It’s that time of the year: cold & flu season. It seems like we all know someone who has come down with a cold or a case of the flu, even our kids.
Irvine Community News & Views’ health columnist, Dr. Phyllis Agran recently sat down with sports medicine specialist, Dr. Chris Koutures to discuss ways we can keep our kids — and our community — safe.
Dr. Agran: Pediatricians are often asked if children should continue to play sports and/or exercise when they aren’t feeling well. Parents also want to know what symptoms should keep kids off the playing field. How do you determine if a young athlete is too ill to participate in sports?
Dr. Koutures: It’s important to determine whether exercise will place the young athlete at risk of developing a more serious or longer-lasting illness. We also need to know if the athlete is contagious. Studies show that a fever over 100.4 degrees Fahrenheit increases metabolic demands of the body, often making exercise more difficult. That’s why doctors recommend either limiting or stopping exercise completely until the fever has been gone for at least 24 hours.
I also use the “neck rule” to assist in decisions regarding sports participation: If symptoms are entirely above the neck (runny nose, sore throat, mild headache, etc.) and there is no fever, then there is less potential risk. In this case, I recommend light exercise at first, and if symptoms do not worsen, then the athlete can gradually increase the intensity of exercise. However, if symptoms are below the neck (productive cough with mucous, chest pain/tightness, stomachache, vomiting/diarrhea, rash, muscle/body aches) then there is greater risk not only for worsening individual symptoms, but also for the illness to spread to teammates. In this case, I recommend limiting all activity until these symptoms are gone for 24 hours. If there is any concern, I urge parents to contact their medical provider to receive further evaluation.
Dr. Agran: How can we ensure athletes do not spread colds & other illnesses?
Dr. Koutures: No athlete wants to be sick and spread illness to teammates.
Following these basic rules can prevent the spread and help our children recover from an illness more quickly:
- Do not share water bottles, cups, towels, washcloths, or tissues.
- Shower immediately after exercise and change into clean clothes.
- Launder athletic equipment on a regular basis.
- If prescribed medications, take them as directed for the full length of the prescription.
- Use antibiotics only for the intended illness; never use them for a new illness or when they were not specifically prescribed.
- Incomplete or improper use of antibiotics can lead to bacterial resistance.
- Get adequate sleep and nutrition since fatigue and poor diets can weaken the immune system.
- Get no fewer than 8 hours of sleep a night, and schedule at least one rest day from exercise per week.
- Low-fat diets (less than 10-15% of daily calories as fat) and less than 4-5 fruits/vegetables per day can also reduce ability to fight infection.
- Consider the Influenza Vaccine (flu shot) in the fall months. This is especially important because the flu can spread rapidly to teammates, classmates, and family members — including grandparents who may have weakened immune systems.
Dr. Agran: Any final thoughts?
Dr. Koutures: Studies show that both intensity of exercise and fitness level can influence the risk of upper respiratory tract (URT) infection. More moderate levels of exercise can be protective against illness. Exercising at lower and higher levels of intensity may actually be related to an increased risk. This is often why athletes get sick right after higher level competitions (such as what I saw at the Olympic Games Medical Clinics) or at the end of a sports season. Higher levels of fitness may also be protective against respiratory illnesses. I always advise young athletes to never hesitate to seek immediate medical care when they feel ill. The decision to exercise when someone is ill should take into account the long-term health not just of one athlete, but also of the entire team. Make sure you know exactly what’s going on with your health, what are the potential risks, and how to best return to the top of your game.
Chris Koutures, MD, FAAP grew up here in Irvine. He is a dual board-certified pediatric and sports medicine specialist who practices at ActiveKidMD in Anaheim Hills. He is a team physician for USA Volleyball (including participating in the 2008 Beijing Olympics); the U.S. Figure Skating Sports Medicine Network; Cal State Fullerton Intercollegiate Athletics; and the Chapman University Dance Department. He offers a comprehensive blend of general pediatric and sports medicine care with an individualized approach to each patient and family.
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