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Rx for Child Health & Safety: Sports Injuries: Q & A with Dr. Chris Koutures


As a long-time pediatrician, it has been my privilege to be an activist and leader in our local, state and national organizations.  This has given me the opportunity to collaborate with many outstanding pediatricians and health professionals here in Orange County and across the U.S.

Allow me to introduce Chris Koutures, M.D. A former Irvine resident, he is a dual board-certified Pediatrician and Pediatric Sports Medicine specialist, affiliated with ActiveKidMD in Anaheim Hills. Dr. Koutures is the team physician for the USA Volleyball National/Olympic Teams, CSU Fullerton Intercollegiate Athletics, Chapman University Dance, and Orange Lutheran High School.  His website, www.ActiveKidMD.com, includes frequently asked questions — and answers — about sports injuries among young athletes.

Q: Typically, when do we see injuries in sports?  And what are their causes?

A: Sports injuries occur under a number of circumstances, and fall into several categories.  For example, I’ve found that a remarkable number of injuries occur when an athlete is not wearing appropriate protective equipment.  Bike helmets do no good when they are strapped to the handlebars, just like shin guards cannot work if they are left in the gym bag.  I tell athletes — and their parents — to make sure their equipment is in good condition, that it fits well (especially with growing children), and that it is always properly used. 

Q: What are some of the other risk factors for sports injuries?

A: Typically, many sports injuries occur within 30 days of undertaking a new season or a new activity.  Good studies on Marine recruits show that foot stress fractures are most commonly seen three weeks into boot camp.  My experience with young athletes is quite similar — about three weeks into a new sport, I will start to see overuse injuries.  The body is unable to handle the stress of a new activity, and breakdown occurs.  The answer to this problem?  Prepare for a new sports activity with light conditioning.  Going straight into football with double-workout days on the field can be a recipe for disaster.  Also, start slow and increase intensity or length of workouts slowly in order to allow the body to adjust.  And don’t forget those rest days!

Q: What advice can you give to parents of kids who are “sports crazy” — and seem to be taking on too much?

A: Young, enthusiastic athletes rarely have the judgment needed to reduce the risks of injury.  That’s where good  coaching, good parenting, and common sense come into play.  Kids are at risk when they are playing more than one sport at a time; or when they are playing just too much of one sport.  They are also at risk when they step up to a higher level of sports competition, playing with older and bigger athletes; or when they enroll in an intense sports camp; or start high school or college training.  No matter what success the young athlete has enjoyed in the past, these situations can overtax a young body.  Sports medicine physicians are mindful of a mantra that coaches and parents should take to heart as well:  Too Much, Too Fast, Too Soon is a recipe for overuse injuries.

Appropriate sports activities can be terrific for kids — and grownups too — in building strong bodies, good health, and good character.  The idea is to enjoy sports while avoiding sports injuries.

Phyllis Agran, MD, MPH, FAAP
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