What is Sports Nutrition?

Sports nutritionis the practical science of hydrating and fueling before, during, and after exercise.

What is Pre Training Meal?

The meal/snack choice just prior to training is pre training meal.The primary purpose of this meal is to prevent hunger, ensure mental alertness and to provide immediately available glucose into the blood stream for the upcoming exercise.

Should I eat during Training?

Eating is not essential for training less than 1 hour. For longer events or training sessions  (>1 hour), consuming 0.7 g carbohydrate/kg body weight per h (approximately 30 to 60 g per h) has been shown unequivocally to extend endurance performance. Consuming carbohydrates during exercise is even more important in situations when athletes have not carbohydrate-loaded, consumed pre exercise meals, or restricted energy intake for weight loss.

How long should I wait to eat after Exercise?

The timing and composition of the post competition or post exercise meal or snack depend on the length and intensity of the exercise session (i.e., whether glycogen depletion occurred), and when the next intense workout will occur.

For example, most athletes will finish a marathon with depleted glycogen stores, whereas glycogen depletion would be much less marked following a 90-min training run. However, most athletes competing in a marathon in the morning will not be doing another race or hard workout in the afternoon. Timing and composition of the post exercise meal are thus less critical for these athletes. Conversely, a triathlete participating in a 90-min run in the morning and a 3-h cycling workout in the afternoon needs to maximize recovery between training sessions, and the post workout meal assumes considerable importance in meeting this goal. Timing of post exercise carbohydrate intake affects glycogen Synthesis over the short term. Consumption of carbohydrates beginning immediately after exercise (generally within ½ hour) (1.5 g carbohydrate/kg at 2-h intervals is often recommended) results in higher glycogen levels at 6 h post exercise than when ingestion is delayed for 2 h .

Energy drinks & food bars- power/hype

Food bars/energy drinks will never beat a well-balanced meal. They contain excessive sugar and calories & just contribute to weight gain, and tooth decay. Energy drinks are often full of caffeine. Also  stimulant drug Causes - jitteriness, upset stomach, headaches, and sleep problems. Large amounts causes- fast or irregular heartbeats, high blood pressure, hallucinations and seizures. (especially people with medical conditions)  Not the same as sports drinks Food bars don't make good meal replacements. They may contain mysterious ingredients which  may not be regulated by U.S. Food and Drug Administration.Therefore both do not contribute for power.

Choosing the Correct Supplement?

When choosing supplements consider the nutrient content (per serving ) & other substances.

What are banned during Sports?

Click here to view WADA prohibited list 2015

Why I feel Thirsty during Training?

During exercise,  heart rate speeds up and the muscles work faster. These actions create a lot of heat in the  body. To cool the body  begin to sweat, which causes water and salts from the  body to seep out of the  pores. When the water and salts evaporate, the extra air cools the body. While this is a natural reaction, during exercising, the sensors in kidneys detect the  lost water. As a result begin to feel thirsty.

What is Sport?

A sport is commonly defined as an organized, competitive, and skillful physical activity requiring commitment and fair play. It is governed by a set of rules or customs.

What is Sport Injury?

Injury which experience by athletes(players) due to sporting activities.This can be sudden or slowly progressive.

Dealing with Sports Injuries

Prevention First

The best way to deal with sports injuries is to keep them from happening in the first place. Think of avoiding injury as just another part of playing by the rulebook. Knowing the rules of the game you're playing and using the right equipment can go a long way toward preventing injurie.

Types of Sports Injuries

• Common reasons why teens get injured playing sports include:
• Not training or playing properly.
• Training too much.
• Not wearing the right footwear.
• Not wearing the right safety equipment.
• Rapid growth during puberty.

There are two kinds of sports injuries:

• Acute Ttraumatic Injuries - are things like fractures, sprains and strains, concussions, and cuts. They usually happen after a blow or force - like getting tackled in football or wiping out while skateboarding.
• Overuse Injuries - include things like stress fractures and tendonitis. These injuries are also called chronic injuriesbecause they happen over time, usually from repetitive training,like running, overhand throwing, or serving a ball in tennis. Overuse injuries can be just as damaging as acute injuries, even though they might not seem serious at first. If they're not treated, they usually get worse.

What to Do    

If you think you've been injured, pull yourself out the game or stop doing your activity or workout. Let a coach or parent know what happened in case you need to see a doctor.

Call a doctor when:

• Pain is very bad.
• Pain is worse when you're active.
• The injured area is swollen.
• You're limping.
• Your range of motion is limited.
• Pain continues for a while, gets worse at times, or lasts for a week or more following an injury.

Where Injuries Happen

You can get a sports injury anywhere on your body. Here are some key points to know about common sports injuries.

Head and Neck Injuries

Serious head and neck injuries happen most often in athletes who play contact sports (like football or rugby) or sports with the potential for falling accidents, such as horseback riding and gymnastics.

Head injuries include fractures, concussions, contusions (bruises), and hematomas. A hematoma is bleeding or pooling of blood in or around the brain caused by an impact to the head from a fall, forceful shaking of the head, or a blow to the head.

Neck injuries include strains, sprains, fractures, burners, and whiplash, which is an injury to the neck caused by an abrupt jerking motion of the head. Neck injuries are among the most dangerous sports injuries.

Never try to move someone who may have a neck injury. A mishandled neck fracture could lead to permanent paralysis or even death. Keep the injured person still with his or her head held straight while someone calls for emergency medical help. If the person is lying on the ground, do not try to move him or her.

Back Injuries

Most back injuries are caused by twists or overexertion of back muscles during bending or lifting movements. Back injuries are most common in contact sports like football and ice hockey, or in weightlifting, rowing, golf, figure skating, gymnastics, and dancing.

Sex Organ Injuries

Injuries to the sex organs usually affect guys more than girls because the penis and testicles are outside the body and are more exposed. Injuries to the uterus or ovaries are rare, but breast injuries are a common complaint among teen girls. As the breasts develop, they often can be sore, and a blow from a softball or a collision during field hockey can be painful.

Hand and Wrist Injuries

Hand, finger, and wrist injuries can happen after things like a fall that forces the hand or fingers backward, or a direct blow. As with other injuries, hand and wrist injuries are most common in contact sports, such as football, lacrosse, and hockey, or in sports like gymnastics, field hockey, rowing, and basketball where the fingers, hands, and wrists are at risk.

Foot and Ankle Injuries

Feet and ankles are particularly vulnerable to injury in sports that involve a lot of running. Another reason for foot injuries is wearing the wrong shoes, especially if someone has flat feet, high arches, or other foot differences.

Getting Back in the Game

Your first question after a sports injury will probably be, "When can I play again?" This depends on the injury and what your doctor tells you. Even if you can't return to your sport right away, a doctor or physical therapist might have suggestions and advice on what you can do to stay fit. Always check with your doctor before trying any activity following an injury.

Rehab

A rehabilitation program also can help you stay fit as you recover. If rehabilitation ("rehab" for short) is part of your treatment program it might include exercise, manual therapy from a physical therapist, and ultrasound or other technology to help relieve pain and promote healing.

Preventing Re-Injury

When you've recovered, you might need new protective gear to protect an injured body part. This can include modified shoes, tape to provide extra support, or additional padding to protect against a direct blow.

To help prevent re-injury, be sure to warm up before practice and games. Take it slow when you first get back to your sport and gradually build back up to your pre-injury level.

Most importantly, know your limits. Check in with your body: if a previously injured area (or any body part) begins to hurt, stop right away and rest. Get help from a doctor if the pain continues. Pain is your body's way of saying something isn't right.

Common Sports Injuries

Achilles Tendonitis	Medial Collateral Ligament (MCL) Injuries
Ankle Sprains	Medial Epicondylitis
Anterior Cruciate Ligament (ACL) Injuries	Meniscus Tears
Blount Disease	Muscular Dystrophy
Broken Bones	Osgood-Schlatter Disease
Bursitis	Osteomyelitis
Casts and Splints	Plantar Fasciitis
Chronic Fatigue Syndrome	Proximal Biceps Tendonitis
Clavicle Fracture	Quadriceps Contusion
Costochondritis	Repetitive Stress Injuries
Female Athlete Triad	Scoliosis
Fibromyalgia	Scoliosis : Personal Stories (Video)
Groin Strain	Sinding-Larsen-Johansson Syndrome
Guillain-Barré Syndrome	Slipped Capital Femoral Epiphysis (SCFE)
Hamstring Strain	Spinal Muscular Atrophy : Steven's Story (Video)
Hip Pointer	Strains and Sprains
Juvenile Idiopathic Arthritis	Stress Fractures
Knee Injury : Caroline's Story	What Causes Muscle Twitches?
Kyphosis	What to Expect When Your Cast Comes Off
Lupus

How will I prevent these Injuries?

Pre participation medical examination

Before starting any sports advised to fill the following form of pre participation evaluation (PPE -Form is available at the ISM website).This designed to early identification of potential risk of injury due to -

• Medical causes-such as fever, CVS or pulmonary abnormalities
• Anatomical abnormalities
• Previous injury
• Poor conditioning
• Malnutrition
• Growth in children
• If you are planning to go to a gym or any other physical activities it is strongly recommend to fill the PAR-Q (Physical Activity Readiness Questionnaire) first. If you answer any of the question with the answer yes then you should seek medical advise prior to starting any activity.

Adequate warm up

• Needs to elevate core temperature 1-2 C.
• Increase release of oxygen from  Hemoglobin / Myoglobin.
• Improved mechanical efficiency of  contracting muscles.
• Augment function of nerve system.
• Increase blood flow to working muscle.

Adequate stretching

• It increase elasticity of Tendon, Muscle
• It increase flexibility
• It decrease injuries
• It increase tissue temperature
• It increase muscle blood flow
• It increase innervation of a muscle tendon unit
• When and how to do stretching?

When -

• Light stretching before warm up.
• Dynamic stretching during warm up.
• Static Stretching after warming down.   

How -

• Stretching of muscle parallel to long axis of muscle.
• Keep the muscle stretch for about 15/second.

Correct Biomechanics

When you develop skills, technique is more important biomechanics evaluate your Anatomical structure and movements to minimize the risk of injury.

Appropriate equipment including protective equipments in certain sports

• Select standard equipment.
• They should be in good condition.
• Grip size should be appropriate.
• Weight of equipment should be appropriate for age and ability.

Bracing and taping

• This is not a substitute for proper rehabilitation.
• It should only wear to prevent injuries or during rehabilitation period.

Appropriate surfaces

• Choose a surface that suits the game and training.
• It should be safe and environment around that should be safe.
• Try to do training in different surfaces.
• Wet slippery surfaces should be best avoided.

Adequate training

Should always include all health related and skill related components in all sports.Training sessions should include all components according to the sport demand under age specific guidelines. If exceeds these limits overuse injuries may occur.please refer to guidelines and specific forms.

Adequate rest/Recovery

• Cool down period after exercise.
• Sports Massage.
• Adequate rest and sleep.
• Psychological relaxation.
• Optimal recovery food.

