Sports Injury Prevention – What You Need to Know to Keep Your Active Kids Safe and Healthy

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. You're listening to Weekly Dose of Wellness, brought to you by MemorialCare Health System. I'm Deborah Howell. Today's guest is Dr. John Hajaliloo, Assistant Medical Director and Sports Medicine Specialist, Pediatric Orthopedic Center, Miller Children's and Women's Hospital, Long Beach. Dr. Hajaliloo is an orthopedic surgeon with fellowship training in kids sports injuries and sees both adults and children. He was the Chairman of Orthopedic Surgery at Long Beach Memorial and did his fellowship training at Harvard. Today we'll be talking about sports injury prevention and what you need to know about keeping your kids active, safe, and healthy. Welcome, Dr. Hajaliloo.

John Hajaliloo, MD: Yes, hello. Thank you for having me.

Deborah Howell (Host): Thanks for being here. What are the most common types of sports injuries that kids and teens face these days?

John Hajaliloo, MD: Very good question. I usually break it down into two. There's acute injuries that happen right away. Those are the ones that we can recognize that we can see, and then there's overuse type injuries. Those tend to happen over a longer term, but it really is a whole gamut depending on which body part is involved. I'd rather just break it down into simple terms, like an acute injury that one can see and an overuse injury that happens over a long period of time.

Deborah Howell (Host): Sounds good. Well, one I can directly relate to, ACL injury and replacement. I had that in my left knee. It was not a fun recovery.

John Hajaliloo, MD: Yes. That's a common one that I do see and it's important to recognize that and to treat it properly. If not treated properly, that could go on to cause further problems down the road. So I'm very sensitive to trying to correctly diagnose ACL injuries and to treat those.

Deborah Howell (Host): Right, right. Got to hop right on that. No pun intended. Now regarding ACL injuries, what are some of the things kids can do to help prevent these horrific knee injuries?

John Hajaliloo, MD: I think prevention is definitely something that parents can work on and young athletes can participate in. Part of that prevention is proper training. I think going to practice, listening to your coach, and also important to know the rules of the game and proper equipment depending on what sport you're in is important. I think all those things like when the coach tells you to warm up or to stretch and strengthening exercises, I think all of that goes a long way to preventing injury.

Deborah Howell (Host): I can speak to my own and add to that list. I was in a squash tournament and you get out there and you really play hard and you really sweat and you really use your knees, then you sit and you wait for your next game and you cool down and the muscles relax and then you ask them to do the same thing over and over again with small rests in between without maybe stretching properly. So that's what happened to me.

John Hajaliloo, MD: Yeah, I think we can all, everybody can do a little more to prevent injuries. I think coaches, athletes, parents, everybody needs to kind of push for that.

Deborah Howell (Host): I think a lot of it is stretching and keeping warm between when you're sitting on the bench for a while and then you have to go immediately and run around the bases or whatever it is you're doing, that's tough on the body.

John Hajaliloo, MD: Yeah, I think the stop and go, stop and go is tough. And we need to in between maintain mobility and keep our muscles limber and stretch and warm up at the sideline. I think that's what it's about.

Deborah Howell (Host): Absolutely. All right, switching gears a little bit. What are some of the common signs and symptoms that kids and parents should watch out for when they suspect a concussion and what should they do if they think they have sustained one?

John Hajaliloo, MD: Now, one of the common mistakes people make is they ask an athlete who suffered a concussion whether they're okay. I think most of the time they're going to say, yeah, I'm okay, I want to get back in the game. So I think the parents really have to be the eyes and ears, because a lot of these concussions are subtle. They're not like they're completely passed out on the field. Those are easy to recognize. Most of them are they show up like headaches or behavior changes, maybe they have a problem concentrating, maybe they're a little bit more irritable, a little bit more anxious. I think that's where we need the parents to kind of help us out as clinicians to recognize a very subtle concussion.

Deborah Howell (Host): So they can really actually cause personality changes?

John Hajaliloo, MD: Yeah, I think these are, they're not permanent personality changes, I guess they could be if you have repeated concussions, but the acute ones, they can cause irritability, they can't concentrate, maybe more anger type issues come up. But yeah, it could certainly change someone's personality for a short period of time.

