misinformation can cause injuries to be minimized in certain cases or cause unnecessary alarm or worry in others. Parents, athletes and coaches should all be educated on the signs and symptoms of concussion to ensure that concussions are recognized and your athlete then receives the proper medical care. Learn more about how to recognize concussions.

Many families are also asking if the new high technology football helmets can help prevent concussions. There is no magic football helmet that can prevent concussions, yet. Please visit our sports blog to learn more about the current research regarding high technology football helmets.

Aaron Provance, Medical Director, Sports Medicine for Young Athletes, Children's Hospital Colorado, Orthopedics Institute

How old does my child need to be to start lifting weights?

There isn’t a specific age limit at which it is too young to begin weight lifting, fortunately research has made it clear that resistance training doesn’t lead to any disturbance in growth or risk of injury. However, general recommendation for middle school athletes is to perform body weight lifts and machine guided weight training instead of free weights. 
Additionally, they should be well supervised while lifting so they are doing it correctly, lifting weight that is appropriate for them and doing it with good form to get the best benefit out of it and to limit risk of injury.

Finally, the repetition range for lifts should be between 10 and 15 and one repetition “max lifts” should be avoided. For a sport like football, strength is indeed important, but at 7th grade level spending time working on his skills and on field conditioning may benefit him more than weight training depending on the position he plays.

Aaron Provance, Medical Director, Sports Medicine for Young Athletes, Children's Hospital Colorado, Orthopedics Institute

What are the best sports to instill a life-long love of being active in my child?

I would encourage you to let your child play any and all sports at an early age. Every young athlete is unique and may find passion and joy in differing settings and environments. I think the key to your question is the lifelong love of being active! This can be accomplished out of sport as much as in sport. Would hiking with the family every week be any less enjoyable than playing football? 

If you want to instill a passion for being active my best advice is to not worry about what is the best, but exposing the child to a multitude of activities then letting them decide. Just as important, modeling an active lifestyle as a parent and family is what kids really learn from. My experience is a family that is active regularly together teaches a lifestyle that is maintained in the children.

Gregg Brueck, Athletic Trainer, Real Colorado Soccer Club, Orthopedics Institute, Children's Colorado

What is the best snack high school athletes can have after a long day of school and right before intense practice?

A pre-practice snack is very important to fuel a productive high school work out, especially if the athlete has lunch period as early as 10:30 or 11 a.m. It is also important to contribute to their total daily calorie needs that support both sports performance and growth. Look for snacks that are high in carbohydrate and fluids to provide energy for hard-working muscles and hydration. Also look for foods that are low in fat and fiber for easy digestibility. The goal is to prevent hunger and undigested food in your athlete’s stomach during practice. 

Here are some good examples:

  • Drinkable yogurt
  • Low-fat or fat-free yogurt
  • Yogurt and fruit smoothie
  • Low-fat or fat-free milk or milk substitute (soy milk, almond milk, etc.)
  • Low-fat chocolate or strawberry milk or milk substitute 
  • Fresh fruit
  • Sports bars can be used as occasional, on-the-go type snacks before a practice.  Here are some options: Clif MoJo Peanut butter pretzel bar®; Kashi Go Lean Crunchy Chocolate pretzel®; Luna S’mores or lemon zest bar®; and Kashi Go Lean Oatmeal Raisin Protein & fiber bar®

Gregg Brueck, Athletic Trainer, Real Colorado Soccer Club, Orthopedics Institute, Children's Hospital Colorado

Is it okay to give my kids Gatorade, Vitamin Water, or Smart Water after they exercise or should I just stick to regular water and an apple or orange?

In most cases, I would stick to water and a healthy snack. The exception would be if your child consistently exercises at high levels of intensity (such as team or some individual sports) for an extended period of time (one hour or more) or if your child is exercising in harsh weather conditions (very hot or very cold). In these cases, it may be a good idea to drink something other than water in order to improve hydration and/or support recovery.

Gregg Brueck, Athletic Trainer, Real Colorado Soccer Club, Orthopedics Institute, Children's Colorado

My teenager is having difficulty breathing when playing sports. She often has to sit out and take a breather after running for a long time. Could this be asthma related?

In general, children that have difficulty breathing during exercise may have exercise-induced asthma, especially if they carry a diagnosis of asthma. Either consult with your pediatric provider or have an asthma expert at Children's Colorado evaluate her. This may lead to a treatment regimen that may allow her to participate without having to sit out at all, and it may allow her performance to improve.

Shortness of breath associated with exercise can be one of several things apart from asthma. Underlying cardiac issues or even vocal cord dysfunction can cause difficulties with breathing during exercise. Certainly asthma can too. You can have exercised induced bronchospasms that can cause these symptoms. There are other questions that need to be asked, however, before we can say it is asthma. 

For example, how far into exercise do the symptoms occur and how long do the symptoms last after she stops exercising? Is there associated coughing as well? Can you hear wheezing? Is there a personal or family history of asthma or seasonal allergies? Any chest pain or palpitations? Any family history of heart conditions? Any history of fainting? Is this something new or has it been going on for a while? Are there episodes of shortness of breath that occur frequently with colds?

My recommendation is for your daughter to be evaluated first by her pediatrician with this question in mind. Your pediatrician may give a trial of albuterol before activities that can sometimes be helpful in diagnosing exercised induced asthma. If that does not help prevent her symptoms, she would need to be evaluated for other conditions. 

Stanley J. Szefler, M.D., Director, Pediatric Asthma Research Program and Research Medical Director, Breathing Institute, Children’s Colorado

Get more sports and fitness advice for your young athlete.