Adequate psychological preparation and adequate nutrition

General Guidelines -

• Mandatory to complete PPE(Pre–Participation Evaluation).
• Adaquate medical coverage at the event.
• Coach should know the biological, physiological and social problems of the child.
• "Training for maximum performance"( at an early stage) should be condemned on medical and ethical grounds.
• Child’d overall development  over training and competition.
• Early specialization should be discouraged.
• Beside the chronological age , maturity, body size, skills and gender.
• Proper equipment and field/surface playing conditions.
• Planned training sessions should be tailored to the age of the participants to minimize the risk of injury.

Long Distance

• Weekly Training distance should not be more than twice the recommended maximum competition distance .
• Races up to 10 km can be undertaken on a weekly basis.
• Races over 10km require more recovery time (twice or trice the normal training).
• Training frequency  up to 14 years : 3/week.
• Over 15 years 5/week.
• Should wear shoes.
• Recommended Maximum running distance at different ages.

Fluid Replacement(water) for children and adolescents

Other important guidelines

• The child should not participate if the symptoms are general (e.g. temperature, aches, pains, general muscular tiredness).
• For uncomplicated upper respiratory tract symptoms, such as a runny nose or sneezing, the child should be allowed to participate for 10-15 minutes. The child’s condition should then be reassessed, and if they feel unwell, or are obviously struggling to keep up, then they should not continue to participate in that session.
• Parents of a child taking prescription medication should discuss any implications for participation with the treating doctor before participating insport or physical activity.
  • A number of conditions which, when medicallysupervised, do not permanently preclude a child’s.
• Involvement in sporting activity (but may at anygiven time exclude participation). These include:
  • Chronic infections.
  • Cardiovascular abnormalities.
  • Musculoskeletal problems like arthritis.
  • Medical conditions such as diabetes, asthma, epilepsy.

First aid in sports

If you experience an injury inspire of all these principals of prevention please following measures before heading for a doctor.

• P - prevention of further injury - do not continue to play. come out the field and let the medical personnel assess.
• R - relative rest - with his you can avoid aggravating the injury but maintain your physical fitness levels to prevent injuries when you return.
• I - ice you need to keep ice for 10 min for every 2 hours in first 72 hours ( 3 days) make sure not to keep ice straight to the skin but t wrap with a cloth or cellophane paper.
• C - compression when you keep ice and after keep the area bandaged to compress to avoid bleeding inside.
• E - Elevation  elevate the the injury site to a higher level than the heart.
• R - rehabilitation  you should not forget that this is just the first aid but you have to rehabilitate the area otherwise rein jury prevalence is very high e.g.: ankle sprain.

Sports Injuries

Achilles Tendonitis

Kim didn't do much over the summer except hang out at the pool. When she did wear something on her feet, it was often heels. But as soon as school started, she laced on a pair of sneakers and went out for the cross-country team, running a couple of miles each day.Within a week, Kim noticed a pain just above her heel. At first it wasn't too bad, and she kept running. But before too long, the pain got worse and wouldn't go away. Kim had to stop running, and her coach told her to go see a doctor. The doctor examined her heel and told Kim she had Achilles tendonitis.

What Is Achilles Tendonitis and Who Gets It?

Achilles tendonitis is a very common running injury. But it can also affect basketball players, dancers, or people who put a lot of repeated stress on their feet. It can be very painful.

What Are the Symptoms of Achilles Tendonitis?

• Most cases of Achilles tendonitis start out slowly, with very little pain, and then grow worse over time. Some of the more common symptoms include:
• mild pain or an ache above the heel and in the lower leg, especially after running or doing other physical activities.
• Pain that gets worse when walking uphill, climbing stairs, or taking part in intense or prolonged exercise.
• Stiffness and tenderness in the heel, especially in the morning, that gradually goes away.
• Swelling or hard knots of tissue in the Achilles tendon.
• A creaking or crackling sound when moving the ankle or pressing on the Achilles tendon.
• weakness in the affected leg.

What Causes Achilles Tendonitis?

Achilles tendonitis is a common sports injury caused by repeated or intense strain on the tendon. But non-athletes also can get it if they put a lot of stress on their feet.

Other things that contribute to Achilles tendonitis include:

• An increase in activity:Starting a training program after a period of inactivity or adding miles or hills to a jogging regimen are two examples of things that put people at risk for Achilles tendonitis.
• Sports that require sudden starts and stops: for example, tennis and basketball.
• A change in footwear, or wearing old or badly fitting shoes:New shoes, worn-out shoes, or the wrong size shoes can cause a person's feet to overcompensate and put stress on the Achilles tendon. Additionally, wearing high heels all the time can cause the tendon and calf muscles to get shorter, and the switch to flat shoes and exercise can put extra strain on the heel.
• Running up hills:Going uphill forces the Achilles tendon to stretch beyond its normal range.
• Weak calf muscles, flat arches, "overpronation" (feet that roll in when running),or "oversupination" (feet that roll out when running).Overpronation and oversupination make the lower leg rotate and put a twisting stress on the tendon.
• Exercising without warming up: Tight calf muscles or muscles that lack flexibility decrease a person's range of motion and put an extra strain on the tendon.
• Running or exercising on a hard or uneven surface or doing lunges or plyometrics without adequate training.
• A traumatic injury to the Achilles tendon.

How Can You Prevent Achilles Tendonitis?

Take these steps to reduce your risk of Achilles tendonitis:

• Stay in good shape year-round and try to keep your muscles as strong as they can be: Strong, flexible muscles work more efficiently and put less stress on your tendon.
• Increase the intensity and length of your exercise sessions gradually: This is especially important if you've been inactive for a while or you're new to a sport.
• Always warm up before you go for a run or play a sport: If your muscles are tight, your Achilles tendons have to work harder to compensate.
• Stretch it out: Stretch your legs, especially your calves, hamstrings, quadriceps, and thigh muscles - these muscles help stabilize your knee while running.
• Get shoes that fit properly and are designed for your sport: If you're a jogger, go to a running specialty store and have a trained professional help you select shoes that match your foot type and offer plenty of support. Replace your shoes before they become worn out.
• Try to run on softer surfaces like grass, dirt trails, or synthetic tracks: Hard surfaces like concrete or asphalt can put extra pressure on the joints. Also avoid running up or down hills as much as possible.
• Vary your exercise routine: Work different muscle groups to keep yourself in good overall shape and keep individual muscles from getting overused.
• If you notice any symptoms of Achilles tendonitis, stop running or doing activities that put stress on your feet: Wait until all the pain is gone or you have been cleared to start participating again by a doctor.

Sprained Ankle

As a field hockey player, Jill was used to twisting her ankle. She'd always been able to walk it off and get back in the game. But one day she stepped on another player's foot and turned her ankle badly. It hurt a lot, and she had trouble walking and putting weight on it.

After the game, Jill went to her doctor and had him look at her ankle. It was bruised and swollen and felt unstable when she tried to walk on it. The doctor told Jill she had a grade 2 ankle sprain and would have to sit out for 4 to 6 weeks before she could play again.

What Is a Sprained Ankle?

A sprained ankle is a very common injury for teens - athletes and non-athletes alike. It happens when the ligaments that support the ankle get overly stretched or torn. Sprained ankles can happen when you step in a hole, slip walking downhill, or just put your weight down on your foot awkwardly.

What Causes a Sprained Ankle?

Most ankle sprains happen when people turn or twist too fast and too far, or when the foot rolls onto its side, injuring the ligaments that connect the ankle and leg bones. You don't have to be playing hard to injure an ankle: sprains can happen just from taking an awkward step or tripping on the stairs.

The most common type of sprained ankle is called an inversion sprain, or lateral ligament sprain. With this type of sprain, the ankle turns so the sole of the foot is facing inwards, stretching and possibly damaging the ligaments on the outer part of the ankle.

When you turn your ankle the other way, so that the sole of the foot is facing outward, this is called a medial ligament sprain. This damages the ligaments on the inside of a person's ankle. Medial ligament sprains are fairly rare.

If you repeatedly sprain the same ankle or feel pain for more than 4 to 6 weeks, you may have what's called a chronic sprain. This type of lasting sprain can flare up and be made worse by activities that involve rolling or twisting the feet, like running, dancing, or playing sports.

Can I Prevent a Sprained Ankle?

It's impossible to prevent all ankle sprains. But everyone can take precautions to make sprains less likely.

The best way to prevent ankle sprains is keeping your ankles flexible and your leg muscles strong. Your coach, doctor, or PE teacher can give you some easy at-home exercises to build muscle strength (which protects ligaments) and joint flexibility.

Here are some other ways to protect yourself against ankle sprains:

• Always warm up and use the recommended stretching techniques for your ankles before playing sports, exercising, or doing any other kind of physical activity.
• Watch your step when you're walking or running on uneven or cracked surfaces.
• Don't overdo things. If you're tired or fatigued, it can make an injury more likely. Slow down, stop what you're doing, or take extra care to watch your step when you're tired.
• If you've had a sprained ankle in the past, make sure it's completely healed before you try any strenuous physical activities.
• Using tape, ankle braces, or high-top shoes may be helpful if you're prone to ankle sprains.
• Get good shoes that fit your feet correctly, and keep them securely tied or fastened when you're wearing them. Speaking of shoes, one of the biggest causes of ankle sprains in women is wearing high-heeled shoes.

ACL Injuries

A torn anterior cruciate ligament (ACL) is a common knee injury, especially for athletes. Ligaments are long, rope-like bands that fasten bones together. The ACL helps give the knee its stability.

Teens who play contact sports (like football) or sports that feature swift, abrupt movements such as pivoting, stopping, or turning on a dime, are most likely to get ACL injuries. People also can tear an ACL when they jump and land with their knees straight or "locked" instead of flexed. This puts pressure on the knee joint and causes the ACL to tear or break apart.

Teen girls are 8 to 10 times more likely than guys to tear an ACL. There are several reasons why, including the fact that girls and guys have different body shapes and limb alignment. Hormones can play a role, too. Female hormones may loosen the ligaments.

ACL injuries can really hurt. They can also lead people to be unsteady on their feet and have difficulty walking. Depending on the person's age and the severity of the injury, a torn ACL often requires surgery in addition to 6 to 12 months of rehabilitation.

What an ACL Does

The ACL is one of the four main ligaments in the knee joint that connect it to the shinbone (tibia) and thighbone (femur). It's located deep within the joint, behind the kneecap (patella), above the shinbone, and below the thighbone.The ACL works with the PCL (posterior cruciate ligament), which crosses over it to form an "X." Together, these two ligaments help keep the knee stable when rotating. The ACL keeps the shinbone in place and prevents it from moving too far forward and away from the knee and thighbone.

Signs That It Might Be an ACL Injury

Here's what most people notice after tearing an ACL:

• Feeling unstable or "wobbly" when walking.
• Inability to put weight on the affected leg.
• Swelling in the knee joint within 24 hours of the tear.
• Pain, which may be intense.