Deborah Howell (Host): I hadn't heard that. Some crazy number of NFL players have said already this year they've sustained concussions. It was something like 38% or it was an incredible statistic.

John Hajaliloo, MD: Yeah. And I think equipment only goes so far. It's actually anytime you have speed involved, anytime there's a collision, and it could go with any sport. I don't think we have to generalize football, the common ones that show up online. I think it's, you have to recognize that anytime you have an impact and it could be like surfing, it could be getting a wave throwing you against the sand or it could be something like that.

Deborah Howell (Host): Or skateboarding off a rail.

John Hajaliloo, MD: Yeah, anytime speed is involved. And equipment will protect like a skull fracture, things like that, but it's not going to prevent bruising of the brain, which is due to the brain getting jarred within this hard skull of ours. That's where it comes from.

Deborah Howell (Host): How do you treat concussions?

John Hajaliloo, MD: Yeah, I think a concussion is mainly to get them out of the sport that caused it for a short period of time. I think recognition is the most important thing. And usually if parents suspect their child has a concussion, I recommend having a child be examined by a pediatrician or a family medicine physician just to make sure there's no long-term consequences, things like bleeding, things like that, we don't want to miss those. So I think those are all important.

Deborah Howell (Host): But okay, that's diagnosing, but once you determine that a kid does have a concussion, what can you do for him or her?

John Hajaliloo, MD: Yeah, I think like I said, you want to take him out of the sport. You want to basically, you want to rest their mind. You want to avoid things like texting and Facebook, Twitter, things like that or not resting. Video games are not resting. They really need to like sort of maybe listen to music or something calming or where their eyes are not constantly working. And so it involves a lot of resting. And I really think the recognition part is the important part.

Deborah Howell (Host): Okay. And so, so there's really no medical recourse in terms of medication or surgery unless something is very severe with a concussion?

John Hajaliloo, MD: Oh yeah, yeah. The ones that are severe, like let's say a child goes down and there's absence of consciousness for about five minutes or so, those you got to take them to the emergency room, they need a head CT scan, make sure they don't have a bleed. Those are more severe, of course. I'm talking more about the subtle ones that maybe we don't recognize. And those are the more common ones. And what we want to avoid is a second or repeat injury, which could be deadly. That's, the initial injury might not be so severe, but then if you don't take them out of the sport and they have a second or even a third concussion, that could be deadly.

Deborah Howell (Host): It's gotta be so tough for parents whose kids have sustained a concussion who love their sport. And you've seen it once and you're so scared to let them heal up and then get right back in there. Do you have any advice for parents?

John Hajaliloo, MD: Yeah, I think rather than the parents being the bad cop, I think you should let your healthcare provider, like your pediatrician or family medicine doctor, tell the bad news to the young athlete. And the parents could be like, oh, I think you need to get checked out. And coaches and sports programs need to encourage that, that they do go get examined and they come back with a note from their physician.

Deborah Howell (Host): Okay. I almost feel like coaches need a little counseling in this area, some coaches, not all.

John Hajaliloo, MD: Yeah, I think everybody needs a little bit of a refresher course on concussions. And things change. Now we used to think that if an athlete's symptoms subside after 5, 10 minutes we could send them back into the game right away. I think that's changed now.

Deborah Howell (Host): Good. Good. I'm glad to hear that. So for our parents of young athletes who are listening right now, where can they go to learn more?

John Hajaliloo, MD: I usually recommend the American Academy of Orthopaedic Surgeons has a good education portal for parents. And then also the American College of Sports Medicine. Those are good sources. I mean, there's other ones like WebMD, things like that, but I think they're just too simple, too basic, I think. And like for example, American College of Sports Medicine has brochures that you could print out and give to your athlete or to your coaches. So we can pass the information on.

Deborah Howell (Host): Excellent. Knowledge is power. Well, thank you so much, Dr. Hajaliloo. It has been a true pleasure to have you on the show today.

John Hajaliloo, MD: Thank you. Great being here. Thank you so much.

Deborah Howell (Host): Very enlightening. And to listen to the podcast or for more info, please visit memorialcare.org. That's memorialcare.org. I'm Deborah Howell. Join us again next time as we explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. Have a fantastic day.