Many people report hearing a "pop" sound when the ligament tears. Others also report the knee feeling looser than it was before. Sometimes, though, people with ACL injuries don't notice anything different. It all depends on how severe the injury is.

If you injure your knee - whether out on the field or at home - stop all activity to prevent further injury. See a doctor as soon as possible. In the meantime, keep your knee iced and elevated to reduce swelling. Don't put weight on your knee.

Athlete's Foot

Although the words ringworm, jock itch, and athlete's foot may sound funny, if you have one of these skin infections, you're probably not laughing.
The good news is that tinea (the name for this category of common skin infections) is usually easy to treat. Read on to learn some fast facts about one very common type of tinea, athlete's foot.

What Is Athlete's Foot?

The medical name for athlete's foot is tinea pedis. Usually, athlete's foot affects the soles of the feet and the areas between the toes and it may also spread to the toenails. Athlete's foot also can spread to the palms of your hands, groin, or underarms if you touch your feet and then touch another area of your body.

Athlete's foot doesn't just affect athletes; anyone whose feet tend to be damp or sweaty can get this infection. The fungi that cause athlete's foot thrive in warm, moist environments.

The signs and symptoms of athlete's foot include itching, burning, redness, and stinging on the soles of the feet or between the toes. The skin may flake, peel, blister, or crack.

How Can I Prevent It?

Athlete's foot is contagious. It's often spread in damp areas, such as public showers or pool areas. To avoid getting athlete's foot, dry your feet -  and the spaces between your toes - well after showering or swimming. Use a clean towel. (Avoid sharing towels because doing so can spread the infection.) If you use public showers, like those in a locker room, wearing waterproof shoes or flip-flops is a good way to protect your feet.

To keep your feet as dry as possible, try not to wear the same shoes or sneakers all the time, and don't wear socks that make your feet sweat or trap moisture. Cotton or wool socks are a good bet. You also can find socks made of special "moisture-wicking" fabrics in many sports stores - these are designed to keep feet dry.

If possible, choose sneakers that are well ventilated - some sneakers have small ventilation holes that help to keep your feet dry.

Bursitis

Andy's a good tennis player. Correction: Andy is a great tennis player. He loves the competition and intensity of the game and is known for his dominating serve.Recently Andy developed pain in his shoulder. At first he thought nothing of it and continued his training, but the pain became unbearable. The pain was so bad he went to see his doctor, who informed him he had shoulder bursitis.

What Is Bursitis?

From your head down to your big toes, your body has lots of differently shaped and sized joints. Many have something in common near the area of the joint - a customized fluid sac that provides cushioning for movement and pressure. These small cushions are known as bursae (a single one is called a bursa). Bursitis is the term used to describe inflammation or irritation of a bursa. Bursitis can result from a direct hit or from repetitive joint movements (like a tennis serve).

If a bursa becomes irritated, either by a direct hit or from a nearby joint repeating the same movement (like a tennis serve), then bursitis can occur. People can also get bursitis when the body has to change its balance or movement to adapt to differences; for example, if a person has one leg that's shorter than the other.

Where Does Bursitis Occur?

Bursitis, especially in teens, is often likely to happen because of sports-related injuries, usually from repeated use of a particular joint or trauma from a direct hit in a contact sport. It's not only sporty types who get bursitis, though. It can sometimes be caused by other problems, such as arthritis or a bacterial infection of the bursa.

Here are some of the areas in which teens most commonly get bursitis:

• Elbow: Because the elbow is an essential part of many activities, like throwing a ball or swinging a tennis racket, elbow bursitis is one of the most common types of bursitis in teens.
• Knee: Bursitis in the knee can be the result of falling directly on the knee or any activity that requires long periods of kneeling.
• Hip: Bursitis of the hip is often associated with running.
• Shoulder: Bursitis of the shoulder can be the result of an awkward fall or the repetitive movements common in overhead sports such as swimming, baseball, and tennis.
• Ankle: Someone who goes overboard with jumping, running, or walking can get ankle bursitis. Wearing poorly fitted shoes can lead to ankle bursitis.

How to Detect Bursitis

Bursitis can cause a number of different symptoms:

• Pain and sensitivity in or around a joint: This is the most common and obvious sign that a person may have bursitis.
• Difficulty moving the affected joint: This happens because the bursa has swollen and made it tough to move the joint properly.
• Swelling: The affected area may appear swollen due to inflammation.
• Reddening of the skin: The inflamed bursa may cause the skin around the joint to change color. Because the bursa can become infected, seek medical attention if the area becomes very red, warm, and painful.

Avoiding Bursitis

Bursitis is often the result of a hard impact on a joint or overworking a joint, and sometimes these injuries are unavoidable. But taking these steps can help you avoid getting bursitis:

• Stay in shape: Working out regularly strengthens muscles and joints, which helps protect against bursitis.
• Don't overdo it: Too much of anything can be bad, and the same goes for overworking joints.
• Start and stop workouts properly: One of the best ways to prevent bursitis is by working out properly. Warming up and cooling down are essential parts of working out and should never be skipped. Gradually starting and stopping your workout is less stressful for your joints and body.
• Stretch it out: Stretching not only helps improve flexibility, but is also useful in preventing bursitis.
• Mix it up: Whether you're rotating exercises while lifting weights or just taking a breather from a strenuous activity, your joints will thank you.
• Better padded than sorry: Use cushions on wooden or metal chairs and kneepads when kneeling on hardwood or concrete floors to help reduce the risk of developing bursitis. Also avoid putting extreme amounts of pressure or weight directly on joints.
• Keep it moving: Don't stay planted on your butt, knees, or other joints for long periods of time. Even if it's for a few minutes, get up and move around.

If you realize that a particular activity causes you to get bursitis, stop doing it and talk to your doctor or coach about safer methods.

Be on the lookout for bursitis if you participate in a sport. The best way to avoid it is by using the proper techniques and equipment. If your bursitis was caused by something like ill-fitting shoes or other equipment, replace that equipment with something that fits you better.

Clavicle Fracture

Aaron lost his balance while snowboarding and started to fall forward. He put out his arms to break his fall and came down hard on his right arm. He felt a sharp pain near his right shoulder and knew immediately that he'd injured something. His friend got the ski patrol, and they strapped Aaron into a sled and brought him down the mountain to a medical clinic.

The doctor at the clinic took a look at the area near Aaron's shoulder, which was already swollen and bruised, and told Aaron that he had most likely fractured his clavicle (collarbone). Aaron was sent to the hospital, where X-rays confirmed the doctor's diagnosis.

What is a Clavicle Fracture?

Your clavicle is the bone that runs horizontally between the top of your breastbone (sternum) and shoulder blade (scapula). The clavicle (also called the collarbone) helps connect the arm to the body. You can feel it by touching the area between your neck and your shoulder. Most people can see the clavicle beneath the skin when they look in the mirror.

A clavicle fracture, also known as a broken collarbone, is one of the most common types of broken bones. Most clavicle fractures happen when someone falls onto a shoulder or outstretched hand, putting enough pressure on the clavicle to make it fracture or snap.Most clavicle fractures heal on their own if the arm is properly immobilized in a sling and the injury is treated with ice and physical therapy. Sometimes, though, a clavicle injury may need surgery when it gets displaced or the break is particularly severe.

What Causes a Clavicle Fracture?

Clavicle fractures are common in contact sports like football, wrestling, rugby, lacrosse, and hockey. They also often happen in sports where there is a chance of falling hard, such as biking, skiing, snowboarding, and skateboarding. A clavicle also can fracture if the bone is hit directly, as in a car collision or other accident.

Clavicle fractures happen in three situations where stress is enough to break the bone:

• A person suffers a blow to the shoulder.
• Someone falls onto an outstretched arm.
• The clavicle is hit directly (as in a collision).

A person's age plays a role in clavicle fractures: When we're young, our bones are still growing and are more susceptible to injury. Collarbones typically don't harden completely until a person is about 20 years old. That puts people younger than 20 at greater risk of a fracture.

What are the Symptoms?

Signs that someone may have a clavicle fracture include:

• Pain in the affected area.
• Difficulty moving the arm.
• Swelling, tenderness, and bruising along the clavicle.
• Increased pain when trying to move the shoulder or arm.
• A grinding or crackling sensation when trying to raise the arm.
• A bulge above the break (in rare cases, the broken end of the bone might even penetrate the skin and be exposed).
• The shoulder sags down and forward.

What Should You Do?

If you think you've fractured your collarbone, you'll want to see a doctor. Your doctor will first ask questions about how the injury happened and what symptoms you're feeling. The doctor will examine your shoulder and may press gently on your clavicle to see if it is tender. This will also help the doctor find out where the fracture is and make sure no nerves or blood vessels are damaged. This part of the exam also might include checking the feeling and strength in your arm, hand, and fingers.

If the doctor thinks you have a broken collarbone, he or she will order X-rays of your shoulder and the affected area. X-rays will help the doctor pinpoint the location of the break and decide how severe it is. X-rays also let doctors see if other bones are broken.

If other bones are broken or if the doctor needs to see the fracture in greater detail, he or she may ask you to get a computerized tomography (CT) scan.

How Can You Prevent a Clavicle Fracture?

Because clavicle fractures happen suddenly and unexpectedly, it can be hard to prevent them. But you can take a few precautions to decrease your risk:

• When participating in contact sports, wear all the recommended protective gear and learn the proper techniques for your sport: Knowing the right way to play decreases the chances of an awkward fall or unexpected blow.
• Keep your bones strong by eating a well-balanced diet: Be sure to eat lots of vegetables and foods that are rich in calcium and vitamin D to help build strong bones.
• Do strength training and stretching to build strong, flexible muscles: Muscles that are strong and flexible will help support your bones better and keep you agile and less likely to experience a hard fall. A proper warm-up, including dynamic stretching exercises, can help your muscles perform at their best during play.
• Wear well-fitting, supportive footwear that's right for your sport.

Compulsive excise

Rachel and her netball team practice three to five times a week. Rachel feels a lot of pressure to keep her weight down - as the captain, she wants to set an example to the team. So she adds extra daily workouts to her regimen. But lately, she's been feeling worn out, and she has a hard time just making it through a regular team practice.

You may think you can't get too much of a good thing, but in the case of exercise, a healthy activity can sometimes turn into an unhealthy compulsion. Rachel is a good example of how an overemphasis on physical fitness or weight control can become unhealthy. Read on to find out more about compulsive exercise and its effects.

Too Much of a Good Thing?

We all know the benefits of exercise, and it seems that everywhere we turn, we hear that we should exercise more. The right kind of exercise does many great things for your body and soul: It can strengthen your heart and muscles, lower your body fat, and reduce your risk of many diseases.

Many teens who play sports have higher self-esteem than their less active pals, and exercise can even help keep the blues at bay because of the endorphin rush it can cause. Endorphins are chemicals that naturally relieve pain and lift mood. These chemicals are released in your body during and after a workout and they go a long way in helping to control stress.

So how can something with so many benefits have the potential to cause harm?

Why Do People Over exercise?

Lots of people start working out because it's fun or it makes them feel good, but exercise can become a compulsive habit when it is done for the wrong reasons.

Some people start exercising with weight loss as their main goal. Although exercise is part of a safe and healthy way to control weight, many people may have unrealistic expectations. We are bombarded with images from advertisers of the ideal body: young and thin for women; strong and muscular for men. To try to reach these unreasonable ideals, people may turn to diets, and for some, this may develop into eating disorders such as anorexia and bulimia. And some people who grow frustrated with the results from diets alone may overexercise to speed up weight loss.

Some athletes may also think that repeated exercise will help them to win an important game. Like Rachel, they add extra workouts to those regularly scheduled with their teams without consulting their coaches or trainers. The pressure to succeed may also lead these people to exercise more than is healthy. The body needs activity but it also needs rest. Overexercising can lead to injuries like stress fractures and muscle strains.

Are You a Healthy Exerciser?

Fitness experts recommend that teens do at least 60 minutes of moderate to vigorous physical activity every day. Most young people exercise much less than this recommended amount (which can be a problem for different reasons), but some - such as athletes - do more.

Experts say that repeatedly exercising beyond the requirements for good health is an indicator of compulsive behavior. Some people need more than the average amount of exercise, of course -such as athletes in training for a big event. But several workouts a day, every day, when a person is not in training is a sign that the person is probably overdoing it.

People who are exercise dependent also go to extremes to fit activity into their lives. If you put workouts ahead of friends, homework, and other responsibilities, you may be developing a dependence on exercise.

Signs of Compulsive Exercise

If you are concerned about your own exercise habits or a friend's, ask yourself the following questions. Do you :

• Force yourself to exercise, even if you don't feel well?
• Prefer to exercise rather than being with friends?
• Become very upset if you miss a workout?
• Base the amount you exercise on how much you eat?
• Have trouble sitting still because you think you're not burning calories?
• Worry that you'll gain weight if you skip exercising for a day?

If the answer to any of these questions is yes, you or your friend may have a problem. What should you do?

How to Get Help

The first thing you should do if you suspect that you are a compulsive exerciser is get help. Talk to your parents, doctor, a teacher or counselor, a coach, or another trusted adult. Compulsive exercise, especially when it is combined with an eating disorder, can cause serious and permanent health problems, and in extreme cases, death.

Because compulsive exercise is closely related to eating disorders, help can be found at community agencies specifically set up to deal with anorexia, bulimia, and other eating problems. Your school's health or physical education department may also have support programs and nutrition advice available. Ask your teacher, coach, or counselor to recommend local organizations that may be able to help.

You should also schedule a checkup with a doctor. Because our bodies go through so many important developments during the teen years, guys and girls who have compulsive exercise problems need to see a doctor to make sure they are developing normally. This is especially true if the person also has an eating disorder. Girls who over exercise and restrict their eating may stop having periods and develop osteoporosis (weakening of the bones), a condition called female. Medical help is necessary to resolve the physical problems associated with over exercising before they cause long-term damage to the body.

Make a Positive Change

Girls and guys who exercise compulsively may have a distorted body image and low self-esteem. They may see themselves as overweight or out of shape even when they are actually a healthy weight.

Compulsive exercisers need to get professional help for the reasons described above. But there are also some things that you can do to help you take charge again:

• Work on changing your daily self-talk: When you look in the mirror, make sure you find at least one good thing to say about yourself. Be more aware of your positive attributes.
• When you exercise, focus on the positive, mood-boosting qualities.
• Give yourself a break. Listen to your body and give yourself a day of rest after a hard workout.
• Control your weight by exercising and eating moderate portions of healthy foods: Don't try to change your body into an unrealistically lean shape.
• Talk with your doctor: dietitian, coach, athletic trainer, or other adult about what a healthy body weight is for you and how to develop healthy eating and exercise habits.

Exercise and sports are supposed to be fun and keep you healthy. Working out in moderation will do both.

Concussion

If you play sports or follow professional or college teams, you probably know that concussions are a serious issue. Playing sports increases a person's risk of falls and collisions with objects or other players. These can cause concussions -  a type of brain injury. That's true of all sports, not just contact sports like football and hockey.

As long as people play sport, there will be concussions from time to time. But wearing the right protective gear and playing the right way can make a brain injury less likely.

If you do get a concussion, take a break from sports. Making sure you let your brain heal completely helps prevent long-term problems.

How Do Concussions Happen?

The brain is soft. The body protects it by cushioning it incerebrospinal fluid inside a hard skull. Because the brain floats in the fluid, it can move around and even bang against the skull.

A fall or collision that makes the brain bang against the skull can bruise the brain. It also can tear blood vessels and injure nerves. These injuries can cause a concussion -  a temporary loss of normal brain function.

There are lots of ways concussions can happen in sports, such as:

• Helmet-to-helmet tackles in football.
• Getting checked against the boards in hockey.
• Heading a ball incorrectly in soccer.
• Skateboarding or biking wipeouts.
• Collisions between skiers or snowboarders.

preventing Concussions in Sports

Start With the Right Equipment

Everyone should wear properly fitting, sport-appropriate headgear and safety equipment when playing contact sports or biking, rollerblading, skateboarding, snowboarding, or skiing. You can't prevent every concussion. But helmets, mouthguards, and other safety gear can reduce the risk of a brain injury.

Play it Safe

Headgear is your first line of defense. But you can still get a concussion because helmets don't stop injury from happening on theinside. If you hit your head, your brain can still bang against your skull, even if you're wearing a helmet.

Don't take chances because you think your headgear protects you. This is one reason why there are rules in sports. Learning the right technique and developing the skill to avoid dangerous plays can make all kinds of injuries less likely to happen.

When Concussions Happen

If you hurt your head while playing a sport, stop playing immediately. A coach should know to take you off the field. But if you don't have a coach, or your coach doesn't pull you from play, take yourself out of the game.

If you're biking, stop riding. Don't take a chance on hurting your head again. A second head injury can lead to a condition called second-impact syndrome. Second-impact syndrome doesn't happen very often, but it can cause lasting brain damage and even death.

If you hurt your head playing organized sports, a coach or athletic trainer may examine you right after your injury. This is known as sideline testing because it might happen on the sidelines during a game. Sideline testing is common in schools and sports leagues. By watching you and doing a few simple tests, a trained person can see if you need medical care.

Lots of schools or sports leagues test players at the start of a sports season to measure their normal brain function. These tests are called baseline concussion tests. Coaches, trainers, or doctors often compare these baseline results against sideline tests to see if a player's brain is working OK.

If you were playing a sport and banged your head but didn't do anything about it when it happened, be alert for signs of a concussion. Concussions don't always show up right away. It can take up to 3 days for signs to become obvious.

See a doctor as soon as you can if think you might have a concussion and develop any of these problems:

• Headache.
• Dizziness.
• Feeling sick or throwing up.
• Difficulty with coordination or balance.
• Blurred vision.
• Slurred speech or saying things that don't make sense.
• Feeling confused and dazed.
• Difficulty concentrating, thinking, or making decisions.
• Trouble remembering things.
• Feeling sleepy.
• Having trouble falling asleep.
• Sleeping more or less than usual.
• Feeling anxious or irritable for no apparent reason.
• Feeling sad or more emotional than usual.

When Can I Play Again?

The 1 question athletes ask after a concussion is how soon they can start playing again. The answer is simple: When a doctor tells you it's OK.

Concussions can be tricky: You might feel fine, but your thinking, behavior, and/or balance may not be back to normal. Only a doctor can tell these things for sure.

It's essential to wait until the doctor says it's safe to return to sports, but people sometimes feel pressure to start playing again. They worry about letting down the team or they feel pushed by a coach. This is one reason why most U.S. states have rules about when kids and teens can start playing sports again after a concussion. These rules are there to protect players so they're not pushed into getting back in the game too soon - when the risk of second-impact syndrome is high.

There are a number of ways doctors can tell if someone is ready to return to play. A doctor will consider you healed when:

• The symptoms of concussion are gone.
• You regain all of your memory and concentration.
• You don't have symptoms after jogging, sprinting, sit-ups, or push-ups.
• Once the doctor tells you it's OK to start playing sports again, ease back into things. Stop playing right away if any symptoms return (that second-Impact syndrome thing again). With the right diagnosis and treatment, most teens with concussions recover within a week or two without lasting health problems.

Dehydration

What Is Dehydration?

Dehydration is a condition that occurs when someone loses more fluids than he or she takes in. Dehydration isn't as serious a problem for teens as it can be for babies or young children. But if you ignore your thirst, dehydration can slow you down.

Our bodies are about two thirds water. When someone gets dehydrated, it means the amount of water in his or her body has dropped below the level needed for normal body function. Small decreases don't cause problems, and in most cases, they go completely unnoticed. But not drinking enough to keep up with the loss of fluid can sometimes make a person feel quite sick.

Causes of Dehydration

One common cause of dehydration in teens is gastrointestinal illness. When you're flattened by a stomach bug, you lose fluid through vomiting and diarrhea. On top of that, you probably don't feel very much like eating or drinking. Even if you don't have a stomach virus, you can get dehydrated for other reasons when you're sick. For example, if you have a sore throat, you might find it hard to swallow food or drink. And if you have a fever, water evaporates from your skin in an attempt to cool your body down.

You might also hear that you can get dehydrated from playing sports. If you don't replace the fluid you lose through sweat as you go, you can become dehydrated from lots of physical activity, especially on a hot day. Even mild dehydration can affect an athlete's physical and mental performance.

Signs of Dehydration

To counter dehydration, you need to restore the proper balance of water in your body. First, though, you have to recognize the problem.

Thirst is one indicator of dehydration, but it is not an early warning sign. By the time you feel thirsty, you might already be dehydrated. Other symptoms of dehydration include:

• Feeling dizzy and lightheaded.
• Having a dry or sticky mouth.
• Producing less urine and darker urine.

As the condition progresses, a person will start to feel much sicker as more body systems (or organs) are affected by the dehydration.

Preventing Dehydration

The easiest way to avoid dehydration is to drink lots of fluids, especially on hot days. Water is usually the best choice. Drinking water does not add calories to your diet and is great for your health.

The amount that people need to drink will depend on factors like age, size, level of physical activity, and environmental temperature.

When you're going to be outside on a warm day, dress appropriately for your activity. Wear loose-fitting clothes and a hat if you can. That will keep you cooler and cut down on sweating. If you do find yourself feeling parched or dizzy, take a break and sit in the shade or someplace cool and drink water.

Fainting

Reasons Why You Might Swoon

Here are some of the reasons why teens faint:

• Physical triggers: Getting too hot or being in a crowded, poorly ventilated setting are common causes of fainting in teens. People can also faint after exercising too much or working out in excessive heat and not drinking enough fluids (so the body becomes dehydrated). Fainting also can be triggered by other causes of dehydration, as well as hunger or exhaustion. Sometimes just standing for a very long time or getting up too quickly after sitting or lying down can cause someone to faint.
• Emotional stress: Emotions like fright, pain, anxiety, or shock can affect the body's nervous system, causing blood pressure to drop. This is the reason why people faint when something frightens or horrifies them, like the sight of blood.
• Hyperventilation: A person who is hyperventilating is taking fast breaths, which causes carbon dioxide (CO2) to decrease in the blood.This can make a person faint. People who are extremely stressed out, in shock, or have certain anxiety disorders may faint as a result of hyperventilation.
• Drug use: Some illegal drugs (like cocaine or methamphetamine) or using inhalants ("huffing") can cause fainting.
• Low blood sugar: The brain depends on a constant supply of sugar from the blood to work properly and keep a person awake. People who are taking insulin shots or other medications for diabetes can develop low blood sugar and pass out if they take too much medicine or don't eat enough. Sometimes people without diabetes who are starving themselves (as with crash dieting) can drop their blood sugar low enough to faint.
• Anemia: A person with anemia has fewer red blood cells than normal, which decreases the amount of oxygen delivered to the brain and other tissues. Girls who have heavy periods or people with iron-deficiency anemia for other reasons (like not getting enough iron in their diet) may be more likely to faint.
• Pregnancy: During pregnancy the body normally undergoes a lot of changes, including changes in the circulatory system. This leads to low blood pressure that may cause a woman to faint. In addition, the body's fluid requirements are increased, so pregnant women may faint if they aren't drinking enough. And as the uterus grows, it can press on and partially block blood flow through large blood vessels, which can decrease blood supply to the brain.
• Eating disorders: People with anorexia or bulimia may faint for a number of reasons, including dehydration, low blood sugar, and changes in blood pressure or circulation caused by starvation, vomiting, or overexercising.
• Cardiac problems: An abnormal heartbeat and other heart problems can cause a person to faint. If someone is fainting a lot, especially during exercise or exertion, doctors may suspect heart problems and run tests to look for a heart condition.
• Some medical conditions : like seizures or a rare type of migraine headache - can cause people to seem like they are fainting. But what's happening is not the same thing as fainting and is handled differently.

Can You Prevent Fainting?

Some people feel dizzy immediately before they faint. They may also notice changes in vision (such as tunnel vision), a faster heartbeat, sweating, and nausea. Someone who is about to faint may even throw up.

If you think you're going to faint, you may be able to head it off by taking these steps:

• If possible, lie down. This can help prevent a fainting episode as it allows blood to circulate to the brain. Just be sure to stand up again slowly when you feel better - move to a sitting position for several minutes first, then to standing.
• Sit down with your head lowered forward between your knees. This will also help blood circulate to the brain, although it's not as good as lying down. When you feel better, move slowly into an upright seated position, then stand.
• Don't let yourself get dehydrated. Drink enough fluids, especially when your body is losing more water due to sweating or being in a hot environment. Drink enough fluids before, during, and after sports and exercise.
• Keep blood circulating. If you have to stand or sit for a long time, periodically tense your leg muscles or cross your legs to help improve blood return to the heart and brain. And try to avoid overheated, cramped, or stuffy environments.

What Should You Do?

If you've only fainted once, it was brief, and the reasons why are obvious (like being in a hot, crowded setting), then there's usually no need to worry about it. But if you have a medical condition or are taking prescription medications, it's a good idea to call your doctor. You should also let your doctor know if you hurt yourself when you fainted (for example, if you banged your head really hard).

If you also have chest pain, palpitations (heart beating fast for no reason), shortness of breath, or seizures, or the fainting occurred during exercise or exertion, talk with your doctor - especially if you've fainted more than once. Frequent fainting may be a sign of a health condition, like a heart problem.

Helping Someone Who Faints

If you're with someone who has fainted, try to make sure the person is lying flat, but avoid moving the person if you think he or she might have been injured when falling (moving an injured person can make things worse).

Instead, loosen any tight clothing - such as belts, collars, or ties - to help restore blood flow. Propping the person's feet and lower legs up on a backpack or jacket can also help move blood back toward the brain.

Someone who has fainted will usually recover quickly. Because it's normal to feel a bit weak after fainting, be sure the person stays lying down for a bit. Getting up too quickly may bring on another fainting spell.

Athlete Triad

Hannah joined the track team her freshman year and trained hard to become a lean, strong sprinter. When her coach told her losing a few pounds would improve her performance, she immediately started counting calories and increased the duration of her workouts. She was too busy with practices and meets to notice that her period had stopped - she was more worried about the stress fracture in her ankle slowing her down.

Although Hannah thinks her intense training and disciplined diet are helping her performance, they may actually be hurting her - and her health.

What is Female Athlete Triad?

Sports and exercise are part of a balanced, healthy lifestyle. People who play sports are healthier; get better grades; are less likely to experience depression; and use alcohol, cigarettes, and drugs less frequently than people who aren't athletes. But for some girls, not balancing the needs of their bodies and their sports can have major consequences.

Some girls who play sports or exercise intensely are at risk for a problem called female athlete triad. Female athlete triad is a combination of three conditions: disordered eating, amenorrhea, andosteoporosis. A female athlete can have one, two, or all three parts of the triad.

Triad Factor 1: Disordered Eating

Most girls with female athlete triad try to lose weight as a way to improve their athletic performance. The disordered eating that accompanies female athlete triad can range from not eating enough calories to keep up with energy demands to avoiding certain types of food the athlete thinks are "bad" (such as foods containing fat) to serious eating disorders like anorexia nervosa or bulimia nervosa.

Triad Factor 2: Amenorrhea

Exercising intensely and not eating enough calories can lead to decreases in the hormones that help regulate the menstrual cycle. As a result, a girl's periods may become irregular or stop altogether. Of course, it's normal for teens to occasionally miss periods, especially in the first year. A missed period does not automatically mean female athlete triad. It could mean something else is going on, like pregnancy or a medical condition. If you are having sex and miss your period, talk to your doctor.

Some girls who participate intensively in sports may never even get their first period because they've been training so hard. Others may have had periods, but once they increase their training and change their eating habits, their periods may stop.

Triad Factor 3: Osteoporosis

Estrogen is lower in girls with female athlete triad. Low estrogen levels and poor nutrition, especially low calcium intake, can lead to osteoporosis, the third aspect of the triad. Osteoporosis is a weakening of the bones due to the loss of bone density and improper bone formation. This condition can ruin a female athlete's career because it may lead to stress fractures and other injuries.

Usually, the teen years are a time when girls should be building up their bone mass to their highest levels - called peak bone mass. Not getting enough calcium now can also have a lasting effect on how strong a woman's bones are later in life.

Who Gets Female Athlete Triad?

Many girls have concerns about the size and shape of their bodies. But being a highly competitive athlete and participating in a sport that requires you to train extra hard can increase that worry.

Girls with female athlete triad often care so much about their sports that they would do almost anything to improve their performance. Martial arts and rowing are examples of sports that classify athletes by weight class, so focusing on weight becomes an important part of the training program and can put a girl at risk for disordered eating.

Participation in sports where a thin appearance is valued can also put a girl at risk for female athlete triad. Sports such as gymnastics, figure skating, diving, and ballet are examples of sports that value a thin, lean body shape. Some athletes may even be told by coaches or judges that losing weight would improve their scores.

Even in sports where body size and shape aren't as important, such as distance running and cross-country skiing, girls may be pressured by teammates, parents, partners, and coaches who mistakenly believe that "losing just a few pounds" could improve their performance.

The truth is, losing those few pounds generally doesn't improve performance at all. People who are fit and active enough to compete in sports generally have more muscle than fat, so it's the muscle that gets starved when a girl cuts back on food. Plus, if a girl loses weight when she doesn't need to, it interferes with healthy body processes such as menstruation and bone development.

In addition, for some competitive female athletes, problems such as low self-esteem, a tendency toward perfectionism, and family stress place them at risk for disordered eating.

What Are the Signs and Symptoms?

If a girl has risk factors for female athlete triad, she may already be experiencing some symptoms and signs of the disorder, such as:

• Weight loss.
• No periods or irregular periods.
• Fatigue and decreased ability to concentrate.
• Stress fractures (fractures that occur even if a person hasn't had a significant injury).
• Other injuries.

Girls with female athlete triad often have signs and symptoms of eating disorders,such as:

• Continued dieting in spite of weight loss.
• Preoccupation with food and weight.
• Frequent trips to the bathroom during and after meals.
• Using laxatives.
• Brittle hair or nails.
• Dental cavities because in girls with bulimia tooth enamel is worn away by frequent vomiting.
• Sensitivity to cold.
• Low heart rate and blood pressure.
• Heart irregularities and chest pain.

What if I think someone I know has it?

It's tempting to ignore female athlete triad and hope it goes away. But it requires help from a doctor and other health professionals. If a friend, sister, or teammate has signs and symptoms of female athlete triad, discuss your concerns with her and encourage her to seek treatment. If she refuses, you may need to mention your concern to a parent, coach, teacher, or school nurse.

You might worry about seeming nosy when you ask questions about a friend's health, but you're not: Your concern is a sign that you're a caring friend. Lending an ear may be just what your friend needs.

Tips for Female Athletes

Here are a few tips to help teen athletes stay on top of their physical condition:

• Keep track of your periods. It's easy to forget when you had your last visit from Aunt Flo, so keep track of your periods on a calendar and mark down when your period starts and stops and if the bleeding is particularly heavy or light. That way, if you start missing periods, you'll know right away and you'll have accurate information to give to your doctor.
• Don't skip meals or snacks. If you're constantly on the go between school, practice, and competitions you may be tempted to skip meals and snacks to save time. But eating now will improve performance later, so stock your locker or bag with quick and easy favorites such as bagels, string cheese, unsalted nuts and seeds, raw vegetables, granola bars, and fruit.
• Visit a dietitian or nutritionist who works with teen athletes. He or she can help you get your dietary game plan into gear and find out if you're getting enough calories and key nutrients such as iron, calcium, and protein. And if you need supplements, a nutritionist can recommend the best choices.
• Do it for you. Pressure from teammates, parents, or coaches can turn a fun activity into a nightmare. If you're not enjoying your sport, make a change. Remember: It's your body and your life. You - not your coach or teammates - will have to live with any damage you do to your body now.

Groin Strain

What Is a Groin Strain?

A groin strain - also known as a groin pull - is a partial or complete tear of one or more of the muscles that help you squeeze your legs together.

There are five of these muscles, called the adductor muscles: Thepectineus, adductor brevis,and adductor longus (the short adductors) run from your pelvis to your thighbone. The gracilis andadductor magnus (long adductors) run from your pelvis to your knee.

Groin strains are a common injury in hockey and skiing, as well as sports like football and track and field that require running or jumping. They can range from grade 1, which is a mild injury with few symptoms and a short recovery time, to grade 3, which is a complete or nearly complete tear of a groin muscle.

What Are the Symptoms of a Groin Strain?

The symptoms of a groin strain vary somewhat depending on the grade of the strain. All groin strains will cause pain and tenderness in the affected area, and many will hurt when you bring your legs together or raise your knee. If a strain is severe, you may feel a popping or snapping sensation during the injury and severe pain afterward.

What Causes a Groin Strain?

Groin strains usually happen when the adductor muscles get stretched too far and begin to tear. Strains also can occur when the adductor muscles suddenly have stress put on them when they aren't ready for it (as when someone doesn't go through a proper warm-up before playing) or when there's a direct blow to one of the muscles.

Some of the risk factors that can make a groin pull more likely include:

• Sports that require sprinting, bursts of speed, or sudden changes in direction: Examples include track and field, particularly the hurdle and long jump events, basketball, soccer, football, rugby, hockey, and skiing.
• Tight muscles: Muscles that haven't been warmed up and stretched properly are more likely to tear. This is especially true in cold weather.
• Poor conditioning or fatigue: Weak muscles are less able to handle the stress of exercise, and muscles that are tired lose some of their ability to absorb energy, making them more likely to get injured.
• Returning to activities too quickly after an injury: Groin strains need time and rest to heal completely. Trying to come back from a strain too soon will make you more likely to injure your groin again.

How Can You Prevent a Groin Strain?

The main thing you can do to help prevent a strained groin is to warm up and stretch before any exercise or intense physical activity. Jog in place for a minute or two, or do some jumping jacks to get your muscles warmed up. Then do some dynamic stretching (ask a coach, athletic trainer, or sports medicine specialist to show you how to do this type of stretching).

Some other things you can do to try and prevent groin strains include:

• Keep your muscles strong and flexible year round: Get regular exercise (even in the off-season) and follow a good stretching program.
• Increase the duration and intensity of your exercise slowly: A good rule of thumb is to make sure you add no more than 10% each week to the miles you run or the time you spend playing a sport.
• If you feel pain in your groin, stop your exercise or activity immediately: If you're worried that you might have strained your groin, give it time to rest, and don't resume your activity until you are pain-free and your injured adductor muscles feel as strong as the uninjured ones.
• Learn and use proper technique when exercising or playing sports: Your coach or trainer can give you pointers and tips for your sport.
• Wear shoes or skates that fit correctly and offer your feet good support: Replace shoes with a new pair when they show signs of wear or the soles start to lose their shape. The same goes for skates — you want to be sure they maintain good ankle and foot support.

Hamstring Strain

Frank was trying to beat an opposing player to a loose ball during a soccer game when he felt a sharp pain at the back of his left leg. He dropped to the ground, but when he tried to get up and walk, he fell down again and had to be helped off the field.

The next day, Frank went to see a doctor. The doctor asked him a few questions, examined his leg, and told him he had a grade 2 strain - a partial tear - of one of the muscles in his hamstring.

What Is a Hamstring Strain?

Three muscles run down the back of your leg, from your thigh to your knee - thebiceps femoris,semitendinosus, andsemimembranosus - and help you bend your knee and extend your hip. As a group, they are known as the hamstring. A hamstring strain, sometimes called a pulled hamstring, happens when one or more of these muscles gets stretched too far and starts to tear.

Hamstring strains can be relatively mild, with little pain and a short recovery time. Or, in the case of complete muscle tears, they can require surgery to repair and put a person on crutches for weeks.

What Are the Symptoms of a Hamstring Strain?

Chances are that if you strain your hamstring while running, you'll know it immediately. You'll feel a sharp pain and possibly a popping sensation at the back of your leg. You won't be able to keep running and you may fall.

Other symptoms of a hamstring strain include:

• Pain in the back of your thigh when you flex or extend your leg.
• Tenderness, swelling, and bruising in the affected area.
• Weakness in your leg that lasts for a long time after the injury.

In the event of a particularly severe strain or complete tear, you may feel a gap in the torn muscle.

What Causes a Hamstring Strain?

A hamstring strain generally occurs as a result of muscle overload, such as when you are running and your leg is fully extended just before your foot strikes the ground. In a situation like that, the hamstring muscles can get stretched too far, and if they're forced to take on a sudden load - like when your foot strikes the ground and all your weight is on it - they may start to tear.

People who take part in certain activities that involve sprinting or jumping (like track and field, soccer, football, lacrosse, basketball, and dance) are more at risk of getting hamstring strains. These kinds of injuries are also more common in teens who are going through growth spurts.That's because the leg bones may grow faster than a person's muscles, pulling the muscles tight and leaving them more susceptible to getting stretched too far.

Some of the more common things that can contribute to a hamstring strain include:

• Not warming up and stretching properly before exercising: Tight muscles are much more likely to strain than muscles that are stretched and kept strong and flexible.
• Being out of shape or overdoing it: Weak muscles are less able to handle the stress of exercise, and muscles that are tired lose some of their ability to absorb energy, making them more likely to get injured.
• An imbalance in the size of your leg muscles: It's not uncommon for the quadriceps, the muscles at the front of your legs, to be larger and more powerful than your hamstring muscles. When you do an activity that involves running, the hamstring muscles can grow fatigued more quickly than the quadriceps, putting them at greater risk of a strain.
• Poor technique: If you don't have a good running technique, it can increase the stress on your hamstring muscles.
• Returning to activities too quickly after an injury: Hamstring strains need plenty of time and rest to heal completely. Trying to come back from a strain too soon will make you more likely to injure your hamstring again.

How Can You Prevent a Hamstring Strain?

Keeping your muscles in good shape is the best way to prevent hamstring injuries. Here are some ways to help protect yourself against them (and other sports injuries):

• Warm up and stretch properly before exercise or intense physical activity: Jog in place for a minute or two, or do some jumping jacks to get your muscles going. Then do some dynamic stretching - ask your coach or an athletic trainer to show you how. After you play, do some static stretches where you gently stretch your muscles, holding each stretch for 30 seconds or more.
• Keep your muscles strong and flexible year-round: Get regular exercise and adopt a good stretching program so your muscles don't get a shock when you do an intense workout.
• Increase the duration and intensity of your exercise slowly: A good rule of thumb is to make sure you add no more than 10% each week to the miles you run or the time you spend playing a sport.
• If you feel pain in your thigh, stop your activity immediately: If you're worried that you might have strained your hamstring, give it time to rest and don't resume your activity until your leg feels strong, you have no pain, and you can move your injured leg as freely as the other one.

Jumper's knee

Jumper's knee - also known as patellar tendonitis or patellar tendinopathy - is an inflammation or injury of the patellar tendon, the cord-like tissue that joins the patella (kneecap) to the tibia (shin bone). Jumper's knee is an overuse injury (when repeated movements cause tissue damage or irritation to a particular area of the body).

Constant jumping, landing, and changing direction can cause strains, tears, and damage to the patellar tendon. So people who regularly play sports that involve a lot of repetitive jumping - like track and field (particularly high-jumping), basketball, volleyball, gymnastics, running, and soccer - can put a lot of strain on their knees.

Jumper's knee can seem like a minor injury that isn't really that serious. Because of this, many athletes keep training and competing and tend to ignore the injury or attempt to treat it themselves. But it's important to know that jumper's knee is a serious condition that can get worse over time and ultimately require surgery. Early medical attention and treatment can help prevent continued damage to the knee.

How Does the Knee Work?

To understand how jumper's knee happens, it helps to understand how the knee works. The knee, which is the largest joint in the body, provides stability to the leg and allows it to bend, swivel, and straighten. Several parts of the body interact to allow the knee to function properly:

• Bones like the femur (thighbone), the tibia (shinbone), and the patella (kneecap) give the knee the strength needed to support the weight of the body. The bones that meet at the knee allow it to bend smoothly.
• Muscles provide the tug on the bones needed to bend, straighten, and support joints. The muscles around the knee include the quadriceps (at the front of the thigh) and the hamstring (on the back of the thigh). The quadriceps muscle helps straighten and extend the leg, and the hamstring helps bend the knee.
• Tendons are strong bands of tissue that connect muscles to bones. The tendons in the front of the knee are the quadriceps tendon and the patellar tendon. The quadriceps tendon connects to the top of the patella and allows the leg to extend. The patellar tendon connects to the bottom of the kneecap and attaches to the top of the tibia.
• Similar to tendons, ligaments are strong bands of tissue that connect bones to other bones.

By working together, bones, muscles, tendons, and ligaments enable the knee to move, bend, straighten, provide strength to jump, and stabilize the leg for landing.

About Jumper's Knee

When the knee is extended, the quadriceps muscle pulls on the quadriceps tendon, which in turn pulls on the patella. Then, the patella pulls on the patellar tendon and the tibia and allows the knee to straighten. In contrast, when bending the knee, the hamstring muscle pulls on the tibia, which causes the knee to flex.

In jumper's knee, the patellar tendon is damaged. Since this tendon is crucial to straightening the knee, damage to it causes the patella to lose any support or anchoring. This causes pain and weakness in the knee, and leads to difficulty in straightening the leg.

Symptoms

Common symptoms of jumper's knee include:

• Pain directly over the patellar tendon (or more specifically, below the kneecap).
• Stiffness of the knee, particularly while jumping, kneeling, squatting, sitting, or climbing stairs.
• Pain when bending the knee.
• Pain in the quadriceps muscle.
• Leg or calf weakness.

Less common symptoms include:

• Balance problems.
• Warmth, tenderness, or swelling around the lower knee.

About Knee Injuries

Knee injuries often occur among active teens, especially athletes, and a torn medial collateral ligament (MCL) - a ligament that helps give the knee its stability - is a common knee injury.

Teens who play contact sports, like football and soccer, are most likely to have a torn MCL. The injury happens when the outside of the knee is struck, causing it to unnaturally bend inward (toward the other knee). This creates tension on the MCL, a rope-like band, and it stretches or breaks in half.

Someone with a partially or completely torn MCL might have swelling and pain within the first 24 hours of injury. Fortunately, this injury can heal on its own with anywhere from 1 to 6 weeks of resting the joint.

Most people with an MCL injury will still need to undergo rehabilitation ("rehab") therapy to help regain strength in the joint.

What an MCL Does

The MCL is one of the four main ligaments in the knee joint. It's located on the side of the knee that is closer to the other knee. One end of the ligament is attached to the femur, while the other end is attached to the tibia.

Together with the lateral collateral ligament (LCL), which is in the same location on the outside of the knee, the MCL helps prevent the overextension of the knee joint from side-to-side.

Signs and Symptoms

Someone with a partially or completely torn MCL may or may not have symptoms, depending on the severity of the injury.

Pain and swelling can be very intense initially, and some people (with more severe injuries) will have some instability when walking, feeling "wobbly" or unable to bear weight on the affected leg.

Many people, especially those who are familiar with the injury or have torn a ligament before, report hearing a "pop" sound - the sound of the ligament tearing.

Someone who has injured a knee - whether out on the field or at home - should stop all activity (to prevent further injury) and seek immediate medical care. In the meantime, keep the area iced and elevated as much as possible to reduce swelling. Do not bear weight on the knee.

Osgood-Schlatter Disease

Chris is about to take part in his first soccer championship. Lately, though, he's had swelling, tenderness, and aching pain below his kneecap. He seems to feel better when he takes a break from sports and other physical activities for a few days.

After visiting his doctor, Chris discovered that he has a condition called Osgood-Schlatter disease (OSD), a common cause of knee pain in teens. The condition most often affects guys between 13 and 14 years old and girls between 11 and 12 years old.

What Is Osgood-Schlatter Disease?

In 1903, doctors Robert Osgood and Carl Schlatter first described OSD after recognizing a pattern of symptoms in their patients. The doctors found that OSD was a growth-related problem seen mostly in young, athletic guys. It's most likely to happen during a growth spurt.

Osgood-Schlatter disease is anoveruse injury of the knee. Frequent use and physical stress cause inflammation (pain and swelling) at the point where the tendon from the kneecap (called the patella) attaches to the shinbone (tibia).

Because the area is stressed by frequent use, it often leads to inflammation (pain and swelling) or even a tiny fracture of the shin bone. The pain usually worsens with exercise, jumping, and sports such as basketball, volleyball, soccer, figure skating, and gymnastics. In some people, both knees are affected.

The condition affects guys more than girls, especially guys who are active in sports involving deep knee bends, jumping, and running. But OSD affects girls, too, and the number of girls with OSD is increasing since more and more girls are participating in competitive sports.

Signs and Symptoms of OSD

The symptoms of OSD include:

• Pain, swelling, or tenderness below the knee.
• Pain that becomes worse during activities such as running and jumping.
• Limping after physical activity.

With OSD, these symptoms usually go away or feel better when a person rests.

OSD can cause very different symptoms in different people; it all depends on the severity of the condition. Some people may feel mild knee pain only when they play sports. Others may feel constant pain that makes playing any sport difficult.

Plantar Fasciitis

Emily wasn't sure how she let her friend talk her into signing up for a 10-mile race. The most she'd ever jogged was 3 miles. Now, with just a few days to go before the race, Emily felt woefully unprepared, so she jogged 6 miles one day and then 8 the next to get ready.

The morning of the race, Emily's heel hurt a little bit when she woke up, but she still joined her friend and made it the full 10 miles. The next day her heel was in so much pain that she could barely walk, so Emily went to see a doctor. The doctor asked her some questions about her activities, then told Emily she had a condition called plantar fasciitis.

What Is Plantar Fasciitis?

At the bottom of your foot there's a thick band of connective tissue called the plantar fascia or arch tendon. It connects your heel bone (calcaneus) to the front of your foot.

If the plantar fascia becomes irritated and sore from overuse, it's known as plantar fasciitis. Plantar fasciitis sometimes can be mistaken for heel spurs, which is a different kind of injury with similar symptoms.

Plantar fasciitis is a common cause of heel pain in runners, dancers, and athletes in sports that involve a lot of running or jumping.

You don't have to be active to get plantar fasciitis. It can affect anyone. People who are overweight, pregnant women, people whose jobs involve a lot of standing, and people who wear worn-out shoes all have a higher chance of getting plantar fasciitis.

What Are the Symptoms?

The most obvious symptom of plantar fasciitis is a sharp pain on the bottom of the foot, near the heel. Here are some signals that this pain may be plantar fasciitis:

• The pain is strongest first thing in the morning but gets better after a few minutes of walking around.
• The pain is worse after standing for a long time or after getting up from sitting.
• The pain develops gradually and becomes worse over time.
• The pain is worse after exercise or activity than it is during activity.
• It hurts when stretching the foot.
• It hurts when pressing on the sides of the heel or arch of the foot.

What Causes Plantar Fasciitis?

Because the plantar fascia supports your foot and gets used every time you take a step, it has to absorb a large amount of stress and weight. If too much pressure is put on the plantar fascia, the fibers can become damaged or start to tear. The body responds by causing inflammation in the affected area. This is what causes the pain and stiffness of plantar fasciitis.

Things that can increase the risk of plantar fasciitis include:

• Tight calf muscles. Tight calves make it harder to flex your foot, and this puts more stress on the plantar fascia.
• Weight. Carrying a few extra pounds puts added pressure on your feet every time you take a step.
• Activities that put a lot of stress on the feet. This includes things like running, hiking, dancing, and aerobics.
• Bad shoes. Footwear that doesn't give your foot the support it needs increases your risk of plantar fasciitis. You'll want to ditch any shoes that have thin soles or inadequate arch support, or ones that don't fit your feet properly. Routinely wearing high heels can also cause your Achilles tendon to contract over time, making it harder to flex your foot.
• Jobs that involve a lot of standing or walking on hard surfaces. Jobs that keep you on your feet all day, like waiting tables or working in a store, can cause damage to your plantar fascia.
• High arches, flat feet, or other foot problems. The shape of your foot can affect the way your weight is distributed on your feet when you stand. If weight distribution is a bit off, it can add to a person's risk of plantar fasciitis. How someone walks can increase the stress on certain parts of the foot too.

Can I Prevent Plantar Fasciitis?

More than with most sports injuries, a little bit of prevention can go a long way toward keeping you free from plantar fasciitis. Here are some tips to follow:

• Wear supportive shoes that fit you well. When your shoes start to show wear and can no longer give your feet the support they need, it's time to get a new pair. Runners should stop using their old shoes after about 500 miles of use. Have a trained professional at a specialty running store help you find the right pair for your foot type, and then keep your shoes tied and snug when you wear them.
• Stay in good shape. By keeping your weight in check, you'll reduce the amount of stress on your feet.
• Stretch your calves and feet before you exercise or play a sport. Ask an athletic trainer or sports medicine specialist to show you some dynamic stretching exercises.
• Start any new activity or exercise slowly and increase the duration and intensity of the activity gradually. Don't go out and try to run 10 miles the first time you go for a jog. Build up to that level of exercise gradually.
• Talk to your doctor about getting heel pads, custom shoe inserts, or orthotics to put in your shoes. Foot supports can help cushion your feet and distribute your weight more evenly. This is especially true for people with high arches or flat feet. Your doctor will be able to tell you if shoe inserts and supports might lower your chances of heel injury

Repetitive Stress Injuries

Michael started running track freshman year, gradually working up to longer and longer distances. Now a senior, he recently took up trail running and dreams of running the Marine Corps Marathon someday.

Michael's love for his chosen sport made it really hard when he started having some shin pain during his sophomore year. His doctor told him to take a break from running for 6 weeks because he had developed a stress fracture. But after a few weeks of rest, Michael went back to running as if nothing had happened and he hasn't had any problems since.

What Are Repetitive Stress Injuries?

Repetitive stress injuries (RSIs) are injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage. This stress generally occurs from repeating the same movements over and over again.

RSIs are common work-related injuries, often affecting people who spend a lot of time using computer keyboards.

While most common in adults, RSIs are becoming more prevalent in teens because they spend more time than ever using computers. Playing sports like tennis that involve repetitive motions can also lead to RSIs. You may hear sports-related RSIs referred to as overuse injuries. Teens who spend a lot of time playing musical instruments or video games are also at risk for RSIs.

In general, RSIs include more than 100 different kinds of injuries and illnesses resulting from repetitive wear and tear on the body. These injuries vary from person to person in type and severity.

In teens, overuse injuries most often occur at growth plates (areas at the ends of bones where bone cells multiply rapidly, making bones longer as someone grows). Areas most affected by RSIs are the elbows, shoulders, knees, and heels.

What Causes Repetitive Stress Injuries?

Most RSI conditions found in teens are linked to the stress of repetitive motions at the computer or in sports. When stress occurs repeatedly over time, the body's joints don't have the chance to recover, and the joints and surrounding tendons and muscles become irritated and inflamed.

Certain jobs that involve repetitive tasks - such as scanning items as a supermarket checker or carrying heavy trays as a waiter - can lead to RSIs. Sometimes, playing musical instruments can cause problems from overuse of certain hand or arm movements. Any repetitive movement can cause an injury - even text messaging!

Using improper equipment while playing sports is another important factor in RSIs. For example, running in athletic shoes that don't provide enough support can lead to shin splits and foot and ankle problems. Improperly fitted tennis rackets can contribute to a condition called tennis elbow.

Teens may be susceptible to RSIs because of the significant physical growth that occurs in the teen years. The growth spurt (the rapid growth period during puberty) can create extra tightness and tension in muscles and tendons, making teens more prone to injury.

Nutritional factors also come into play in RSIs. Proper nutrition is essential for developing and maintaining strong muscles and bones - and to keep up the energy levels needed to play sports and perform other physical activities well.

What Happens When Teens Have RSIs?

Symptoms of RSIs include:

• Tingling, numbness, or pain in the affected area.
• Stiffness or soreness in the neck or back.
• Feelings of weakness or fatigue in the hands or arms.
• Popping or clicking sensation.

If you notice any of these warning signs of RSIs, make an appointment to see a doctor. Even if your symptoms seem to come and go, don't ignore them or they may lead to more serious problems.Without treatment, RSIs can become more severe and prevent you from doing simple everyday tasks and participating in sports, music, and other favorite activities.

What Kinds of Repetitive Stress Injuries Can Teens Get?

RSIs that can develop in teens include:

• Bursitis: Inflammation of a bursa, which is a fluid-filled sac that acts as a cushion for a joint, is known as bursitis (pronounced: bur-SYE-tis). Signs of bursitis include pain and swelling. It is associated with frequent overhead reaching, carrying overloaded backpacks, and overusing certain joints during sports, such as the knee or shoulder.
• Carpal tunnel syndrome: In carpal tunnel syndrome, swelling occurs inside a narrow "tunnel" formed by bone and ligament in the wrist. This tunnel surrounds nerves that conduct sensory and motor impulses to and from the hand, causing pain, tingling, numbness, and weakness. Carpal tunnel syndrome is caused by repeated motion that can happen during activities like typing or playing video games (using joysticks). It's rare in teens and more common in adults, especially those in computer-related jobs.
• Epicondylitis: This condition is characterized by pain and swelling at the point where the bones join at the elbow. Epicondylitis (pronounced: eh-pih-kon-dih-LYE-tis) is nicknamed "tennis elbow" because it frequently occurs in tennis players.
• Osgood-Schlatter disease: This is a common cause of knee pain in teens, especially teen athletes who are undergoing a growth spurt. Frequent use and physical stress (such as running long distances) can cause inflammation at the area where the tendon from the kneecap attaches to the shinbone.
• Patellofemoral syndrome: This is a softening or breaking down of kneecap cartilage. Squatting, kneeling, and climbing stairs and hills can aggravate pain around the knee.
• Shin splints: This term refers to pain along the shin or front of the lower leg. Shin splints are commonly found in runners and are usually harmless, although they can be quite painful. They can be difficult to tell apart from stress fractures.
• Stress fractures: Stress fractures are tiny cracks in the bone's surface caused by rhythmic, repetitive overloading. These injuries can occur when a bone comes under repeated stress from running, marching, walking, or jumping, or from stress on the body like when a person changes running surfaces or runs in worn-out sneakers.
• Tendonitis: In tendonitis, tearing and inflammation occur in the tendons, rope-like bands of tissue that connect muscles to bones. Tendonitis is associated with repetitive overstretching of tendons from overuse of certain muscles.

Preventing RSIs

Preventing Computer-Related Injuries

To prevent injuries from computer use, make sure your computer equipment and furniture fit you properly and that you use correct typing and sitting positions. If your parents are shopping for new computer furniture, suggest that they buy pieces that can be adjusted for each family member.

Here are some tips:

• Make sure the top of your computer screen is aligned with your forehead.
• Sit up straight with your back touching the back of your seat. Chairs that provide extra support, especially lumbar (lower back) support are helpful. Avoid slouching over your keyboard or tensing your shoulders, which can place unnecessary stress on your neck, back, and spine.
• Let your legs rest comfortably with your feet flat on the floor or on a footrest. (To test whether your legs are in a good position, try placing a pencil on your knee - the pencil should roll toward your waist, not off of your knee.)
• Use a light touch when typing. Place the keyboard close to you so that you don't have to reach for it.
• Fingers and wrists should remain level while typing. Try a wrist rest for extra support. Your wrists and forearms should be at a 90-degree angle to the upper part of your arms. Elbows should be placed close to the side of the body to prevent bending the wrists side to side.
• It's easy to lose track of time when you're surfing the Internet or immersed in a homework assignment. Be sure to take breaks (to stretch or walk around) about every 30 minutes - even if you don't feel tired or feel any pain. (If you lose track of time, use a timer so you know when you're due for a break.)

Try an ergonomic ("ergonomic" means specially designed for comfort) keyboard that has a curved design, and use a trackball instead of a mouse.

Runner's Knee

Mark decided to try out for the school cross country team. Over the vacation he bought a pair of running shoes and took up jogging. He started with short distances, but soon started increasing his mileage in an effort to get up to race distance in time for tryouts.After a few weeks, though, Mark began noticing swelling and pain in his right knee. He went to see a doctor and was told he had runner's knee.

What Is Runner's Knee?

Runner's knee is the term doctors use for a number of specific conditions affecting the knee, such as patellofemoral pain syndrome and chondromalacia of the patella, to name just two. It's the most common overuse injury among runners, but it can also strike other athletes who do activities that require a lot of knee bending, such as biking, jumping, or skiing.

Runner's knee happens when the kneecap (patella) tracks incorrectly over a groove in the thighbone (femur) known as the femoral groove when you bend and straighten your knee. In healthy knees, the patella rests in the femoral groove and slides easily up and down when you use your knee. But when the patella is out of place, it can irritate the femoral groove and wear away the cartilage beneath the patella, leading to knee pain.

Symptoms of Runner's Knee

The most common symptom of runner's knee is tenderness or pain behind or on the sides of the patella, usually toward the center or back of the knee where the thighbone and kneecap meet. In addition, the knee might be swollen.

The pain will generally feel worse when bending the knee - when walking, kneeling, squatting, or running, for example. Walking or running downhill or even down a flight of steps also can lead to pain if someone has runner's knee. So can sitting for a long period of time with your knee bent, such as in a movie theater.

In some cases, someone with runner's knee may notice a popping or cracking sensation in the knee, as well as a feeling that the knee may be giving out.

If it goes untreated for a long period of time, runner's knee can damage the cartilage of the knee and hasten the development of arthritis.

What Causes Runner's Knee?

Runner's knee can happen for a variety of reasons, many of them having to do with the muscles and bones of the leg. Some of the more common causes are:

• Direct trauma to the knee: Falling on your knee or taking a blow to the knee can dislocate the patella or move it out of place, causing it to track incorrectly along the femoral groove.
• Excessive training or overuse: Repeatedly bending and flexing the knee can irritate the nerves around your kneecap and strain your tendons to the point of discomfort.
• Misalignment of the patella: If your kneecap is out of alignment, activities like running or biking can wear down the cartilage of the kneecap (chondromalacia of the patella), which can lead to pain and irritation in the underlying bone and joint lining.
• Tight or weak leg muscles: Tight hamstrings and calf muscles can put excessive pressure on the knee when you run, and weak quadriceps muscles can result in misalignment of the kneecap.
• Foot problems: Flat feet, also called fallen arches or overpronation, can stretch the muscles and tendons of your leg and lead to pain in the knee.

Preventing Runner's Knee

The good news about runner's knee is that you can take precautions to protect yourself against it. If you're going to be doing an activity that puts a lot of stress on your knees, follow these tips:

• Warm up and stretch before running or doing any other knee-intensive activity, and be sure to stretch again after you're done: Keeping your leg muscles strong and flexible will allow them to support the knee better and make it less likely to be irritated during exercise.
• Keep yourself in good shape: The heavier you are, the more weight your knees will have to bear with every step you take. By keeping your weight in check, you can minimize the stress on your knees and decrease the likelihood of pain.
• Use proper running gear: Buy a good pair of running shoes that fit your feet and offer plenty of support, and replace them with a new pair when they show signs of wear or the soles start to lose their shape. If you have flat feet, consider getting shoe inserts or custom-made orthotics.
• Try to run on soft, flat surfaces: Concrete and asphalt surfaces create extra stress on your knees. If possible, try to run on grass, dirt, or a synthetic track with a softer surface. Running downhill in a straight line can also cause pain in your knees. Walk down hills or run down them in a zigzag pattern.
• Increase the intensity of your workouts slowly: Build up to the distance you want to run over a period of time. If you're used to only running a mile or so, don't try to go out and suddenly run 5 miles. Work up to it with a series of intermediate steps.
• If you've had runner's knee before, wearing a knee brace may help.

Testicular Injuries

hurts to even think about it. A baseball takes an unexpected bounce when you're crouched and waiting to field a grounder, an opponent misses a kick on the soccer field and his foot has only one place to go, or you're speeding along on your bike and you hit a big bump. All result in one really painful thing - a shot to the testicles, one of the most tender areas on a guy's body.

Testicular injuries are relatively uncommon, but guys should be aware that they can happen. So how can you avoid injury?

Why They Happen and What You Can Do

If you're a guy who plays sports, likes to lift weights and exercise a lot, or leads an all-around active life, you've probably come to find out that the testicles are kind of vulnerable and can be injured in a variety of ways.

Because they hang in a sac outside the body (the scrotum), the testicles are not protected by bones and muscles like other parts of your reproductive system and most of your other organs. Also, the location of the testicles makes them prime targets to be accidentally struck on the playing field or injured during strenuous exercise and activity.

The good news is that because the testicles are loosely attached to the body and are made of a spongy material, they're able to absorb most collisions without permanent damage. Testicles, although sensitive, can bounce back pretty quickly and minor injuries rarely have long-term effects. Also, sexual function or sperm production will most likely not be affected if you have a testicular injury.

You'll definitely feel pain if your testicles are struck or kicked, and you might also feel nauseated for a short time. If it's a minor testicular injury, the pain should gradually subside in less than an hour and any other symptoms should go away.

In the meantime, you can do a few things to help yourself feel better such as take pain relievers, lie down, gently support the testicles with supportive underwear, and apply ice packs to the area. At any rate, it's a good idea to avoid strenuous activity for a while and take it easy for a few days.

However, if the pain doesn't subside or you experience extreme pain that lasts longer than an hour; if you have swelling or bruising of the scrotum or a puncture of the scrotum or testicle; if you continue to have nausea and vomiting; or if you develop a fever, get to a doctor immediately. These are symptoms of a much more serious injury that needs to be addressed as soon as possible.

Serious Testicular Injuries

Examples of serious testicular injury are Testicular Torsion and Testicular Rupture.

Testicular torsion is when the testicle twists around, cutting off its blood supply. It's rare, but when it does happen it's often for no obvious reason. Occasionally torsion is brought on by a serious trauma to the testicles or strenuous activity.

Testicular torsion is an emergency. It usually affects guys ages 12 to 18, so if you think it's happening to you, go to the emergency room right away.

If doctors fix a torsion within 4 to 6 hours of the time the pain starts there's usually no lasting damage to the testicles. But if torsion isn't fixed within that timeframe, there's a high chance of losing a testicle or having permanently reduced sperm production. Doctors sometimes fix torsion manually by untwisting the testicle. If that doesn't work, they do a simple surgery.

Testicular rupture is a rare type of testicular trauma. This can happen when the testicle receives a forceful direct blow or when the testicle is crushed against the pubic bone (the bone that forms the front of the pelvis), causing blood to leak into the scrotum. Testicular rupture, like testicular torsion and other serious injuries to the testicles, causes extreme pain, swelling in the scrotum, nausea, and vomiting. To fix the problem, surgery is necessary to repair the ruptured testicle.

Seeing a Doctor

If you have to see a doctor, he or she will first need to know how long you have been experiencing pain and how severe your discomfort is. To rule out a hernia or other problem as the cause of the pain, the doctor will examine your abdomen and groin.

In addition, the doctor will look at your scrotum for swelling, color, and damage to the skin and examine the testicle itself. Because infections of the reproductive system or urinary tract can sometimes cause similar pain, your doctor may do a urine test to rule out a urinary or infection of the reproductive organs.

Preventing Testicular Injuries

It's wise to take precautions to avoid testicular injuries, especially if you play sports, exercise a lot, or just live an all-around active life. Here are some tips to keep your testicles safe and sound:

• Protect your testicles: Always wear an athletic cup or athletic supporter when playing sports or participating in strenuous activity. Athletic cups are usually made of hard plastic, are worn over the groin area, and provide a good degree of shielding and safety for the testicles. Cups are best used when participating in sports where your testicles might get hit or kicked, like football, hockey, soccer, or karate.
  An athletic supporter, or jock strap, is basically a cloth pouch that you wear to keep your testicles close to your body. Athletic supporters are best used when participating in strenuous exercise, cycling, or doing any heavy lifting.
• Check your fit: Make sure the athletic cup and/or athletic supporter is the right size. Safety equipment that's too small or too big won't protect you as effectively.
• Keep your doctor informed: If you play sports, you probably have regular physical exams by a doctor. If you experience testicular pain even occasionally, talk to your doctor about it.
• Be aware of the risks of your sport or activity: If you play a sport or participate in an activity with a high risk of injury, talk to your coach or doctor about any additional protective gear you should use.

Participating in sports and living an active life are great ways to stay fit and relieve stress. But it's important to make sure your testicles are protected. When you're exercising or playing sports, make sure that using protective gear is part of your routine and you'll be able to play hard without fear of testicular injury!